Screening for osteopenia and osteoporosis in an urban community in India

Osteoporosis is a disease characterized by reduction in the bone mass and disruption of bone architecture leading to impaired skeletal strength and an increased susceptibility of fractures. It is a major public health problem associated with substantial morbidity and socio-economic burden worldwide. The present study was planned to screen bone status of adults over 20 years (when peak bone mass is formed) utilizing calcaneal quantitative ultrasound (QUS) (Hologic Sahara 0058 USG) as a diagnostic tool. A screening camp was conducted in the 1st week of February 2008 at the Terna Hospital and Research Centre along with the Orthopedic Department. A questionnaire was administered to all the screened individuals which included socio-demographic data, assessment of susceptibility to osteoporosis and dietary habits. The bone mineral density (BMD) was measured at the calcaneus by QUS and T-scores were calculated based on WHO criteria. The study yielded a prevalence of 41.4% among women and 33.33% among men for Osteopenia and 12.85% among women 3.7% among men for Osteoporosis respectively. The mean age of the screened sample was 44.25 years. The mean weight, height and body mass index was 56.95 kg, 157.47 cms and 23.047 respectively. The mean bone density was -0.749. A total of 97 individuals screened; of which 70 (72.1%) were females and 27 (27.9%) were males. There was a significant trend of decreasing bone density with an increase in age. Age had an influence on the outcome of osteopenic and osteoporosis score in present study. The subjects with low bone mineral density (BMD) were advised to undergo a Dual energy X-ray absorptiometry (DEXA) scan in order to confirm the diagnosis. The US Preventive Services Task Force recommends routine screening for Osteoporosis in women over 65 years. In India we need to carry out further studies on whether we need to consider screening at an earlier age and also to study osteoporosis in males.