BONE-MINERAL DENSITY IN RELATION TO MEDICAL AND LIFE-STYLE RISK-FACTORS FOR OSTEOPOROSIS IN PREMENOPAUSAL, MENOPAUSAL AND POSTMENOPAUSAL WOMEN IN GENERAL-PRACTICE

Background. Interest in the prevention of osteoporosis is increasing a nd thus there is a need for an acceptable osteoporosis prevention prog ramme in general practice. Aim. A study was undertaken to identify a c ohort of middle-aged women attending a general practice who would be e ligible for a longitudinal study looking at bone mineral density, oste oporosis and the effectiveness of hormone replacement therapy. This st udy aimed to describe the relationship between medical and lifestyle r isk factors for osteoporosis and the initial bone density measurements in this group of women. Method. A health visitor administered a quest ionnaire to women aged between 48 and 52 years registered with a Belfa st general practice. The main outcome measures were menopausal status, presence of medical and lifestyle risk factors and bone mineral densi ty measurements. Results. A total of 358 women out of 472 (76%) took p art in the study which was conducted in 1991 and 1992. A highly signif icant difference was found between the mean bone mineral density of pr emenopausal, menopausal and postmenopausal women within the narrow stu dy age range, postmenopausal women having the lowest bone mineral dens ity. A significant relationship was found between body mass index and bone mineral density, a greater bone mineral density being found among women with a higher body mass index. Risk factors such as smoking and sedentary lifestyle were common (reported by approximately one third of respondents) but a poor relationship was found between these two an d all the other risk factors and bone mineral density in this age grou p. Conclusion. Risk of osteoporosis cannot be identified by the presen ce of risk factors in women aged between 48 and 52 years. In terms of a current prevention strategy for general practice it would be better to take a population-based approach except for those women known to be at high risk of osteoporosis: women with early menopause or those who have had an oophorectomy.