Abstract
Background: Poverty is associated with a great number of diseases, but the prevalence of quality alterations of the bone, measured by trabecular bone score and quantitative ultrasounds and its association to osteoporosis and fragility fractures are less well known.
Objective: To evaluate the associations between poverty, bone quality and fragility fractures in a population of Southern European postmenopausal women.
Method: Cross-sectional study was carried out in 762 postmenopausal Caucasian Spanish women. The socio-economic status of the participants was determined after a personal interview, according to the criteria of the Spanish Institute of Statistics. Participants were divided into two socio-economic levels: low (poverty) and medium or high socioeconomic level. The study protocol included a health questionnaire, a complete physical examination, lateral radiograph of the dorsal and lumbar spine and measurement of bone mineral density (BMD) at the lumbar spine (L2-L4) and proximal femur, trabecular bone score (TBS) at the lumbar spine and Quantitative ultrasounds at the heel.
Results: Low socio-economic status was associated with lower values of TBS at the lumbar spine and also lower values of QUS (QUI and BUA) after adjusting by age and BMI. Poverty was also associated with a higher prevalence of all type of fragility fractures: vertebral, hip fracture and some non-vertebral: Colles´, Humerus and tibia but not to ribs fractures.
Conclusions: Poor postmenopausal Caucasian Spanish women have a high prevalence of osteoporosis and osteoporotic fractures. Poverty was associated with older age and higher BMI and lower values of TBS and QUS could reflect a worse bone quality.
Keywords
Poverty, Bone quality, Quantitative ultrasound, Trabecular bone score, Fragility fractures, Postmenopausal, Caucasian Spanish women