Ayfer Gemalmaz

Knowledge and awareness about osteoporosis and its related factors among rural Turkish women

The aim of this study is to evaluate the awareness, perception, sources of information, and knowledge of osteoporosis in a sample of rural Turkish women, to examine the factors related to their knowledge, and organize effective education programs. A total of 768 women mean age 53.6 ± 8.2 (40–70) were randomly selected and interviewed during their visits to primary care centers in three rural towns in West Anatolia. A structured questionnaire was administered by trained nurses. Chi-squared test was performed in age and educational level groups for revealing factors influencing the awareness, perception, and knowledge sources of osteoporosis. One-way analysis of variance (ANOVA) analysis was carried out in calculating the difference of knowledge scores among groups. Of the women, 60.8% had heard of and 44.9% had the correct definition for osteoporosis. Awareness and accurate definition of osteoporosis was high in younger and high educated women (p < 0.001). Television was the main source of knowledge with the rate of 55%, doctors and nurses/midwives were the second and third sources, respectively. Osteoporosis knowledge was low with a mean score of 5.52 out of 20. Younger and more educated women had higher knowledge scores. Low calcium in diet and menopause were the first two risk factors chosen for osteoporosis. Knowledge about osteoporosis among rural Turkish women is low, and majority of women are unaware of the risk factors and consequences of osteoporosis. Therefore, appropriate educational programs should be planned according to community needs, and the target of these programs should be less educated and older women.

Identifying osteoporosis in a primary care setting with quantitative ultrasound: relationship to anthropometric and lifestyle factors

Dual-energy X-ray absorptiometry (DXA), the “gold standard” for diagnosis of osteoporosis, is not recommended for population screening, and thus quantitative ultrasound (QUS) of the calcaneus is gaining popularity. The aim of the present study was to evaluate the relationship between QUS values and anthropometric and lifestyle factors, and to assess the diagnostic performance of QUS in predicting DXA-defined osteoporosis. Eight hundred and thirty-two women and 87 men aged 40–88 years were included in the study. Anthropometric measurements, the questionnaire, and QUS and DXA measurements were performed by trained physicians. Both QUS and DXA T-scores were lower for women than for men. Postmenopausal women had significantly lower QUS T-scores compared to premenopausal women (P < 0.001). Age over 50, female sex, sedentary lifestyle, fracture history, presence of chronic disease, and ≥5 years since menopause were associated with QUS T-scores lower than −1.00 by multivariate analysis. Low QUS T-scores were related to lack of direct sun exposure, high parity, fair skin color, and no education by univariate analysis (P < 0.005). A weak correlation was found between calcaneal QUS and DXA T-scores at lumbar spine (r = 0.310, P < 0.001) and femoral neck (r = 0.288, P < 0.001). The sensitivity and specificity of the QUS test were 73.7% and 57.4%, respectively, regarding the identification of osteoporotic patients. Lower QUS T-scores were associated with several osteoporotic risk factors, and the sensitivity and specificity of QUS for predicting DXA-defined osteoporosis were at optimum values at ages between 50 and 59 years. We conclude that, even though the accuracy of QUS for predicting DXA-defined osteoporosis is not remarkably high, it can be applied to identify subjects at risk in this age group in developing countries and rural districts who should be the focus of fracture prevention.