Background: Osteoporosis and menopausal women’s health had paucity data from Africa, especially Sub-Saharan countries. The current study aimed to assess the relationship between lipid profile, atherogenic Index of Plasma (AIP), anthropometric measurements, and the risk of cardiovascular disease (CVD) among osteoporotic Sudanese postmenopausal women.Methods: An epidemiological, cross-sectional comparative, community-based study was conducted. Postmenopausal women (n = 300), aged 47- 90 years, with an average one year postmenopause, were recruited from various centers in Khartoum State. Dual-energy X-ray absorptiometry (DEXA) was used to assess bone density. DEXA scan was interpreted in terms of T-score as per World Health Organization guidelines. Weight, height, and waist circumference were measured twice following standard protocols. In addition, fasting blood samples (5ml) were collected for the determination of total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C). AIP was calculated as an indicator for CVD risk. Blood samples were assayed on the Roche/Hitachi Cobas c311 system (Roche Diagnostics GmbH, Germany). Statistical analysis was carried out using SPSS version 26. Results: The mean age of the postmenopausal women was 61.7±10.3 years, with 80 women having normal T-score and an equal number of osteoporotic and osteopenic (n = 110 each). Most women (59%) aged 47-64 years. The prevalence of osteoporosis was 36.7%. Many postmenopausal women with normal BMD suffered from general (68%) and central obesity (94%) compared with their counterparts. Hypercholesterolemia, hypertriglyceridemia, high LDL-C, hypo-HDL-C were identified among 26.4%, 31%, 16.3%, and 32.7% osteoporotic women respectively. Osteoporotic postmenopausal (36.4%) women had medium to high risk of CVD according to their AIPs. There was a significantly inverse correlation between age and HDL-C (r= -0.205; p=0.032) whereas positive association between AIP and TC (r=0.230; p=0.016), among osteoporotic women. Osteoporotic (52%) and osteopenic (42%) women had ≥2 CVD risk factors. Multiple Linear regression analysis showed T-score value decreased significantly with age and AIP and increased with BMI. Conclusion: Osteoporosis is prevalent among Sudanese postmenopausal women who are at increased risk for CVD. Necessary steps are needed for public education and wider dissemination of information about osteoporosis, CVD and their prevention.
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