Epidemiological pattern of osteoporosis and osteopenia among Jordanian females and their associated clinical illnesses

ABSTRACT

Osteoporosis is a multifactorial disease and several risk factors are thought to influence its prevalence, many of which can be removed or modified. Even those risk factors that cannot be modified are important for identifying patients at- risk, who may gain most from therapies that change other risk factors. Moreover, broad variance in the osteoporosis epidemiological pattern among geographic and ethnic groups can be expected. The current cross-sectional study was conducted to determine the clinical illnesses associated with development of osteoporosis in the Jordanian society. Stratified sampling technique was employed to recruit women from middle, north and south regions of Jordan. The main settings of study procedures w ere two community hospitals in Amman city. Bone densitometry was performed for all subjects, while thorough assessment of clinical issues related to physical examination, social history, family history of osteoporosis, and past medical history was carried out using a structured questionnaire. After collection of fasting blood samples, we quantitatively explored the potential effect of lipid parameters, fasting blood sugar, thyroid hormones, and calcium level on absolute bone mineral density. Among the 400 participants, 119 [29.6%] were identified as having osteoporosis, 176 [43.8%] were osteopenic, and 107 [26.6%] had normal bone mineral density. In the multivariable logistic regression model, women aged 50 years or more were 7.27 times more likely to incur osteoporosis [95% CI, 2.68-19.74]. Clinical variables, which remained significantly associated with increased risk of osteoporosis in the final stepwise logistic model after adjustment for age and BMI were current smokers of more than 25 cigarettes day, gastrointestinal disease, rheumatoid arthritis, osteoarthritis, hypertension, and thyroid replacement therapy. Moderate physical activity, diabetes mellitus type I, clinical hyperthyroidism were significant protective factors. Family history of osteoporosis, clinical hypothyroidism, hyperlipidemia, diabetes mellitus type II, coronary artery disease, and corticosteroid therapy were not independent predictors of osteoporosis among the studied population. It is concluded that the high prevalence of osteopenia and osteoporosis among the Jordanian women, which is even encountered in younger age categories compared to previous international surveys, demonstrated multiple disease pattern, with the gastrointestinal disease being the most frequent illness. Therefore, prophylactic management standards accompanied with increased culture education are mandatory for further reduction in morbidity and cost implications