Densitometric osteoporosis was identified in a relevant proportion of women younger than 65 years without traditional risk factors, supporting an individualized approach to bone health assessment.
Abstract
Osteoporosis is the most prevalent metabolic bone disease and is associated with an increased risk of fragility fractures. Current guidelines recommend bone mineral density (BMD) assessment by DXA primarily in women aged ≥65 years or in younger women with clinical risk factors. However, DXA is frequently performed in women under 65 years without guideline-based indications. Objective: To describe the prevalence of densitometric osteoporosis in women under 65 years undergoing DXA in the absence of clinical risk factors. Methods: A descriptive cross-sectional study was conducted at a referral center. Women aged 40–65 years consecutively referred for DXA between February and September 2024 were included. Participants with FRAX® clinical risk factors, major osteoporotic fractures, secondary metabolic bone diseases, or dietary restrictions were excluded. BMD was assessed at the lumbar spine, total hip, and femoral neck. Osteoporosis was defined as a T-score ≤ -2.5. Results: A total of 119 women were included (mean age 53 years; range 43-62). Mean T-scores were -0.9±1.3 at the lumbar spine, -0.9±1.1 at the total hip, and -1.0±1.0 at the femoral neck. BMD values within the osteoporotic range was observed in 13% (n=15) at the lumbar spine and in 7% (n=8) at both the total hip and femoral neck. Overall, 17% (n=20) had BMD values within the osteoporotic range at at least one skeletal site. Conclusion: Densitometric osteoporosis was identified in a relevant proportion of women younger than 65 years without traditional risk factors, supporting an individualized approach to bone health assessment.
ABSTRACT Abnormal bone mineral density (BMD), including osteopenia/low bone mass and osteoporosis, imposes a substantial clinical and socioeconomic burden on Chinese women. However, prevalence estimates vary markedly because primary studies differ in age composition, study setting, and the BMD outcome category reported. To systematically review and meta-analyze the prevalence of distinct BMD outcomes and the influencing factors associated with abnormal BMD among Chinese women aged 40 years and older. We searched nine international and Chinese databases from inception to July 10, 2025, for cross-sectional or case-control studies involving Chinese women aged 40 years or older. Prevalence was synthesized separately for abnormal BMD, osteopenia/low bone mass, and osteoporosis. Twenty-eight studies comprising 36,984 participants were included. Outcome-specific meta-analyses showed a pooled prevalence of 61 percent for abnormal BMD (95 percent CI: 50 percent-72 percent; n = 17,294), 41 percent for osteopenia/low bone mass (95 percent CI: 37 percent-46 percent; n = 19,032), and 29 percent for osteoporosis (95 percent CI: 23 percent-35 percent; n = 35,082). Heterogeneity remained substantial (I2 = 99.5 percent, 97.1 percent, and 99.1 percent). Postmenopausal status, menopause duration > 5 years, older age, BMI < 18 kg/m2, lack of exercise, low vitamin D intake, and fracture history were associated with higher odds of abnormal BMD, whereas regular exercise, dairy products, bean products, and calcium supplementation were protective. Abnormal BMD represents a substantial bone-health burden among Chinese women aged 40 years and older. Outcome-specific meta-analyses showed pooled prevalence estimates of 61 percent for abnormal BMD, 41 percent for osteopenia/low bone mass, and 29 percent for osteoporosis. Both non-modifiable susceptibility factors and potentially modifiable lifestyle and nutritional factors were associated with abnormal BMD. These findings support risk-based BMD assessment and targeted strategies addressing modifiable factors, including physical activity and adequate calcium and vitamin D intake, to promote bone health in middle-aged and older Chinese women.
Ming-Yue Jia, Ting-Zhi Chen, Shu-Wei Zhang et al.· Women & health· 0 citations
Background/aim Osteoporosis and sarcopenia are diseases of bone and muscle tissue, respectively. Studies reported that these disorders were interrelated. However, this relation was explored in older adults and/or with certain comorbidities, and information about nonelderly postmenopausal women is scarce. This study’s objectives were to investigate the relationship between osteoporosis and SARC-F-defined sarcopenia risk in postmenopausal women aged ≤70 years and to examine the effect of other factors on this risk. Materials and methods This multicenter case-control study included postmenopausal women aged 45–70 years. Dual-energy X-ray absorptiometry was utilized to diagnose osteoporosis. Sociodemographic and clinical variables, sarcopenia risk (SARC-F), muscle strength (grip strength and five-times sit-to-stand test: 5T-STS), and physical activity levels (International Physical Activity Questionnaire-Short Form) were compared between osteoporotic and nonosteoporotic participants. Results A total of 119 osteoporotic (median age: 58 years) and 119 nonosteoporotic (median age: 59 years) participants were recruited. No differences were observed between the osteoporotic and nonosteoporotic groups regarding SARC-F-defined sarcopenia risk (48.7% vs. 38.7%, p = 0.117), probable sarcopenia (14.5% vs. 15.3%, p = 0.876), grip strength (23 vs. 22 kg, p = 0.329), 5T-STS (13.90 vs. 13.96 s, p = 0.986), or physical activity levels (907.5 vs. 792 MET-min/week, p = 0.983). Although educational level [odds ratio (OR): 0.366, 95% confidence interval (CI): 0.189–0.707, p = 0.003], proton pump inhibitor (PPI) use (OR: 2.494, 95% CI: 1.227–5.068, p = 0.012), and physical activity level (OR: 0.966, 95% CI: 0.945–0.988, p = 0.003) were independent predictors of SARC-F-defined sarcopenia risk, osteoporosis was not (p = 0.176). Conclusion SARC-F-defined sarcopenia risk was not increased in women with postmenopausal osteoporosis aged ≤70 years compared to nonosteoporotic controls. Lower educational status, PPI use, and low physical activity levels were associated with an increased SARC-F-defined sarcopenia risk.
B. K. Turan, A. Küçükdeveci, Z. Günendi et al.· Turkish Journal of Medical S...· 0 citations
Effective care in cases of male osteoporosis requires an integrated risk-based approach that extends beyond BMD to include clinical risk factors, secondary causes, and functional status, and improved recognition and sex-specific management strategies are essential to reduce the fracture burden and improve long-term outcomes in men.
Selin Tekin, A. Gürlek· Turkish Journal of Medical S...· 0 citations
INTRODUCTION
Osteoporotic vertebral fractures (OVFs) are a major cause of morbidity in older adults, leading to pain, disability, and decreased quality of life. Although osteoporosis is traditionally associated with women, men also experience substantial morbidity and mortality after fractures. However, the mechanisms underlying sex differences in OVF remain unclear. This study aimed to investigate sex differences in comorbidities, bone mineral density (BMD), nutritional status, and MRI findings in patients with OVF.
METHODS
We retrospectively analyzed 492 patients (126 men and 366 women) hospitalized for OVF between 2015 and 2021. Clinical data, including comorbidities, BMD, Prognostic Nutritional Index (PNI), and MRI signal patterns, were collected. MRI patterns were classified into low- and high-risk groups for delayed bone union. Multivariate logistic regression analysis was performed to identify independent factors associated with high-risk MRI patterns.
RESULTS
Men had a significantly higher prevalence of cardiac, renal, and brain disorders, as well as malignancy, compared with women. Men also had significantly higher BMD but lower PNI values. High-risk MRI patterns were more frequent in men in univariate analysis (41.3% vs. 30.0%, p = 0.039). However, multivariate logistic regression analysis revealed that PNI was independently associated with high-risk MRI patterns (OR 0.943 per point increase, 95% CI 0.902-0.986, p = 0.0098), whereas sex was not.
CONCLUSIONS
Poor nutritional status was independently associated with high-risk MRI patterns in patients with OVF. The observed sex differences in acute radiological risk may be partially explained or mediated by differences in baseline nutritional status rather than biological sex itself.
Tatsuya Yasuda, Junichiro Sarukawa, Kaoru Yamazaki et al.· Journal of Orthopaedic Scien...· 0 citations
The model integrates LS-BMD T-score, fall risk, Vitamin D, testosterone, testosterone, and glucocorticoid use, but external validation is required before clinical application, but decision curve analysis confirmed clinical net benefit.
Yi-You Fang, Liang Zhang, Gang Dong et al.· Orthopedic Research and Revi...· 0 citations
In postmenopausal women, higher BMI was associated with higher BMD but lower TBS, supporting a divergent relationship between densitometric findings and DXA-derived trabecular texture parameters, and suggesting that TBS may complement BMD in describing skeletal imaging status in overweight and obese women.
Robert Bot, S. Cavalu· Medicina· 0 citations
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