Bone health status of postmenopausal Chinese women

Objectives: To evaluate the prevalence of osteoporosis in treatment-naive postmenopausal women, their treatment adherence, and the risk factors for osteoporosis. Design: Cross-sectional study of bone density reports, a self-administered health checklist, and computerised consultation records. Setting: Primary care sexual and reproductive health service in Hong Kong. Participants: Postmenopausal Chinese women who had never received osteoporosis treatment or hormone replacement therapy. Intervention: Each woman completed a checklist of risk factors for osteoporosis, menopause age, history of hormone replacement therapy, and osteoporosis treatment prior to undergoing bone mineral density measurement at the postero-anterior lumbar spine and left femur. The consultation records of those with osteoporosis were reviewed to determine their treatment adherence. Main outcome measures: T-score at the spine and hip, presence or absence of risk factors for osteoporosis, and treatment adherence. Results: Between January 2008 and December 2011, 1507 densitometries were performed for eligible women; 51.6% of whom were diagnosed with osteopenia and 25.7% with osteoporosis. The mean age of women with normal bone mineral density, osteopenia, and osteoporosis was 57.0, 58.0, and 59.7 years, respectively. Approximately half of them had an inadequate dietary calcium intake, performed insufficient weight-bearing exercise, or had too little sun exposure. Logistic regression analysis revealed that age, body mass index of <18.5 kg/m(2), parental history of osteoporosis or hip fracture, and duration of menopause were significant risk factors for osteoporosis. Among those with osteoporosis, 42.9% refused treatment, 30.7% complied with treatment, and 26.3% discontinued treatment or defaulted from follow-up. Those who refused treatment were significantly older. Conclusions: Osteoporosis is prevalent in postmenopausal women. Only 50% adopted primary prevention strategies. Almost 70% refused treatment or stopped prematurely.