[Osteoporosis in Thailand]

Osteoporosis is a health problem which is becoming more prevalent in Thailand. A number of differences compared to Caucasian populations, however, exist which include the burden and the diagnosis of osteoporosis, genetics of osteoporosis, vitamin D status and calcium intake. Thai postmenopausal women suffer less hip fractures despite lower bone mineral density (BMD). Other environmental or genetic factor are likely to play modulatory role on the determination of osteoporotic fractures besides BMD. Distal renal tubular acidosis is prevalent in certain parts of Thailand. The disorder in which low BMD is a clinical feature needs to be excluded before the diagnosis of osteoporosis based on bone densitometry can be made. Genetic factors play important role in the determination of osteoporosis and osteoporotic fractures. The cohort of genes involved in osteoporosis and their impact are likely to be different among populations with different ethnic background. Besides genetic factors, environmental factors such as calcium intake and vitamin status are also crucial. Thailand is situated in a geographic area with abundant sunlight exposure and vitamin D deficiency is not commonly found in our elderly who are still active and ambulatory. Due to adequate vitamin D status, favorable vitamin D receptor genotype and less urinary calcium loss because of smaller body built, the optimal calcium in Thais may not be as high as that recommended in Caucasians.