Prevalence of Osteoporosis by Educational Level in a Cohort of Postmenopausal Women

Abstract

To evaluate whether the prevalence of osteoporosis and related risk factors might be influenced by the level of education, as has been demonstrated for many other chronic diseases, 6160 postmenopausal women at their first densitometric referral were interviewed about reproductive variables, past and current use of estrogens, prevalence of chronic diseases, and lifestyle factors such as calcium intake, physical activity, smoking and overweight. This sample was stratified by years of formal education. Densitometric evaluation was performed by dual-energy X-ray absorptiometry. Age at menarche, past exposure to oral contraceptives, use of hormone replacement therapy, prevalence of chronic diseases, physical activity, overweight and smoking showed significant trends according to the years of education. The prevalence of osteoporosis showed an inverse relationship with level of education, ranging from 18.3% for the most educated to 27.8% for the least educated women. Multiple logistic regression analysis demonstrated a predictive role toward osteoporosis by age, age at menarche and menopause, hormone replacement therapy, calcium intake, physical activity and body mass index. Using the lowest educational level as reference category, increases in educational status were associated with a significantly reduced risk for osteoporosis (OR = 0.76, 95% CI 0.65-0.90 for 6-8 years of schooling; OR = 0.68, 95% CI 0.57-0.82 for 9 years or more). This study shows differences in the prevalence of osteoporosis among educational classes and the protective role played by increases in formal education. If these results are confirmed in other population studies, public health intervention programs will have to consider the socioeconomic and cultural background of the population strata that run a greater risk of osteoporosis.

Deleterious Effect of Late Menarche on Distal Tibia Microstructure in Healthy 20-Year-Old and Premenopausal Middle-Aged Women

“…Late menarche is associated with low bone mass at several sites of the skeleton in both premenopausal (1)(2)(3) and postmenopausal women. (4)(5)(6)(7) These findings are supported by observations that late pubertal maturation is linked to an increased risk of vertebral and nonvertebral fragility fractures. (8)(9)(10)(11) Retrospective epidemiological studies have shown that the inverse relationship between bone mineral mass or density and age of menarche seen in premenopausal women has generally been ascribed to the duration of sex hormone exposure up to the time of peak bone mass.…”

Coffee Consumption Might Reduce the Risk of Osteopenia/Osteoporosis in Premenopausal Taiwanese Women

“…Education above college level was shown to be preventive against osteoporosis/osteopenia among the premenopausal women involved in the current study. This was consistent with some previous studies where higher educational level had a protective role on osteoporosis [25,26,27,28]. Education plays a good role in bringing awareness to individuals about most diseases and their risk factors.…”

Fracture risk among First Nations people: a retrospective matched cohort study

“…Socioeconomic status has been identified as a factor in hip fractures. [13][14][15] Hip fractures are also reported to be more common in urban areas 16,17 and more northern latitudes. 18 Diabetes is a significant risk factor for fractures, 19,20 and any putative benefit of type 2 diabetes in terms of enhanced bone mass appear to be overwhelmed by other adverse consequences of this disorder.…”