Risk factors for osteoporosis in women - Risk assessment with ORAI and DEXA

Abstract

Introduction: The Osteoporosis Risk Assessment Instrument (ORAI) is used as an method of evaluation of osteoporosis risk. Osteodensitometry by Double Energy X-ray Absorciometry (DEXA) evaluates bone mineral density. The universal screening of feminine osteoporosis using DEXA is not recommended. Currently, the individual risk assessment is considered the best way to select which patients should be submitted to DEXA. Aims: to describe osteoporosis risk in women above 45 years of age with ORAI, to analyse the association of risk and submission to DEXA and to assess risk factors of osteoporosis. Methods: Cross-sectional study in the Health Centre of Ermesinde, Valongo, Portugal. Population: women above 45 attending the Health Centre; random sample of 400 women. Study variables - osteoporosis risk, submission to DEXA, bone mineral density, age, weight, estrogens use, tobacco use, menopause, personal history of fractures, and family history of osteoporosis. Qui-square and exact Fishers tests were used. Adjusted Odds Ratios were calculated by logistic regression. The level of significance considered was 0,05. Results: 53,4% of women had high risk of osteoporosis and the proportion of women submitted to DEXA was 47,7%. However, no association was found between submission to DEXA and osteoporosis risk. Osteoporosis risk factors found in this study were age>64, early menopause and family history of osteoporosis. Discussion: There are doubts about the criteria used in the selection of patients submitted to DEXA. As in other studies, ORAI proved to be a good screening method for low bone mineral density. Other risk factors may as well be considered. The impossibility to analyse tobacco use in this context is one of the study limitations.