Educational level and osteoporosis risk in postmenopausal Chinese women

Many studies have shown that better education is favorable for lowering the risks for a number of chronic diseases, but little information is available on the relation with bone health. The authors examined the association of educational level, classified as levels I-IV, with bone mineral density (BMD) and with the prevalence of osteoporosis among 685 population-based, postmenopausal, Chinese women aged 48-63 years during 1999-2001. They observed a significant dose-response positive relation between educational level and BMDs at the total-body (p = 0.011), lumbar spine, and hip sites (p < 0.001) after adjusting for age, years since menopause, and body weight. Mean BMDs of educational level IV women were higher by 4.2-11.9% at the various sites compared with level I women (analysis of covariance, p < 0.05). Similarly, the authors also observed a significant inverse dose-response relation between educational level and prevalence of osteoporosis. Women of educational level I were 3.5-8.6 times more likely to be osteoporotic compared with those of level IV at the various sites. The proportion of BMD or osteoporosis variations accounted for by educational level was attenuated by about 40% after further controlling for potentially explanatory covariates. In conclusion, a higher level of education is independently associated with better BMDs and lower prevalence of osteoporosis among postmenopausal Chinese women.