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 Table of Contents  
ORIGINAL ARTICLE
Year : 2016  |  Volume : 2  |  Issue : 1  |  Page : 15-17

Prevalence of Osteoporosis in Bihar: A Sample Study


1 Associate professor
2 Assistant professor
3 Senior Resident
4 Santosh Kumar

Date of Web Publication12-Feb-2016

Correspondence Address:
Ritesh Runu
Associate professor, Department of Orthopaedics,IGIMS, Patna-14

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Source of Support: None, Conflict of Interest: None


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  Abstract 


Osteoporosis is a silent disease increasing the fracture risk and load on public hospitals. Proper diet and preventive medication can reduce the chances of osteoporosis. Presently we have population data regarding osteoporosis from northern and southern part of India but no such data is available from eastern region. The aim of present study was to collect such data for assessment of osteoporosis in our population. 363 (246 males, 117 females) patients with age more than 20years (average age 43.01years) were selected for the study. The patients with BMD data measured using distal radius quantitative ultrasound and expressed as T score were collected. It was analyzed by logistic regression analysis. Average BMD was minus 1.2 (normal). 201 (55.37%) patients had normal BMD, 140(38.56%) were osteopenic and 22(6.06%) were osteoporotic. In less than 50 years of age most of the females were osteopenic while most of the males were having normal BMD. The prevalence of osteoporosis was 4 times higher in females of age more than 50 years. In males the prevalence of osteopenia and osteoporosis was same in all age groups. There was significant difference in incidence between males and females (p 0.002) while insignificant (0.772) in two age groups.

Keywords: Osteoporosis, osteopenia, BMD, IGIMS


How to cite this article:
Runu R, Jain M, Singh NN, Kumar S. Prevalence of Osteoporosis in Bihar: A Sample Study. J Indira Gandhi Inst Med Sci 2016;2:15-7

How to cite this URL:
Runu R, Jain M, Singh NN, Kumar S. Prevalence of Osteoporosis in Bihar: A Sample Study. J Indira Gandhi Inst Med Sci [serial online] 2016 [cited 2022 Oct 2];2:15-7. Available from: http://www.jigims.co.in/text.asp?2016/2/1/15/303361




  Introduction: Top


Osteoporosis in Indian population has been studied at many centres.[1],[2],[3],[4],[5],[6]. The effect of osteoporosis is directly related to increased incidence of bone pain, fatigue, fractures, morbidity and mortality.[2] Therefore it is also known as silent killer.[2] Several studies of prevalence of osteoporosis has been done in different parts of India but we don’t have similar studies in Bihar. Our aim of present study was to collect a sample data from the patients reporting to orthopedic OPD in our institute to find the prevalence of osteoporosis in our population.


  Material and methods: Top


This was a retrospective study done from May 2015 to December 2015. All the patients reporting to orthopaedic OPD were enrolled in this study. Patients less than 20 years, having multiple medical problems, on long term steroid therapy, patients with rheumatoid arthritis, or having hypo or hyperthyroidism were excluded from the present study. Bone Mineral Density (BMD) measured using distal radius quantitative ultrasound and expressed as T score were collected. The patients were classified as normal having T score more than -1.5, osteopenia having T score equal or less than -1.5 and more than - 2.5 and osteoporosis have T score equal or less than - 2.5. The study population was divided in two groups. Group I had patients age less than 50 years and group II had patients age more than 50 years.


  Results: Top


A total of 363(246 males, 117 females) patients were enrolled in the present study. The average ages of the patients were 43.01(20-74) years. Average BMD was minus 1.2 (normal). Overall females had high prevalence of osteopenia and osteoporosis compared to males. The prevalence of osteoporosis was double in females.

In group I most of the males had normal BMD while females were mostly osteopenic. These females when enter the postmenopausal age group with osteopenia had high chances of osteoporosis.
Table 1: BMD profile in study sample

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Table 2: BMD in age less than 50 years (group I)

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Table 3: BMD in age more than 50 years (group II)

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In group II, most of the males had normal BMD. The prevalence of osteoporosis in females was 19% which is 4.33 times higher compared to group I. Overall the prevalence of osteoporotic patients doubled in group II i.e. 9.9% from 4.36%.

The binary logistic regression analysis showed that prevalence of poor BMD is 2.02 times higher in females compared to males. It also showed that chance of osteopenia and osteoporosis is 1.07 times higher in population more than 50 years of age. The test of significance done using chi square test showed that sex difference is significant (p 0.002) while age difference is insignificant (0.772).


  Discussion Top


Several studies have been done on the BMD of various populations around the globe.[1],[2],[3],[4],[5],[6],[7]. Some studies have been done in India as well.[1],[2],[3],[4],[5],[6],[8],[9],[10]. We lack data of BMD in eastern India and Bihar. Our institute being nodal institute of the state catering the population from all the regions, hence this study was conducted.

Osteoporosis and osteopenia has been designated as silent killer.[3] It affects all age groups and sexes. It is of two types - primary and secondary osteoporosis. Postmenopausal and senile osteoporosis is primary osteoporosis while disease related osteoporosis is secondary. The major effect of osteoporosis is high incidence of fracture in old age which increases the morbidity and mortality.[3] According to National Health and Nutrition and Nutrition Examination survey (NHANES III) around 14 million American women over age 50 yrs are affected by low density at the hip. The prevalence of osteoporosis is up to 70% of women over the age of 80 years.[10]

BMD is an important tool for diagnosis of osteoporosis. The gold standard for measuring BMD is Dual Energy X-ray absorptiometry. This requires large machine and high cost of investigation; hence screening is difficult. Quantitative ultrasound machine is best alternative to DEXA as it is small, handy, and can give fair results regarding the status of bone mass.[11] It can be used for assessment of BMD of population in all areas.

In our study, female population had lower BMD compared to males. Majority of males had normal BMD (61%) while females (47%) were osteopenic. Similar results have been found in other studies.[2],[4],[11],[12].

High prevalence of osteopenia in females in group I was noticed and similar results were found in study by Rao et al.[2] The prevalence of osteoporosis was 2.02 times higher in females than males.

In age group more than 50 years, 35% males and 38% females had osteopenia. Osteoporosis is 5% and 19% in males and females respectively. This finding shows that females had higher rate of bone loss. This also shows relative difference of osteoporosis in males and females.
Table 4: The Indian studies done and results.

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  Conclusion: Top


Osteoporosis is more common in females especially in age more than 50 years. The females in age less than 50 years are mostly osteopenic and they should be target population for osteoporosis prevention activities.



 
  References Top

1.
Aggarwal N, Raveendran A, Khandelwal N, Sen RK, Thakur JS, Dhaliwal LK, Singla V, Manoharan SRR. Prevalence and related risk factors of osteoporosis in peri - and postmenopausal Indian women. J Midlife Health 2011;2(2): 81-85.  Back to cited text no. 1
    
2.
Rao H, Rao N, Sharma LR. A clinical study of bone mineral density using heel ultra - densitometer in Southern Maharashtra. Indian J Orthop 2003; 37(2): 9.  Back to cited text no. 2
    
3.
Gupta A. Osteoporosis in India - The nutritional hypothesis. The National Med J India 1996; 9(6): 268- 274.  Back to cited text no. 3
    
4.
Vaidya R, Shah R. Bone mineral density and reference standards for Indian women. J Midlife Health 2010; 1(2): 55.  Back to cited text no. 4
    
5.
Mukherjee A, Mathur A. Population based reference standards of Peak bone mineral density of Indian Males and Females. ICMR bulletin 2011;41(4): 21-25.  Back to cited text no. 5
    
6.
Babu AS, Ikbal FM, Noone MS, Joseph AN, Samuel P. Osteoporosis and osteopenia in India: A few more observations. Indian J med Sci 2009;63:76-77.  Back to cited text no. 6
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7.
Patni R. Normal BMD values for Indian females aged 20-80years. J Midlife Health 2010; 1(2): 70-73.  Back to cited text no. 7
    
8.
Sharma S, Khandelwal S. Effective risk assessment tools for osteoporosis in the Indian menopausal females. J Midlife Health 2010; 1(2): 79-85.  Back to cited text no. 8
    
9.
Paul TV, Selvan SA, Asha HS, Thomas N, Venkatesh K, Commen AT, Mathai T, Sheshadri M. Hypovitaminosis D and other risk factors of femoral neck fracture in South Indian Post menopausal women: A Pilot Study. www.jcdr.net; June 2015.  Back to cited text no. 9
    
10.
Hyderabad, India: Indian Council of Medical research; 1998. National Institute of Nutrition. Dietary guidelines for Indians - a manual.  Back to cited text no. 10
    
11.
Stewart A, Reid DM. Quantitative ultrasound or clinical risk factors: which best identifies women at risk of osteoporosis? Br J Radiol 2000; 73:165-71.  Back to cited text no. 11
    
12.
Sharma S, Tandon VR, Mahajan A, Kour A, Kumar D. Preliminary screening of osteoporosis and osteopenia in urban women from Jammu using calcaneal QUS. Indian J Med Sci 2006; 60:183-189.  Back to cited text no. 12
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  [Table 1], [Table 2], [Table 3], [Table 4]



 

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