Risk factors and prevalence of osteoporosis in premenopausal women from poor economic backgrounds in Colombia

Abstract

John Londono,1 Paula Valencia,1 Ana María Santos,1 Luisa F Gutiérrez,2 Roberto Baquero,1 Rafael Valle-Oñate1,3 1Rheumatology Department, Universidad de La Sabana, Chía, Cundinamarca, Colombia; 2Preventive Care Ltd, Research Unit, Chía, Cundinamarca, Colombia, 3Rheumatology Department, Hospital Militar Central, Bogotá, DC, Colombia Introduction: The prevalence of osteoporosis in premenopausal women along with associated risk factors has not been well elucidated. Recent studies have shown that poverty is a risk factor for osteoporosis. Objective: To determine the prevalence of osteoporosis and its risk factors in a group of premenopausal women of poor economic background in Colombia. Materials and methods: The study comprised 1483 women between 35 and 53 years of age with at least one risk factor for osteoporosis. Demographic characteristics, reproductive factors, comorbidities, and risk factors for osteoporosis were evaluated. Lumbar vertebrae (L2–L4) and the femur neck were assessed using dual-energy X-ray absorptiometry. Results: Of the 1483 patients, 1443 (97.3%) had at least one risk factor for osteoporosis and 40 (2.7%) had no risk factors. Patients with one risk factor were referred to have a dual-energy X-ray absorptiometry scan, which 795 women completed. Osteopenia was found in 30.5% and osteoporosis in 4.8% of these women. The majority of these women were homemakers, and 18.5% of the patients with osteoporosis were also illiterate (P < 0.001). The risk factors identified in this population were: hypothyroidism (odds ratio [OR] = 5.19, 95% confidence interval [CI]:1.6–16), age over 45 years old (OR = 1.13, 95% CI: 1.0–1.2), a history of malnutrition or low birth weight (OR = 2.35, 95% CI: 1.0–5.2), or early-onset menopause (OR = 3.4, 95% CI: 1.6–7.2). Conclusion: Premenopausal Colombian women from impoverished areas showed increased rates of osteopenia and osteoporosis compared with the data described in the current literature. Hypothyroidism was an outstanding risk factor in Colombian premenopausal women with osteoporosis. This shows the influence of poverty and other risk factors on the onset of osteoporosis in women aged 35–53 years. Keywords: osteopenia, osteoporosis, malnutrition, hypothyroidism