Assessment of the bone status of Nigerian women by ultrasound and biochemical markers

Ultrasound analysis of the calcaneus and serum markers of bone turnover wer e used to examine the bone status of healthy Nigerian women who reside in a n area of the world where dietary calcium intake is generally low and estro gen replacement therapy is not widely available. A total of 218 women (108 premenopausal and 110 postmenopausal) between the ages of 16 and 95 years w ere enrolled in the study. Broadband ultrasound attenuation (BUA) and speed of sound velocity (SOS) were measured and used to calculate the stiffness index (SI) of the calcaneus. In this cross-sectional study, the Nigerian wo men exhibited a marked age-dependent decline in SI that was defined by the regression equation SI = 105.9 - 6.62E-3 x Age(2). SI was significantly cor related with age (r = -0.41, P < 0.001) and with serum NTx concentrations ( r = -0.26, P < 0.001), but not with serum levels of bone-specific alkaline phosphatase (BSAP). Years since menopause was also significantly correlated with SI (r = 0.40, P < 0.001). A significant increase in serum NTx concent ration occurred at least a decade before a significant decline in SI was ev ident. In the total study group, 24% of the women had T-scores indicative o f osteopenia and 9% had T-scores indicative of osteoporosis, based on US re ference data. Although the reported current incidence of fracture is low in women in sub-Saharan West Africa, these data show that after menopause Nig erian women have a decline in bone quality and increase in bone turnover si milar to North American Caucasian women.