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LETTERS TO EDITOR
Year : 2019  |  Volume : 8  |  Issue : 4  |  Page : 288

Low bone mineral density and its risk factors in an urban adult population of South India


Department of Paediatrics, Al-Kindy College of Medicine, University of Baghdad, Baghdad, Iraq

Date of Submission02-Mar-2019
Date of Acceptance10-Sep-2019
Date of Web Publication15-Oct-2019

Correspondence Address:
Prof. Mahmood Dhahir Al-Mendalawi
Department of Paediatrics, Al-Kindy College of Medicine, University of Baghdad, P.O. Box 55302, Baghdad Post Office, Baghdad
Iraq
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijhas.IJHAS_8_19

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How to cite this article:
Al-Mendalawi MD. Low bone mineral density and its risk factors in an urban adult population of South India. Int J Health Allied Sci 2019;8:288

How to cite this URL:
Al-Mendalawi MD. Low bone mineral density and its risk factors in an urban adult population of South India. Int J Health Allied Sci [serial online] 2019 [cited 2019 Nov 19];8:288. Available from: http://www.ijhas.in/text.asp?2019/8/4/288/269253



Sir,

I read the interesting study by Sharma et al.[1] published in January–March 2019 issue of the International Journal of Health & Allied Sciences. The authors studied bone mineral density (BMD) and its risk factors in an urban adult population of South India. They used quantitative ultrasound (QUS) of right tibia, and T-scores for the speed of sound (SOS) were obtained to define normal or low BMD status. They found prevailing low BMD in the studied population. Women were affected with osteoporosis and osteopenia earlier than men, and significant associations were found with increasing age in both genders.[1] They postulated that BMD loss appeared to begin at young ages, and they suggested the need for early institution of preventive measures.[1] Apart from few limitations addressed by the authors, I presume that the following methodological limitation might cast additional suspicions on the accuracy of the study results. The authors mentioned in the methodology that the World Health Organization (WHO) recommendations for T-score, based on densitometer readings, were used for classifying BMD status. T-score >−1 was considered normal, while <−1 was considered as low BMD; T-score from −1 to −2.5 was considered osteopenia, whereas <−2.5 was considered osteoporosis.[1] It is worthy to mention that the WHO introduced the definition criteria of osteoporosis and osteopenia using T-scores in 1994. Importantly, certain concerns were triggered on the precision of the use of the WHO T-score thresholds of −2.5 for osteoporosis and −1.0 for osteopenia. This might be related to the inappropriateness of these definition criteria at skeletal sites other than the spine, hip, and forearm or when other modalities, such as QUS, are employed.[2],[3] In a British study, evaluating the age dependence of T-scores for SOS estimations at the radius, tibia, phalanx, and metatarsal to determine the prevalence of osteoporosis and osteopenia at these sites by the use of the WHO criteria revealed interesting results. The study showed that the WHO definition criteria were not suitable for use with SOS measurements, and the revised T-score thresholds for the diagnosis of osteoporosis of −2.6, −3.0, −3.0, and −2.2 and for osteopenia of −1.4, −1.6, −2.3, and −1.4, for the radius, tibia, phalanx, and metatarsal, respectively, were suggested.[3] Despite the study limitations, assessment of BMD status remains critical to improve strategies in detecting and counteracting osteopenia and osteoporosis in vulnerable populations like the Indian population.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Sharma PK, Sriram S, Krishna A, Gandhi A, Ganguly E. Low bone mineral density and its risk factors in an urban adult population of South India. Int J Health Allied Sci 2019;8:61-7.  Back to cited text no. 1
  [Full text]  
2.
Frost ML, Blake GM, Fogelman I. Can the WHO criteria for diagnosing osteoporosis be applied to calcaneal quantitative ultrasound? Osteoporos Int 2000;11:321-30.  Back to cited text no. 2
    
3.
Knapp KM, Blake GM, Spector TD, Fogelman I. Can the WHO definition of osteoporosis be applied to multi-site axial transmission quantitative ultrasound? Osteoporos Int 2004;15:367-74.  Back to cited text no. 3
    




 

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