Educational difference in the prevalence of osteoporosis in postmenopausal women: a study in northern Iran

BMC Public Health

M Karandish²  SH Sharami¹  M Maddah² 

[1] Department of Gynecology, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran;Nutrition Research Center, Ahvaz Jundishapur University of Medical Sciences, P.O. Box: 41635-3197, Ahvaz, Rasht-Iran, Iran

关键词: Postmenopausal women;    Osteoporosis;    Educational levels;   

Others  :  1164091
DOI  :  10.1186/1471-2458-11-845

 received in 2011-03-28, accepted in 2011-11-03,  发布年份 2011

【 摘 要 】

Background

Osteoporosis is the most common metabolic bone disease in the world and it is rapidly increasing in Iran. In this study the relationship between educational levels and osteoporosis was investigated among Iranian postmenopausal women.

Method and subjects

Seven hundred and six women aged 50-75 years old were randomly recruited from urban (n = 440) and rural (n = 266) areas in Guilan. Osteoporosis was diagnosed by quantitative ultrasound technique and dual X-ray absorptiometry. Serum 25(OH) D3, body weight and height were measured in all subjects. Other data including age, educational level, menopause age, medications and history of illness were also collected.

Results

We found that the prevalence of osteoporosis was significantly greater among women with low educational level than women with high educational status (18.0% vs 3.8% P < 0.0001). However, women with low educational level had higher mean serum level of vitamin D than women with high educational level. Osteoporosis was significantly more prevalent among women living in rural areas than women living in urban areas (19.1% v.s 13.3%, P < 0.0001).

Conclusion

This study showed that educational level is associated with bone health in this population of postmenopausal women with significantly higher osteoporosis found in lower social groups. Therefore, we suggest that women with low social level should be carefully evaluated for signs of osteoporosis during routine physical examinations.

【 授权许可】

   
2011 Mohsen Maddah; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Cauley JA, Thompson DE, Ensrud KC, Scott JC, Black D: Risk of mortality following clinical fractures. Osteoporos Int 2000, 11:556-561.
• [2]Norris RJ: Medical costs of osteoporosis. Bone 1992, 13(suppl 2):S11-S16.
• [3]Melton LJ: 3rd Adverse outcomes of osteoporotic fractures in the general population. J Bone Miner Res 2003, 18:1139-1141.
• [4]Winkleby MA, Fortmann SP, Barrett DC: Social class disparities in risk factors for disease: eight-year prevalence patterns by level of education. Prev Med 1990, 19:1-12.
• [5]Adler NE, Ostrove JM: Socioeconomic status and health: what we know and what we don't. Ann N Y Acad Sci 1999, 896:3-15.
• [6]Larijani B, Hossein-Nezhad A, Mojtahedi A, Pajouhi M, Bastanhagh MH, Soltani A, Mirfezi SZ, Dashti R: Normative data of bone mineral density in healthy population of Tehran, Iran: a cross sectional study. BMC Musculoskelet Disord 2005, 6:38. BioMed Central Full Text
• [7]Amiri M, Nabipour I, Larijani B, Beigi S, Assadi M, Amiri Z, Mosaghzadeh S: The relationship of absolute poverty and bone mineral density in postmenopausal Iranian women. Int J Public Health 2008, 53:290-296.
• [8]Hejazi J, Mohtainia J, Kolahi S, Ebrahimi-Mamaghani M: Nutritional status among postmenopausal osteoporotic women in north west of Iran. Asian Pac J Clin Nutr 2009, 18:48-53.
• [9]Sharami SH, Milani F, Alizadeh A, Ranjbar ZA, Shakiba M, Mohammadi A: Risk factors of osteoporosis in women over 50 years of age: a population based study in the north of Iran. J Turkish-German Gynecol Assoc 2008, 9:38-44.
• [10]Kanis JA, Melton LJ, Christiansen C, Johnston CC, Khaltaev N: The diagnosis of osteoporosis. J Bone Miner Res 1994, 9:1114-1137.
• [11]Winkleby MA, Jatulis DE, Frank E, Fortmann SP: Socioeconomic status and health: how education, income, and occupation contribute to risk factors for cardiovascular disease. Am J Public Health 1992, 82:816-820.
• [12]Leslie WD, McWilliam L, Finlayson GS, Reed M: The effect of socioeconomic status on bone density testing in a public heath-care system. Osteoporosis Int 2007, 18:153-8.
• [13]Brennan SL, Pasco JA, Urguhart DM, Oldenburg B, Wang Y, Wluka AE: Association between socioeconomic status and bone mineral density in adults: a systematic review. Osteoporosis Int 2011, 22:517-527.
• [14]National assessment of iron, zinc, calcium, vitamin A and vitamin D in different age groups, 2001 In Final report of national survey. Tehran: Iranian Ministry of Health; 2005. [in Farsi]
• [15]Maddah M, Sharami SH: Intake of calcium/vitamin D in Iranian postmenopausal women. Arch Osteoporosis 2009, 4:95-96.