Prevalence Of Risk Factors For Osteoporosis Research Articles

Feasibility of vitamin D supplementation interventions to mitigate HIV pre-exposure prophylaxis-related bone mineral density loss: a cross-sectional survey.

BackgroundDaily tenofovir disoproxil fumarate (TDF)/emtricitabine as HIV pre-exposure prophylaxis (PrEP) causes subclinical decreases in bone mineral density (BMD). We surveyed PrEP users to assess feasibility for a clinical trial of vitamin D supplementation to mitigate TDF-induced BMD loss.MethodsWe recruited participants using or starting PrEP in Toronto and Vancouver. The primary objective was to assess the acceptability of daily or weekly vitamin D supplementation. We also assessed the acceptability of calcium supplementation, existing use of non-pharmacological bone health interventions, prevalence of osteoporosis risk factors, and bone health knowledge (Osteoporosis Knowledge Test, OKT).ResultsOf 161 participants, 72.1% were current PrEP users, 18.0% were starting PrEP, and 9.9% did not indicate their PrEP status. All identified as males, 88.8% as gays, and 67.1% as Whites. Median (IQR) age was 32.0 (29.0, 40.0) years, and 62.1% reported family income $$60,000/year. Among those not already using the interventions, willingness to supplement with daily vitamin D, weekly vitamin D, or daily calcium was very high at 90.9%, 96.4%, and 93.0 %, respectively. Only 31.0% reported adequate dietary calcium intake, while 42.9% reported $1 osteoporosis risk factor (most commonly, alcohol and smoking). Overall bone health knowledge was low, as median (IQR) OKT score was 16/32. In post hoc comparisons, current PrEP users may have been more likely than new PrEP users to engage in bone loading exercise (Bone-specific Physical Activity Questionnaire score=12.5 vs 3.6, P=0.001) and have greater bone health knowledge (OKT=17 vs 14, P=0.08), but they had similar levels of current vitamin D supplementation (37.4% vs 21.4%, P=0.11), calcium supplementation (11.2% vs 13.8%, P=0.70), and adequate dietary calcium intake (32.7% vs 25.0%, P=0.43).DiscussionThe high acceptability of vitamin D and calcium supplementation in this cohort suggests that enrollment into a clinical trial of such interventions to mitigate PrEP-induced BMD loss is feasible.

Prevalence of Fracture and Osteoporosis Risk Factors in American Indian and Alaska Native People

Little is known about prevalence of osteoporosis risk factors among American Indians and Alaska Natives (AIAN). We included AIAN people (n=8,039) enrolled in the Education and Research Towards Health (EARTH) Study. Prevalence ratios were used to determine cross-sectional associations of risk factors with self-reported bone fractures. There is a high prevalence of multiple risk factors for osteoporosis in AIAN, although the factors that are associated with past fracture vary by gender and geographical area. In general, women who reported a fracture reported more risk behaviors, more than two medical conditions, and low physical activity. Men with higher BMI were less likely to report a fracture. Smoking history was associated with fracture for both genders, though not significantly in all sub-groups. We prevent a high prevalence of risk factors for osteoporosis for AIAN. Future research for osteoporosis risk reduction and prevention in AIAN people is indicated.

Assessing osteoporosis risk factors in Spanish menopausal women

Objectives. (1) To assess the prevalence of osteoporosis risk factors in Spanish menopausal women; (2) to detect medical and lifestyle risk factor differences between perimenopausal and postmenopausal women; (3) and to identify the main factors responsible for osteoporosis.Methods. Cross-sectional descriptive study encompassing women aged 45–65 across Spain. The study population sample was collected through random sampling and a total of 10,514 women were included. Socio-demographic, medical history, and lifestyle data were assessed.Results. The prevalence of osteoporosis risk factors was 67.6%. The most common risk factors were physical inactivity (53.6%), use of medication related to osteoporosis risk (45.9%), and low calcium intake (30.1%). There were statistically significant differences between peri- and postmenopausal women in terms of smoking status, alcohol intake, personal history, poor dairy product intake, and medication use that could increase risk. Logistic regression analysis showed that osteoporosis was significantly associated with age, family history, age at onset of menopause, Kupperman Index, prolonged immobilization, weight loss, and other diseases that increase the probability of developing osteoporosis.Conclusions. A high prevalence of women taking osteoporosis risk-related medication was observed in our study. There was correlation between the menopausal symptoms' degree of severity and the risk of suffering from osteoporosis.

The potential impact of new National Osteoporosis Foundation guidance on treatment patterns

This analysis of National Health and Nutrition Examination Survey III data describes the prevalence of risk factors for osteoporosis and the proportions of men and postmenopausal women age 50 years and older who are candidates for treatment to lower fracture risk, according to the new FRAX-based National Osteoporosis Foundation Clinician's Guide. Little information is available on prevalence of osteoporosis risk factors or proportions of US men and women who are potential candidates for treatment. The prevalence of risk factors used in the new National Osteoporosis Foundation (NOF) FRAX-based Guide to the Prevention and Treatment of Osteoporosis was estimated using data from the third National Health and Nutrition Examination Survey (NHANES III). Risk factors not measured in NHANES III were simulated using World Health Organization cohorts. The proportion of US men and postmenopausal women age 50+ years who are treatment candidates by the new NOF Guide were calculated; for non-Hispanic white (NHW) women, the proportion eligible by the new NOF Guide was compared with that based on an earlier NOF Guide. Twenty percent of men and 37% of women were potential candidates for treatment to prevent fractures by the new NOF Guide. Among NHW women, 53% were potential candidates by the previous NOF Guide compared with 41% by the new guide. One fifth of men and 37% of postmenopausal women are eligible for osteoporosis treatment consideration by the new NOF Guide. However, fewer NHW women are eligible by the new guide than by the previous NOF Guide.

Anthropometric and Lifestyle Associations of Bone Mass in Healthy Pre-Menopausal Mexican and Asian American Women

Few studies have established the lifestyle predictors of peak bone mineral density (BMD) in Mexican-American (MA) and Asian-American (AA) women. Pre-menopausal MA (n = 48) and AA (n = 58) women aged 30-45 years old were tested for BMD, body composition, aerobic fitness, and muscle function. Socio-demographic characteristics, health status, prevalence of osteoporosis risk factors, physical activity, and diet were determined via questionnaire. Pearson's correlations and multiple linear regressions were used to test the associations between various osteoporosis risk factors and BMD. Body composition, anthropometric, and BMD differences were noted between groups. Hip, but not spine BMD, remained significantly higher for the MA compared to the AA group after adjustment for age, BMI, income, and physical activity index. Lean body mass was a significant predictor of hip BMD for both groups and this relationship was stronger for the AA group. Lean body mass may explain ethnic differences in BMD.

Prevalence of osteoporosis risk factors and treatment among women aged 50 years and older.

We conducted a cross-sectional, retrospective review to evaluate screening, diagnosis, and treatment of 389 women aged 50 years or older at risk for osteoporosis in a large primary care practice. Records randomly selected from a computerized database were reviewed for drug history, age, height, weight, and osteoporosis-related diagnoses, symptoms, and risk factors. Among the 389 women, 255 (65.5%) were receiving bone-preserving treatment (247 estrogen replacement exclusively). Most (70.4%) were white, with an average age of 61 years, and an average of 3.3 risk factors for osteoporosis. Risk factors were postmenopausal status 94%, age 65 years or older 53%, hysterectomy 39%, cigarette smoking 33%, and physical inactivity 30%. By logistic regression, the only positive predictor of antiresorptive therapy was hysterectomy (adjusted odds ratio [AOR] 2.52, 95% confidence interval [CI] 1.54-4.14). Negative predictors were physical inactivity (AOR 0.44, 95% CI 0.25-0.71), rheumatoid arthritis (AOR 0.31, 95% CI 0.12-0.79), and age 65 years and older (AOR 0.54, 95% CI 0.34-0.86). Controlling for age, women with four or more risk factors were 62% less likely to be receiving antiresorptive treatment (AOR 0.38, 95% CI 0.23-0.64) than those with fewer risk factors.

Osteoporosis: risk factor prevalence and drug and densitometry utilization

Objective: To evaluate the prevalence of selected risk factors for postmenopausal osteoporosis, use of bone protective medications, and utilization of bone densitometry (DXA).Methods: Computerized records on demographics, medications dispensed, diagnostic/procedure summary lists, and radiology files for 33,662 women more than age 50 years who were current members of a health maintenance organization were merged and analyzed.Results: Overall, 4,733 (14%) women had recently been dispensed one or more bone protective medications: estrogens conjugated, 4,625 (13.7%); all other estrogens, 578 (2%); alendronate, 240 (1%); calcitonin, 499 (1%); etidronate disodium, 58 (1%); raloxifene, 82 (<1%); tamoxifen, 445 (1%). There were 14,668 (44%) who had one or more selected risk factors: current cigarette smoking, 7,607 (23%); weight less than 125 lb, 3,522 (11%); high-dose steroid use, 81 (<1%); on thyroid replacement, 3,227 (9.6%); chronic renal failure, 221 (1%); vertebral fractures, 208 (<1%); fracture of pelvis, 88 (<1%); femoral neck fractures, 240 (1%); on antiseizure medication, 177 (<1%); and on benzodiazepam or lithium, 1,145 (3%). Bone protective drug use was 17% in those with risk factors and 13% in those with none. Prior DXA was performed in 2.0% of those with risk factors and in 1% of those without risk factors.Conclusions: In this population (probably not unlike other populations), despite high prevalence of osteoporosis risk factors, DXA screening utilization is low (<2%), as is use of bone protective medications (14%).

Risk factors for osteoporosis and fracture in patients attending rheumatology outpatient clinics.

Bone mineral density (BMD) using dual energy X-ray absorptiometry (DXA) scanning is the best predictor of osteoporotic fracture but may not be cost effective for all patient groups. Risk factors (RF) other than BMD may be useful for fracture prediction. To assess the prevalence of RF for osteoporosis (OP) and fracture in patients attending a public hospital rheumatology clinic and to document physician awareness of these RF. Two hundred and twenty rheumatology outpatients completed a self-administered questionnaire pertaining to known RF for OP and fracture. Initiatives were documented by the treating rheumatologist. One hundred and fifty-four females and 66 males completed questionnaires: 57% had an inflammatory disorder and 32% had received significant glucocorticoid therapy. Forty-five (68%) males and 126 (82%) females had three or more RF for OP and fracture. Diagnosis of rheumatoid arthritis or connective tissue disorder (CTD) was the variable most significantly associated with increasing numbers of RF. Antiosteoporotic medication (AOM) use at assessment (64/219, 29.2%) was accounted for primarily by the use of hormone replacement therapy in females between 45-54 years. Prednisolone use predicted intervention in 103 (48%) patients. Many rheumatology outpatients have multiple RF for OP and fracture. Infrequent AOM use could be explained by inadequate awareness of high risk patients and the lack of an ideal long term agent. With restricted outpatient resources, the feasibility of identifying high risk patients for OP and fracture would increase if the hierarchical status of RF was better understood.