Bone mineral density among postmenopausal women in Basra
Abstract
Background and objective. Postmenopausal osteoporosis is an important public health problem associated with reduced bone mineral density (BMD) and increased fracture risk. Local data on BMD status among postmenopausal women in Basra remain limited. This study aimed to determine the prevalence of osteoporosis and osteopenia among postmenopausal women in Basra and to evaluate demographic and clinical factors associated with BMD status. Methodology. This cross-sectional study was conducted in Basra, Iraq, between September 2022 and September 2024. A total of 390 postmenopausal women aged 45-75 years were recruited from the outpatient clinic of Basrah Maternity and Child Hospital. Data on sociodemographic characteristics, reproductive history, lifestyle factors, and relevant clinical variables were collected using a structured questionnaire. BMD was assessed by dual-energy X-ray absorptiometry (DEXA) at the lumbar spine and femoral neck. Participants were classified as having normal BMD, osteopenia, or osteoporosis according to World Health Organization T-score criteria. Data were analysed using bivariate statistical tests, including chi-square tests for categorical variables and independent-samples t-tests for continuous variables. Results. Among the 390 postmenopausal women included in the study, 102 (26.1%) had osteoporosis, 63 (16.1%) had osteopenia, and 225 (57.7%) had normal BMD. Most participants were aged 50-60 years. Age, height, BMI, education level, smoking status, and physical activity did not differ significantly according to BMD status. Women with abnormal BMD had significantly lower body weight than women with normal BMD (64.3 ± 9.1 kg vs. 76.3 ± 7.2 kg; p < 0.001). Parity distribution differed significantly across BMD groups; however, high parity, defined as ≥5 pregnancies, was not significantly associated with abnormal BMD in the binary analysis (OR = 1.13; 95% CI: 0.51-2.54). BMD status was also associated with breastfeeding history and previous oral contraceptive use, although these findings should be interpreted cautiously because the analyses were not adjusted for potential confounding variables such as age and BMI. Conclusion. Osteoporosis and osteopenia were common among postmenopausal women attending Basrah Maternity and Child Hospital. Reproductive variables showed associations with BMD status in bivariate analyses, but the non-significant association between high parity and abnormal BMD, together with the absence of multivariable adjustment, prevents firm causal interpretation. Further longitudinal studies using adjusted analyses are needed to clarify the relationship between reproductive factors and bone health in this population.