Bone health in healthy Indian population aged 50 years and above

• Published in: Osteoporosis international Vol. 22; no. 11; pp. 2829 - 2836
• Main Authors: Marwaha, R. K., Tandon, N., Garg, M. K., Kanwar, R., Narang, A., Sastry, A., Saberwal, A., Bhadra, K., Mithal, A.
• Format: Journal Article
• Language: English
• Published: London Springer-Verlag 01-11-2011; Springer; Springer Nature B.V
• Subjects: Absorptiometry, Photon; Age; Aged; Alkaline phosphatase; Biological and medical sciences; Body Mass Index; Bone density; Bone Density - physiology; Bone Diseases, Metabolic - diagnostic imaging; Bone Diseases, Metabolic - epidemiology; Bone mineral density; Calcaneus - diagnostic imaging; Diseases of the osteoarticular system; Dual energy X-ray absorptiometry; Endocrinology; Female; Femur - diagnostic imaging; Forearm; Geriatrics; Hip; Humans; India; Investigative techniques, diagnostic techniques (general aspects); Lumbar Vertebrae - diagnostic imaging; Male; Medical sciences; Medicine; Medicine & Public Health; Middle Aged; Older people; Original Article; Orthopedics; Osteoarticular system. Muscles; Osteopenia; Osteoporosis; Osteoporosis - diagnostic imaging; Osteoporosis - epidemiology; Osteoporosis. Osteomalacia. Paget disease; Parathyroid hormone; Parathyroid Hormone - blood; Post-menopause; Prevalence; Radiodiagnosis. Nmr imagery. Nmr spectrometry; Radius; Radius - diagnostic imaging; Rheumatology; Risk Factors; Sensitivity and Specificity; Spine (lumbar); Vitamin D - analogs & derivatives; Vitamin D - blood; Asia; India; Delhi India; Osteoporosis; Bone mineral density; DXA; Osteopenia; Serum 25(OH)D levels; Diseases of the osteoarticular system; Rheumatology; Indian; Serum; Bone
• ISSN: 0937-941X; 1433-2965
• DOI: 10.1007/s00198-010-1507-8

Summary
One thousand six hundred healthy subjects aged more than 50 years, residing in Delhi, were evaluated for bone mineral metabolic parameters. High prevalence of osteoporosis (35.1% subjects) was observed in this population. Bone mineral density (BMD) correlated positively with body mass index (BMI) and negatively with PTH levels. No correlation was observed with serum 25(OH)D levels.
Introduction
To assess the bone health status in elderly Indians and compare peripheral DXA (pDXA) with central DXA in evaluation of osteoporosis.
Methods
The study involved 1,600 healthy subjects more than 50 years of age residing in Delhi, India, who underwent anthropometric, biochemical, and hormonal evaluation. BMD was measured by DXA at lumbar spine, hip, and distal radius; and by pDXA at forearm and calcaneum.
Results
Seven hundred ninety-two males and 808 postmenopausal females, with a mean age of 57.67 ± 9.46 years were evaluated. Osteoporosis was present in 35.1% subjects (M—24.6%, F—42.5%) and osteopenia in 49.5% (M—54.3%, F—44.9%). Prevalence of osteoporosis increased with age in females, but not in males. BMD at all sites, except distal radius, was positively correlated with BMI (
r
 = 0.037,
p
 = 0.14). Total body BMD was negatively correlated with alkaline phosphatase (
r
 = −0.184,
p
 < 0.00001) and PTH levels (
r
 = −0.099,
p
 < 0.00001), respectively. No significant correlation was observed between serum 25(OH)D levels and BMD at any site. BMD at forearm and calcaneum, measured using pDXA, showed strong positive correlation with BMD measured by central DXA. pDXA had sensitivity of 88%, specificity of 55%, and negative and positive predictive values of 89% and 52%, respectively, at T-score −2.5 at peripheral sites compared to central DXA.
Conclusions
A high prevalence of osteoporosis was observed in elderly Indian subjects. pDXA has high negative predictive value, making it a useful tool in population screening for osteoporosis.