Osteoporosis in Black South African Women: Myth or Reality

Abstract

Aim The study was conducted to ascertain the severity of the occurrence of osteopenia and osteoporosis among black South African women during their transition from premenopause to postmenopause. Materials and methods Sixty-eight black South African women, aged between 32 and 77 years, residents of three districts of Pretoria, South Africa, constituted the participants in the study. Following informed consent, the women were randomly recruited and assessed for age, medical history, and lifestyle data. Each woman was classified as being premenopause, perimenopause, or postmenopause based on her menstrual history within the preceding 12 months to the study. Bone mineral density (BMD) of the L1-L4 vertebrae and the hip vertebrae was measured using dual-energy X-ray absorptiometry (DEXA) method and the results were expressed as T-scores based on World Health Organization (WHO) classifications for osteopenia and osteoporosis. Results Osteopenia was found in 2 of the 8 (25%) premenopausal women aged 37 and 38 years. Similarly, 2 perimenopausal women out of the 28 (7.1%), aged 45 and 49 years, also had evidence of osteopenia. Among 32 postmenopausal women, 11 (34.4%) had osteopenia and 8 (25%) were diagnosed with osteoporosis. There was no statistical significant difference (p = 0.0832) for osteopenia between premenopausal and perimenopausal women. However, the incidence of osteopenia became statistically significant between premenopausal and postmenopausal women (p = 0.0137), and between perimenopausal and postmenopausal women (p = 0.0218). Conclusion Even from this small cohort study, it is apparent that osteoporosis does afflict postmenopausal black South African women. The need to institute screening strategies and appropriate guidance to prevent osteoporosis in these women is strongly advocated. Clinical significance The study draws special attention to the necessity to investigate black South African women for early detection of osteopenia and osteoporosis. How to cite this article Matsela L, Towobola O, Mokgokong ET. Osteoporosis in Black South African Women: Myth or Reality. J South Asian Feder Menopause Soc 2017;5(2):111-116. Source of support The authors herewith express their gratitude to both MSD (South Africa) and the South African Menopause Society for their financial donations, which enabled the DEXA evaluations of participants in this study.

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“…We have shown that, as in other populations globally, ( 41 ) black South African women transitioning through menopause experience substantial declines in BMD across all skeletal sites, and those transitioning into or who are in postmenopause exhibit the greatest losses. Our data add to the findings of a small cross‐sectional study of 68 black South African women that showed that postmenopausal women had lower LS and hip BMD than pre‐ or perimenopausal women ( 42 ) and earlier results from 709 black South African women in Soweto, from which this follow‐up cohort was derived, which found lower TB BMD in postmenopausal than pre‐ or perimenopausal women. ( 43 ) Our data are novel in their longitudinal nature in SSA.…”