Prevalence of osteoporosis among postmenopausal women in Sri Lanka: a cross‐sectional community study

Abstract

AbstractObjective: This study was designed to estimate the prevalence of osteoporosis among postmenopausal women selected from seven provinces in Sri Lanka.Method: The study was a community‐based cross‐sectional survey of a group of 1642 community‐dwelling postmenopausal women in seven provinces, except the North and East, in Sri Lanka. Phalangeal bone mineral density (BMD) was measured in all subjects using an AccuDEXA. In a subgroup of 150 women BMDs in the spine from L2–L4 and proximal femur were measured using a Norland Eclipse central DXA machine. In this subgroup, the diagnosis of osteoporosis was made according to the WHO criteria based on T‐scores of the spine or femoral neck. The sensitivity, specificity, positive predictive value and negative predictive value of different phalangeal BMD levels were examined and the prevalence of osteoporosis was calculated using the most acceptable cut‐off value.Results: A sharp decline in phalangeal BMD (0.006 g/cm2/year) was seen during the postmenopausal period. Phalangeal T‐score of −2.00, which had sensitivity, specificity, positive predictive value and negative predictive value of 78%, 85%, 91% and 68% respectively, was selected as the most suitable value to predict osteoporosis: 357 women had phalangeal T‐scores either equal to or lower than −2.00. When the positive predictive value and negative predictive value of this cut‐off value were applied, 736 women (44.9%) in our sample were likely to have osteoporosis.Conclusions: Osteoporosis is a prevalent disease among postmenopausal women in Sri Lanka. Similar prevalence figures have been reported from other Asian countries.