Utility of anthropometric indicators in predicting osteoporosis in ambulant community dwelling rural postmenopausal women from southern India

Abstract

Osteoporosis is characterised by low bone mineral density (BMD) and is a significant public health problem in India. This cross-sectional study was done to assess the relationship between various anthropometric measures and BMD in 308 rural dwelling South Indian postmenopausal women. Anthropometric variables such as weight, body mass index (BMI), waist circumference (WC), hip circumference (HC) and neck circumference (NC) were measured. BMD was assessed by dual-energy X-ray absorptiometry (DXA) scan at the lumbar spine (LS) and femoral neck (NOF). The mean age ± SD of study participants was 60.7 ± 7.8 years. All anthropometric variables showed positive correlation with BMD at NOF and LS (P < 0.05). Weight showed the best correlation (r = 0.482 for NOF and 0.412 for LS; P < 0.001). On multivariate logistic regression, age and weight remained significant for predicting femoral neck osteoporosis while weight and WC were the best predictors for LS osteoporosis. These anthropometric measures may serve as surrogate markers for osteoporosis and thus be used to screen postmenopausal women for referral to a centre with fewer limited resources.

Keywords

Anthropometry osteoporosis bone mineral density postmenopausal women rural south India

Get full access to this article

View all access options for this article.

References

Paul

Thomas

Seshadri

, et al. Prevalence of osteoporosis in ambulatory postmenopausal women from a semiurban region in Southern India: relationship to calcium nutrition and vitamin D status. Endocr Pract 2008; 14: 665–671.

Shetty

Kapoor

Naik

, et al. Osteoporosis in healthy south Indian males and the influence of life style factors and vitamin D status on bone mineral density. J Osteoporos 2014; 2014: 723238–723238.

Marques

Ferreira

RJO

Santos

, et al. The accuracy of osteoporotic fracture risk prediction tools: a systematic review and meta-analysis. Ann Rheum Dis 2015; 74: 1958–1967.

Koh

Sedrine

Torralba

, et al. A simple tool to identify Asian women at increased risk of osteoporosis. Osteoporos Int 2001; 12: 699–705.

Cadarette

Jaglal

Kreiger

, et al. Development and validation of the Osteoporosis Risk Assessment Instrument to facilitate selection of women for bone densitometry. CMAJ 2000; 162: 1289–1294.

Cherian

Kapoor

Shetty

, et al. Evaluation of different screening tools for predicting femoral neck osteoporosis in rural South Indian postmenopausal women. J Clin Densitom 2018; 21: 119–124.

Meybodi

Hemmat-Abadi

Heshmat

, et al. Association between anthropometric measures and bone mineral density: population-based study. Iran J Public Health 2011; 40: 18–18.

Mpalaris

Anagnostis

Goulis

, et al. Complex association between body weight and fracture risk in postmenopausal women. Obes Rev 2015; 16: 225–233.

Kim

K-C

Shin

D-H

Lee

S-Y

, et al. Relation between obesity and bone mineral density and vertebral fractures in Korean postmenopausal women. Yonsei Med J 2010; 51: 857–863.

10.

Wildner

Peters

Raghuvanshi

, et al. Superiority of age and weight as variables in predicting osteoporosis in postmenopausal white women. Osteoporos Int 2003; 14: 950–956.

11.

Dargent-Molina

Poitiers

Bréart

, et al. In elderly women weight is the best predictor of a very low bone mineral density: evidence from the EPIDOS study. Osteoporos Int 2000; 11: 881–888.

12.

Kumar

Sharma

Mittal

, et al. The relationship between body mass index and bone mineral density in premenopausal and postmenopausal north Indian women. J Obstet Gynaecol India 2016; 66: 52–56.

13.

World Health Organization. Measuring obesity: classification and description of anthropometric data: report on a WHO consultation on the epidemiology of obesity, Warsaw, 21–23 October 1987. Copenhagen: World Health Organization, Regional Office for Europe, 1989.

14.

Bergman

Stefanovski

Buchanan

, et al. A better index of body adiposity. Obesity (Silver Spring) 2011; 19: 1083–1089.

15.

Aoi

Miyake

Harada

, et al. Neck circumference has possibility as a predictor for metabolic syndrome in postmenopausal women. Hiroshima J Med Sci 2014; 63: 27–32.

16.

Hans

Downs

Duboeuf

, et al. Skeletal Sites for Osteoporosis Diagnosis: The 2005 ISCD Official Positions. J Clin Densitom 2006; 9: 15–21.

17.

Johnell

O’Neill

Felsenberg

, et al. Anthropometric measurements and vertebral deformities. European Vertebral Osteoporosis Study (EVOS) Group. Am J Epidemiol 1997; 146: 287–293.

18.

van der Voort

Geusens

Dinant

. Risk factors for osteoporosis related to their outcome: fractures. Osteoporos Int 2001; 12: 630–638.

19.

Joakimsen

Fønnebø

Magnus

, et al. The Tromsø Study: body height, body mass index and fractures. Osteoporos Int 1998; 8: 436–442.

20.

Prieto-Alhambra

Premaor

Fina Avilés

, et al. The association between fracture and obesity is site-dependent: a population-based study in postmenopausal women. J Bone Miner Res 2012; 27: 294–300.

21.

Compston

Watts

Chapurlat

, et al. Obesity is not protective against fracture in postmenopausal women: GLOW. Am J Med 2011; 124: 1043–1050.

22.

Johansson

Kanis

Odén

, et al. A meta-analysis of the association of fracture risk and body mass index in women. J Bone Miner Res 2014; 29: 223–233.

23.

De Laet

Kanis

Odén

, et al. Body mass index as a predictor of fracture risk: a meta-analysis. Osteoporos Int 2005; 16: 1330–1338.

24.

Tariq

Lone

. Relationship of anthropometric measures with bone mineral density in postmenopausal non-osteoporotic, osteopenic and osteoporotic women. J Pak Med Assoc 2017; 67: 590–594.

25.

Yang

Shen

. Association and relative importance of multiple obesity measures with bone mineral density: the National Health and Nutrition Examination Survey 2005–2006. Arch Osteoporos 2015; 10: 14–14.