Abstract
Risk factors for osteoporosis may vary according to different populations. We aimed to investigate the relationship between risk factors of osteoporosis and bone health indices determined via calcaneal quantitative ultrasound (QUS) in a group of Malaysian women aged 50 years or above. A cross-sectional study was performed on 344 Malaysian women recruited from a tertiary medical centre in Kuala Lumpur, Malaysia. They answered a self-administered questionnaire on their social-demographic details, medical history, lifestyle, and physical activity status. Their height was measured using a stadiometer, and their body composition estimated using a bioelectrical impedance device. Their bone health status was determined using a water-based calcaneal QUS device that generated three indices, namely speed of sound (SOS), broadband ultrasound attenuation (BUA), and stiffness index (SI). A T-score was computed from SI values using a reference database from a mainland Chinese population. Women with three or more lifetime pregnancies, who were underweight and not drinking coffee had a significantly lower BUA. Stepwise multiple linear regression showed that SOS was predicted by age alone, BUA and SI by years since menopause, body mass index (BMI), and number of lifetime pregnancies, and T-score by years since menopause and percentage of body fat. As a conclusion, suboptimal bone health in middle-aged and elderly Malaysian women as indicated by QUS is associated with old age, being underweight, having a high body fat percentage, and a high number of lifetime pregnancies. Women having several risk factors should be monitored more closely to protect their bones against accelerated bone loss.
Highlights
Aging of the female skeletal system accelerates at the commencement of menopause [1]
The age and height of Chinese women were significantly higher, whereas their body weight, body mass index (BMI), and body fat percentage were significantly lower compared to Malay women (p < 0.05) (Data not shown)
There were no significant differences in years since menopause and quantitative ultrasound (QUS) indices among the three ethnic groups (p > 0.05) (Table 2)
Summary
Aging of the female skeletal system accelerates at the commencement of menopause [1]. The imbalance in bone homeostasis, which favours resorption over formation, leads to deterioration of bone microarchitecture and mass, and results in a skeleton with reduced strength which is more prone to fragility fractures [3] This condition is known as post-menopausal osteoporosis. Parity, a sedentary lifestyle, cigarette smoking, alcohol and caffeine intake, as well as low calcium consumption are modifiable risk factors known to affect bone health, whereas old age and ethnicity are examples of non-modifiable ones [1,4,5]. These factors are well-established, the interplay between them and bone health could vary from population to population
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