Shaki Omna, Rai Sanjay Kumar, Kashid Manoj, Chakrabarty Barun K
Department of Orthopaedics, INHS Asvini, Colaba, Mumbai, Maharashtra, India.
Department of Pathology, 151 Base Hospital, Guwahati, Assam, India.
J Midlife Health. 2018 Jul-Sep;9(3):117-122. doi: 10.4103/jmh.JMH_84_17.
We conducted our study involving 1400 peri- and post-menopausal women who live in a slum area of Mumbai to determine the prevalence of osteoporosis, awareness about osteoporosis, education (knowledge regarding osteoporosis), treatment and prevention of osteoporosis.
A detailed medical, surgical, obstetrical & gynecological, menstrual, and drug history was recorded in a predesigned questionnaire designated for the study. Height and weight and body mass index were measured, physical activity level especially load bearing exercise was recorded, and amount of sunlight exposure per day was also recorded. Food intake was estimated using the 24 h dietary recall method and calcium and Vitamin D consumption pattern was assessed. We used calcaneum quantitative ultrasound to assess bone mineral density (BMD) for such large population.
The prevalence of low BMD was found in more than half of this population (81%). The mean age in Group I was found to be 36.50 ± 2.74 years as compared to 37.5 ± 3.44 years in Group II with low BMD, which was statistically significant ( = 0.02). The average age at menopause was 51.62 ± 5.72 years in Group I and 49.43 ± 4.52 years in Group II. The number of children and type of menopause has been found to be associated with low BMD in our study. Lack of physical exercise and low-calcium diet were significantly associated with low BMD.
Our study showed that there is a high prevalence of Vitamin D deficiency and Osteoporosis even in adult women who live in a slum area. The findings from the study also suggest the need for large community-based studies so that high-risk population can be picked up early and early interventions and other lifestyle changes can be instituted so that no delay in implementing state and national or international health policy to tackle this increasing global health problem. The public awareness is important, and strategies to identify and manage low BMD in the primary care setting needs to be established and implemented.
我们对居住在孟买贫民窟地区的1400名围绝经期和绝经后妇女进行了研究,以确定骨质疏松症的患病率、对骨质疏松症的认知、教育程度(关于骨质疏松症的知识)、骨质疏松症的治疗和预防情况。
在为该研究设计的预先设计好的问卷中记录详细的医疗、手术、妇产科、月经和用药史。测量身高、体重和体重指数,记录身体活动水平,尤其是负重运动,并记录每天的日照量。采用24小时膳食回顾法估算食物摄入量,并评估钙和维生素D的消费模式。我们使用跟骨定量超声来评估如此大规模人群的骨密度(BMD)。
在该人群中,超过一半(81%)的人骨密度较低。第一组的平均年龄为36.50±2.74岁,而骨密度较低的第二组为37.5±3.44岁,具有统计学意义(P = 0.02)。第一组的平均绝经年龄为51.62±5.72岁,第二组为49.43±4.52岁。在我们的研究中,已发现子女数量和绝经类型与低骨密度有关。缺乏体育锻炼和低钙饮食与低骨密度显著相关。
我们的研究表明,即使在居住在贫民窟地区的成年女性中,维生素D缺乏和骨质疏松症的患病率也很高。该研究的结果还表明,需要进行大规模的社区研究,以便能够早期发现高危人群,并尽早进行干预和做出其他生活方式改变,从而在实施国家和国际卫生政策以应对这一日益严重的全球健康问题方面不出现延误。公众意识很重要,需要制定并实施在初级保健环境中识别和管理低骨密度的策略。