Predictive factors and the relationship between the early detection of osteoporosis and pathological fractures in Indonesian menopausal women

Abstract

Background: Estrogen deficiency in menopausal women induces bone loss and makes them prone to pathological fractures. Age, body mass index (BMI), parental history of osteoporosis, and smoking tobacco also increase bone loss and pathological fractures. This study aims to determine whether age, BMI, parental history of osteoporosis, and smoking tobacco can predict pathological fractures in menopausal women. Moreover, the relationship between the early detection of osteoporosis with pathological fracture incidence will also be determined. Methods: This is an analytic observational epidemiological research with a cross-sectional retrospective design that involved 40 menopausal women. The data were collected from the patients' medical records 2020 in Obstetrics and Gynecology Clinic, Asri Medical Center (AMC) Muhammadiyah Hospital, Yogyakarta. The predictive factors for pathological fracture (age, BMI, parental history, smoking tobacco) were analyzed by using Fisher's exact test and the relationship between osteoporosis early detection, including bone mineral density (BMD) value, parathyroid hormone (PTH) levels, osteocalcin levels, and osteoporosis self-assessment tool for Asians (OSTA) score, with pathological fractures were investigated by using the chi-square test. Result: Age has a significant relationship with the occurrence of pathological fractures in menopausal women (OR = 6.6, 95% CI: 1.128-8.604, p = 0.042), while BMI, parental history of osteoporosis, and smoking tobacco did not have a significant relationship with pathological fractures (p > 0.05). Early detection of BMD and PTH was also found to have a significant relationship to fracture incidence. Additionally, menopausal women with high PTH levels and osteoporosis BMD values are eight times and four times greater risk of acquiring fractures than menopausal women with normal BMD values and PTH levels. Conclusion: Age can be a predictive factor for pathological fractures, and the early detection of PTH and BMD is related to the occurrence of pathological fractures in menopausal women.