Factors Associated with Bone Health in Malaysian Middle-Aged and Elderly Women Assessed via Quantitative Ultrasound

Abstract

Risk factors for osteoporosis may vary according to different populations. We aimed to investigate the relationship between risk factors of osteoporosis and bone health indices determined via calcaneal quantitative ultrasound (QUS) in a group of Malaysian women aged 50 years or above. A cross-sectional study was performed on 344 Malaysian women recruited from a tertiary medical centre in Kuala Lumpur, Malaysia. They answered a self-administered questionnaire on their social-demographic details, medical history, lifestyle, and physical activity status. Their height was measured using a stadiometer, and their body composition estimated using a bioelectrical impedance device. Their bone health status was determined using a water-based calcaneal QUS device that generated three indices, namely speed of sound (SOS), broadband ultrasound attenuation (BUA), and stiffness index (SI). A T-score was computed from SI values using a reference database from a mainland Chinese population. Women with three or more lifetime pregnancies, who were underweight and not drinking coffee had a significantly lower BUA. Stepwise multiple linear regression showed that SOS was predicted by age alone, BUA and SI by years since menopause, body mass index (BMI), and number of lifetime pregnancies, and T-score by years since menopause and percentage of body fat. As a conclusion, suboptimal bone health in middle-aged and elderly Malaysian women as indicated by QUS is associated with old age, being underweight, having a high body fat percentage, and a high number of lifetime pregnancies. Women having several risk factors should be monitored more closely to protect their bones against accelerated bone loss.

Adiposity reduces the risk of osteoporosis in Chinese rural population: the Henan rural cohort study

“…Meanwhile, a meta-analysis included 60,000 subjects with over 250,000 person-years reported that the risk of hip fractures with a BMI of 20 kg/m 2 was increased twofold comparing with a BMI of 25 kg/m 2 [16]. Although it was widely accepted obesity was protective against the risk of osteoporosis, newer studies suggested increasing adiposity might be harmful to bone microarchitecture [13,15,27,28]. A study conducted by Chin et al discovered BFP was inversely associated with bone health although BMI was positively associated with bone status [27].…”

Prevalence and Predictors of Osteoporosis Among the Chinese Population in Klang Valley, Malaysia

“…However, to the best of our knowledge, this is the first study to report on the prevalence and predictors of osteoporosis defined by DXA among middle-aged and elderly Malaysian Chinese in Klang Valley. Other similar studies have been conducted in Malaysia, but they used quantitative ultrasonometry to determine bone health of the subjects [13,49,50].…”

“…For beverages, an intake of less than one unit per week was defined as non-drinker. One unit of milk was defined as 200 mL, while one unit of coffee/tea was defined as one standard cup [13]. Those who consumed beverages or dairy products 3-4 days per week were defined as regular drinkers.…”

“…These were converted to the metabolic equivalent of task (MET) and summed up. Subjects were categorized into inactive, minimally active, or HEPA (health-enhancing physical activity) active based on total MET score or other additional criteria [11,13].…”

Adiposity reduces the risk of osteoporosis in Chinese rural population: the Henan Rural Cohort Study

“…Meanwhile, a meta-analysis included 60000 subjects with over 250000 person-years reported that the risk of hip fracture with a BMI of 20 kg/m 2 was increased two-fold comparing with a BMI of 25 kg/m 2 [16]. Although it was widely accepted obesity was protective against the risk of osteoporosis, newer studies suggested increasing adiposity might be harmful to bone microarchitecture [13,15,27,28]. A study conducted by Chin et al discovered BFP was inversely associated with bone health although BMI was positively associated with bone status [27].…”