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Postmenopausal osteoporosis: what is the real magnitude of the problem in the Thai population?
N Taechakraichana1, P Angkawanich, K Panyakhamlerd
1Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Insights
This study assessed osteoporosis prevalence in 1,047 Thai women using bone mineral density (BMD) measurements. Results indicate a lower prevalence using Thai cutoffs, particularly in postmenopausal women, highlighting the need for population-specific diagnostic criteria.
Area of Science:
- Endocrinology
- Bone Metabolism
- Public Health
Background:
- Osteoporosis is a significant health concern, particularly in postmenopausal women.
- Accurate prevalence assessment is crucial for public health strategies.
- Existing diagnostic criteria may not be universally applicable.
Purpose of the Study:
- To determine the prevalence of osteoporosis in Thai women attending a menopause clinic.
- To compare osteoporosis prevalence using Thai and American bone mineral density (BMD) cut-off values.
- To investigate the influence of menopausal status on osteoporosis prevalence.
Main Methods:
- Bone mineral density (BMD) was measured in 1,047 women using dual-energy X-ray absorptiometry (Hologic QDR 2000).
- Measurements were taken at the lumbar spine (LS) and non-dominant femoral neck (FN).
- The World Health Organization (WHO) definition (2.5 SD below young adult mean) and Thai cut-off values were applied.
Main Results:
- Using Thai cut-off values, osteoporosis prevalence was 15.7% at LS and 9.5% at FN.
- Prevalence was significantly higher in postmenopausal women (LS: 21.4%, FN: 11.9%) compared to premenopausal women (LS: 4.7%, FN: 4.7%).
- Thai cut-off values indicated a lower prevalence than implied by the WHO definition's general application.
Conclusions:
- The prevalence of osteoporosis in Thai women may be lower than previously estimated using general WHO criteria.
- Population-specific cut-off values, potentially derived from local fracture risk data, are needed for accurate osteoporosis diagnosis in Thailand.
- Findings underscore the importance of considering menopausal status in osteoporosis assessment.
Abstract:
To assess the prevalence of osteoporosis, bone mass measurement was performed on 1,047 women attending a menopause clinic at Chulalongkorn Hospital, Bangkok. The mean age of the population was 50.5 +/- 5.7 years. The bone density was measured at lumbar spines (LS) (L1-L4) and the non-dominant femoral neck (FN) site utilizing a Hologic QDR 2000 dual energy X-ray absorptiometer. According to the World Health Organization's (WHO) definition a value of bone mineral density (BMD) that is more than 2.5 standard deviation (SD) below the young adult mean is considered diagnostic of osteoporosis. In this study, Thai and American cut-off values of BMD for osteoporosis were used to compare the prevalence of osteoporosis. Using Thai's cutoff value, the results showed a lower prevalence of osteoporosis of both LS and FN (15.7% and 9.5%, respectively). Considering the subgroups of the studied population, the prevalence of osteoporosis of LS and FN utilizing Thai's cutoff value was significantly higher in postmenopausal than in premenopausal women. (Premenopause vs postmenopause, LS: 4.7% vs 21.4%; FN: 4.7% vs 11.9%, respectively, P < 0.05) WHO's definition of osteoporosis (the cutoff value of 2.5 SD below the young adult mean) is based on the rationale that this cutoff value identifies approximately 30 per cent of postmenopausal white women as having osteoporosis which is approximately equivalent to the lifetime risk of fracture at the spine, hip and forearm of white women at age 50 years. The prevalence of osteoporosis obtained in this study might not represent the true magnitude of the problem in Thailand. Until we have our own lifetime fracture risk which will enable us to have an appropriate cutoff value to diagnose osteoporosis, this prevalence might be used as an approximate figure or initial information for further research in this field.