Prevalence and Risk Factors of Osteoporosis Among Jordanian Postmenopausal Women Attending the National Center for Diabetes, Endocrinology and Genetics in Jordan

Abstract

To assess the prevalence of osteoporosis and osteopenia among Jordanian postmenopausal women attending the National Center for Diabetes, Endocrinology, and Genetics (NCDEG), and to determine the potential associated risk factors. A cross-sectional study was conducted at (NCDEG) in Amman, Jordan. A total of 1079 Jordanian postmenopausal women aged between 45 and 84 years were included in this study that was conducted during the period between April 2013 and December 2014. All patients underwent bone mineral density measurement through dual-energy X-ray absorptiometry (DEXA) scan. DEXA scan was interpreted in terms of T score as per World Health Organization guidelines. The overall prevalence of osteoporosis and osteopenia was 37.5% and 44.6%, respectively. The maximum prevalence of osteoporosis was observed at the lumbar spine (32.4%) followed by the left femoral neck (14.4%), while the maximum prevalence of osteopenia was observed at the left femoral neck (56.1%) followed by the lumbar spine (41.3%). Patients with longer menopausal duration, normal or overweight body mass index, high parity, physical inactivity, positive family history of osteoporosis, inadequate sun exposure, high daily caffeine intake, low daily calcium intake, and delay in the age of menarche were all positively associated with osteoporosis. On the other hand, women with type 2 diabetes mellitus had lower risk of osteoporosis. There is a high prevalence of osteoporosis and osteopenia among Jordanian postmenopausal women. Necessary steps are needed for more public education and a wider dissemination of information about osteoporosis and its prevention.

Effects of Parity and Breastfeeding Duration on Bone Density in Postmenopausal Women

“…In women, pregnancy and breastfeeding affect calcium metabolism, and eventually, BMD [5]. The BMD of the vertebrae and femur decreases owing to high calcium demand and bone resorption during pregnancy [6,7]. However, compared to women who gave birth to one child, those who gave birth to two or more children experienced less reduction in BMD, indicating that parity has a protective effect on bones [8e10].…”

Epidemiology and awareness of osteoporosis: a viewpoint from the Middle East and North Africa

“…Low education was associated with lower BMD and a higher prevalence of OP even after controlling for strong confounders (age, BMI, physical activity) [18,59,61]. Nevertheless, in another study, there was no significant association between OP and educational level [28].…”

“…About 21% of elderly Palestinians had vertebral and 5% had hip OP [27]. The overall prevalence of OP and osteopenia among Jordanian postmenopausal women was 37.5% and 44.6%, respectively [28]. In Lebanon, the prevalence of OP in elderly subjects was 33% in women and 22.7% in men [29].…”

“…There is a conflict of results regarding the relationship between the menopausal status and OP [13,28]. Significant correlations were found between OP, parity, years of menstruation and menopausal status [13].…”

“…Environmental exposure: The relationship between smoking exposure and OP remains controversial; smoking was not associated with OP [28,49] while others considered cigarette smoking as a predictor for OP [43,56,73]. Among battery manufacturing workers, significant elevated levels of lead concentration were accompanied with OP when compared to healthy control.…”