Academic journal article Iranian Journal of Public Health

Risk Factors for Spinal Osteoporosis as Compared with Femoral Osteoporosis in Urban Iranian Women

Academic journal article Iranian Journal of Public Health

Risk Factors for Spinal Osteoporosis as Compared with Femoral Osteoporosis in Urban Iranian Women

Article excerpt

Abstract

Background: We aimed to define and compare the risk factors of spinal and femoral osteoporosis in postmenopausal Iranian women.

Method: It was a multicentre based study carried out in two stages during 2002 to 2005 among post menopausal women in Tehran. In first stage case group included 140 women with diagnosed spinal osteoporosis using DEXA method as definition of WHO and Controls were 167 women with normal spinal BMD. In second stage, among the same study population case groups were 72 women with total femoral neck osteoporosis. The controls included 191 women with normal femoral BMD.' Odds Ratio was used for estimation the association of risk factors with spinal and femoral osteoporosis.

Results: Plus common well known osteoporosis risk factors, significant risk factors for each region with their odds ratios included: Steroid use (2.4) and low activity (3.6) for femoral osteoporosis and parity>3 (2) and lactation duration > 2 yr (1.9) for spinal osteoporosis.

Conclusions: There are some common and different protective and risk factors for spinal and femoral osteoporosis in this population.

Keywords: Osteoporosis risk factors, Femur, Spine, Iranian women, Postmenopausal women

Introduction

Osteoporosis characterized by low bone mass with micro architectural disruption and skeletal fragility, is a complex, multi factorial chronic disease leading to fractures of the hip, spine, wrist and other regions like humerus, and pelvis (1). Osteoporosis is a common disease particularly in old age population and osteoporotic fractures of the hip and spine rises mortality rate of 10 to 20 percent (2, 3). These fractures also cause substantial pain and disability, depression, increasing dependency and decreasing the quality of life (4).

Vertebral fracture, a well-recognized complication of osteoporosis, is the most common osteoporotic fracture. Less than one third of these fractures are clinically identified. Regardless of whether they are symptomatic or are identified on imaging, vertebral fractures are associated with increased mortality and morbidity rates and prevalent vertebral fractures have been shown as a risk factor for future fractures in spine or other regions (5). Prevalence of osteoporosis varies country to country nutritional status, physical activity and lifestyle (6-9) differences in races (10, 11) may cause these variations.

The effect of protective and risk factors might be different for spine and femur. Previous studies conclude that age of attaining peak bone mass at the hip is younger than at the spine and BMC and BSA at the spine continue to increase through the early thirties in female (12, 13).

Discordant hip-spine BMD results and different patterns of fracture risk were reported in another study. This study showed that women with osteoporosis only at hip were at greatest risk for hip fracture, as compared with other fracture types. Women with osteoporosis only at spine were at increased risk for radiographic spine and nonhip - nonspine fractures (14).

There are some evidences that have shown the effect of environmental and genetic factors on spinal and femoral regions are different. In one study, they have found different effect of exercises on different sites of bone (15). In a study on BMD values in 3000 premenopausal Scottish women that were adjusted by regression to identify and account for nongenetic factors, Regression analyses revealed that approximately 39% of spine and 19% of hip rate of change in BMD was accounted for by nongenetic factors (16).

In this study we aimed to define the risk factors of spinal and femoral osteoporosis in postmenopausal Iranian women. This research assesses osteoporosis risk factors in spine versus femur. It assesses the association with osteoporosis of the following factors:

a) Demographic, b) menstrual, c) obstetrical factors, d) nutritional status, e) physical activity, f) medical disorders and g) medication in spinal and femoral osteoporotic subjects and comparing these associations in spine region versus femur. …

Search by... Author
Show... All Results Primary Sources Peer-reviewed

Oops!

An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.