Palestinian Guidelines for diagnosing and treatment of osteoporosis will be developed. Those women at risk for developing bone fracture will be identified using FRAX. A platform will be developed and guidelines will be Palestinian postmenopausal women will validated by WHO to be adopted by the Ministry of Health. The platform will available for Palestinian women to be used through an application to identify those women at risk and direct them to be helped.
(Springer, 2010-05-18) Abd-Alhameed, Intissar; Saba, Elias; Darwish, Hisham M.
Summary The prevalence and awareness of postmenopausal
osteoporosis was assessed among 569 postmenopausal
women randomly selected from the population. Osteoporosis
was assessed based on bone mineral density (BMD)
values at three indicative sites. The results indicate a
significant prevalence of the disease among this fraction
of the population with a poor knowledge of its risk factors.
Introduction Postmenopausal osteoporosis is a major health
problem at the individual and population levels. Assessment
of its prevalence and awareness of risk factors provide
the basis for health plans to control the disease. No
previous studies have been done in our population. A
cross-sectional study including 569 postmenopausal women
showed a significant prevalence of osteoporosis with a poor
awareness of risk factors.
Methods Included in the study were 569 randomly selected
postmenopausal women (≥49 years of age). BMD was
measured in 505 subjects at the lumbar spine, femoral neck
and total hip using dual energy x-ray absorptiometry.
Awareness was evaluated using a special questionnaire.
Results Osteoporosis affected the lumbar spine, femoral
neck and total hip in 24%, 14% and 29.7% of subjects,
respectively. There was a significant negative correlation (p<0.001) between age and number of years since menopause
and BMD at all the sites evaluated. Conversely,
BMD increased at the three sites as weight, height and BMI
increased. There was a significant positive correlation
between BMD at the three sites and the physical characteristics
of the subjects (weight, height and BMI) (p<0.001 at the
hip and femoral neck, and p=0.05 at the lumbar spine). BMD
was higher at the lumbar spine and femoral neck among
subjects aware of the disease (0.893 and 0.746 g/cm2,
respectively) than among subjects unaware of the disease
(0.835 and 0.712 g/cm2, respectively). This investigation is
the first among Palestinian women in this region. It indicates
the urgent need for a comprehensive national programme to
reduce the incidence of osteoporosis.
Conclusion Postmenopausal osteoporosis is significant
among the Palestinian population and there is a poor
awareness of the risk factors.
Summary This study evaluated the association of vitaminD and
bone markers with the development osteoporosis in Palestinian
postmenopausal women. Even though vitamin D deficiency
was very high for the recruited subjects, it was not associated
with osteoporosis except for bones of the hip. Age and obesity
were the strongest determining factors of the disease.
Purpose The purpose of this study was to investigate the association
of bone mineral density (BMD) with serum vitamin
D levels, parathyroid hormone (PTH), calcium, obesity, and
bone turnover markers in Palestinian postmenopausal women.
Methods Three hundred eighty-two postmenopausal women
(≥45 years) were recruited from various women clinics for
BMD assessment (131 women had osteoporosis and 251 were
normal and served as controls). Blood samples were obtained
for serum calcium, PTH, 25(OH)D, bone formation (N-terminal
propeptide (PINP)), and bone resorption (serum Cterminal
telopeptide of type I collagen (CTX1)) markers.
Results Women with osteoporosis had statistically significant
lower mean weight, height, body mass index (BMI), and serum
calcium (p < 0.05) compared to controls. No significant
differences were detected between the mean values of bone
turnover markers (CTX and PINP), 25(OH)D, and PTH of
the two groups. Women with vitamin D deficiency (severe
and insufficiency) represented 85.9% of the study subjects.
Multiple and logistic regression showed that age and BMI
significantly affected BMD and vitamin D had a significant
association with BMD only at the lumbar spine. BMI was
positively correlated with BMD and PTH but negatively
correlated with vitamin D. Logistic regression showed that
the odds ratio (OR) for having osteoporosis decreased with
increasing BMI (overweight OR = 0.11, p = 0.053; obese
OR = 0.05, p = 0.007).
Conclusions There was no direct correlation between BMD
and PTH, bone turnover markers, and vitamin D except at the
lumbar spine. A negative correlation between BMD and age
and a positive correlation with BMI were observed. The protective
effect of obesity on osteoporosis was complicated by
the effect of obesity on vitamin D and PTH.