Levels of Knowledge, Beliefs, and Practices Regarding Osteoporosis and the Associations with Bone Mineral Density among Populations More Than 40 Years Old in Malaysia

Chan, Chin Yi; Subramaniam, Shaanthana; Chin, Ken Min; Soelaiman, Ima Nirwana; Muhammad, Norliza; Ahmad, Fairus; Ng, Pei Yuen; Jamil, Nor Aini; Aziz, Nor Azlina Abd; Mohamed, Norazlina

doi:10.3390/ijerph16214115

Cited by 35 publications

(36 citation statements)

References 50 publications

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“…Based on sex, the prevalence of osteoporosis was 8.4% for men and 16.1% for women. Since the characteristics of the subjects have been described in previous reports [17], they are not tabulated in this paper.…”

Section: Resultsmentioning

confidence: 99%

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Determinants of Bone Health Status in a Multi-Ethnic Population in Klang Valley, Malaysia

Chan

Subramaniam

Mohamed

et al. 2020

IJERPH

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Background and objectives: Studies on osteoporosis risk factors are limited in Malaysia, so this study assesses the factors associated with bone health assessed using dual-energy X-ray absorptiometry (DXA) among Malaysians aged ≥40 years. Subjects and Methods: Data on demography, medical history, dietary and lifestyle practices of 786 Malaysians (51.4% women) aged ≥40 years recruited in Klang Valley were obtained. Their body composition and bone health were determined using DXA. The association between risk factors and bone health status was assessed using binary logistic regression. Results: The prevalence of suboptimal bone health and osteoporosis was higher in women (59.4% and 16.1%) than men (40.8% and 8.4%). Overall, the predictors of suboptimal bone health and osteoporosis among the subjects were increased age and higher fat mass. Lower monthly income was positively associated with osteoporosis. Being menopausal was a risk factor for both suboptimal bone health and osteoporosis in women. Women with no formal education were more likely to get osteoporosis. Being a smoker and Chinese were positively related to suboptimal bone health among men. Meanwhile, predictors of osteoporosis among men were regular alcohol and dairy product consumption, higher fat mass and having a tertiary education. Conclusions: This study calls for immediate and effective interventions for middle-aged and elderly populations with risk factors to halt the progression of bone loss.

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Section: Resultsmentioning

confidence: 99%

“…The current study is a part of a larger population study using the same cohort of subjects, and the protocol of the study has been described in previous publications [15,17]. This cross-sectional study was conducted in Klang Valley, Malaysia from April 2018 to April 2019.…”

Section: Methodsmentioning

confidence: 99%

Determinants of Bone Health Status in a Multi-Ethnic Population in Klang Valley, Malaysia

Chan

Subramaniam

Mohamed

et al. 2020

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“…This cross-sectional study was conducted from April 2018 to April 2019 in Klang Valley, Malaysia. The protocol of the main study has been described previously [27][28][29]. Community-living Malaysian subjects aged ≥40 years were recruited using quota sampling technique, whereby subjects were stratified based on the demographic population in Klang Valley, which is 45% Malays, 45% Chinese and 10% Indians and other ethnic groups [30].…”

Section: Methodsmentioning

confidence: 99%

The Performance of a Calcaneal Quantitative Ultrasound Device, CM-200, in Stratifying Osteoporosis Risk among Malaysian Population Aged 40 Years and Above

et al. 2020

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Background: Calcaneal quantitative ultrasound (QUS) is widely used in osteoporosis screening, but the cut-off values for risk stratification remain unclear. This study validates the performance of a calcaneal QUS device (CM-200) using dual-energy X-ray absorptiometry (DXA) as the reference and establishes a new set of cut-off values for CM-200 in identifying subjects with osteoporosis. Methods: The bone health status of Malaysians aged ≥40 years was assessed using CM-200 and DXA. Sensitivity, specificity, area under the curve (AUC) and the optimal cut-off values for risk stratification of CM-200 were determined using receiver operating characteristic (ROC) curves and Youden’s index (J). Results: From the data of 786 subjects, CM-200 (QUS T-score <−1) showed a sensitivity of 82.1% (95% CI: 77.9–85.7%), specificity of 51.5% (95% CI: 46.5–56.6%) and AUC of 0.668 (95% CI: 0.630–0.706) in identifying subjects with suboptimal bone health (DXA T-score <−1) (p < 0.001). At QUS T-score ≤−2.5, CM-200 was ineffective in identifying subjects with osteoporosis (DXA T-score ≤−2.5) (sensitivity 14.4% (95% CI: 8.1–23.0%); specificity 96.1% (95% CI: 94.4–97.4%); AUC 0.553 (95% CI: 0.488–0.617); p > 0.05). Modified cut-off values for the QUS T-score improved the performance of CM-200 in identifying subjects with osteopenia (sensitivity 67.7% (95% CI: 62.8–72.3%); specificity 72.8% (95% CI: 68.1–77.2%); J = 0.405; AUC 0.702 (95% CI: 0.666–0.739); p < 0.001) and osteoporosis (sensitivity 79.4% (95% CI: 70.0–86.9%); specificity 61.8% (95% CI: 58.1–65.5%); J = 0.412; AUC 0.706 (95% CI: 0.654–0.758); p < 0.001). Conclusion: The modified cut-off values significantly improved the performance of CM-200 in identifying individuals with osteoporosis. Since these values are device-specific, optimization is necessary for accurate detection of individuals at risk for osteoporosis using QUS.

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“…This study is a part of the cohort study investigating the bone health of Malaysians living in Klang Valley, Malaysia [8,[13][14][15]. This cross-sectional study initially recruited 786 community-living Malaysians aged ≥40 years living in Klang Valley, Malaysia using quota sampling technique.…”

Section: Study Populationmentioning

confidence: 99%

Development of Osteoporosis Screening Algorithm for Population Aged 50 Years and above in Klang Valley, Malaysia

Subramaniam

Chan

Soelaiman

et al. 2020

IJERPH

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Background: The current osteoporosis screening instruments are not optimized to be used among the Malaysian population. This study aimed to develop an osteoporosis screening algorithm based on risk factors for Malaysians. Methods: Malaysians aged ≥50 years (n = 607) from Klang Valley, Malaysia were interviewed and their bone health status was assessed using a dual-energy X-ray absorptiometry device. The algorithm was constructed based on osteoporosis risk factors using multivariate logistic regression and its performance was assessed using receiver operating characteristics analysis. Results: Increased age, reduced body weight and being less physically active significantly predicted osteoporosis in men, while in women, increased age, lower body weight and low-income status significantly predicted osteoporosis. These factors were included in the final algorithm and the optimal cut-offs to identify subjects with osteoporosis was 0.00120 for men [sensitivity 73.3% (95% confidence interval (CI) = 54.1%–87.7%), specificity 67.8% (95% CI = 62.7%–85.5%), area under curve (AUC) 0.705 (95% CI = 0.608–0.803), p < 0.001] and 0.161 for women [sensitivity 75.4% (95% CI = 61.9%–73.3%), specificity 74.5% (95% CI = 68.5%–79.8%), AUC 0.749 (95% CI = 0.679–0.820), p < 0.001]. Conclusion: The new algorithm performed satisfactorily in identifying the risk of osteoporosis among the Malaysian population ≥50 years. Further validation studies are required before applying this algorithm for screening of osteoporosis in public.

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Levels of Knowledge, Beliefs, and Practices Regarding Osteoporosis and the Associations with Bone Mineral Density among Populations More Than 40 Years Old in Malaysia

Cited by 35 publications

References 50 publications

Determinants of Bone Health Status in a Multi-Ethnic Population in Klang Valley, Malaysia

Determinants of Bone Health Status in a Multi-Ethnic Population in Klang Valley, Malaysia

The Performance of a Calcaneal Quantitative Ultrasound Device, CM-200, in Stratifying Osteoporosis Risk among Malaysian Population Aged 40 Years and Above

Development of Osteoporosis Screening Algorithm for Population Aged 50 Years and above in Klang Valley, Malaysia

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