Introduction

Osteoporosis is a systemic skeletal disease characterised by low bone mass and microarchitectural deterioration of bone tissue with a consequent  increases in fragility and susceptibility to  fracture (1).
One of the most rapidly emerging global health problem in postmenopausal women is osteoporosis. In India osteoporosis is highly prevalent with an estimated  30 million women   diagnosed to have osteoporosis.(2)The prevalence of osteoporosis in India is high. Osteoporotic fractures are thought to occur early in Indian women. The proportion of elderly population is rapidly increasing in India. Aging population and postmenopausal women are concerned about problem, caused by osteoporosis. Osteoporosis is a silent epidemic, does not have dramatic clinical presentation except when fracture occurs.
Tools like DEXA  (dual energy X ray deabsorptiometry) can help screen those who would be more prone to osteoporosis enabling  us to manage them in a better way. It has helped us to improve Quality of life. Measurement of bone mineral content can help identify those who are  likely to develop osteoporosis. Keeping this in view the above study was undertaken to study BMD using bone densitometer.

Methods

This cross sectional study was conducted on a health camp organised in Bakshi ka Talaab, Lucknow.  All men and women who attended the  camp for general check up  at the station medicare centre were offered bone densitometry. Baseline dexa scans  were analysed and BMD of femur was measured by DEXA. The no. of  participants were 127 ,aged 20 years and above who attended the camp  .A standardised proforma was filled. Upon detection of osteoporosis/osteopenic, patients were referred for treatment .All participants belonged to middle socio economic strata. The instrument used was  DEXA .  Based on densitometer  readings, WHO  has set criteria for defining osteoporosis using T scores .T scores  describes bone mass of the patient compared to the mean peak bone men of the normal young adult reference population. The  results of BMD were classified as T-score as defined by WHO criteria(3) in to normal, osteoporotic  and osteopenic.
WHO CRITERIA;-
Normal (<-1SD)  A value of BMD that is below 1SD of young adult reference mean.
Osteopenia(>1--2.5SD) A value of BMD that is more than 1SD below the young adult mean but less than 2.5SD below this this value.
Osteoporosis(>2.5SD) A value of BMD that is 2.5SD or more below young adult mean.
Severe osteoporosis;- A value of BMD that is more than 2.5SD below young adult mean in  the presence of 1 or more fragility fracture .
Results were tabulated and analysed statistically

Results

Table 1

Age and Sex distribution of participants (n=127)

The above table (Table-1) showing age and sex distribution of the participants revealed that  in our study there were  81(63.77%) females and 46(36.22%) males.  Maximum  no.   ( 19.685%) of  subjects  were in the age group 36-50years  and only 1 person was above 60 years .Minimum age  group was 21-25 years.  There were 48.03%below 40 years  and 51.97% above 40 years

Table 2

Age wise distribution of Osteopenia  and Osteoporosis cases

The above table ( Table ll)  shows age wise distribution of osteopenic and osteoporosis cases reveals    that out of Osteoporotic  women, maximum(31.25%) were in age group of 46-50 years and  among osteopenic women,  26.56% were in age group of 36-40years age group.

Table 3

Distribution of male and female in different subgroups

The above table(table lll) showing distribution of male and female in different subgroups, shows that 37.00% had N BMD as per WHO criteria (T>-1SD),12.59% had osteoporosis (T<-2.5SD) and 50.39% had osteopenia(T<I SD to -2.5SD). Among  male patients ,N BMD was seen in 36.95% and among female patients in 63.83% cases.

Table 4

Frequency distribution of menopausal and nonmenopausal women

The above table (table4) shows that Out of 81 women, 62 (76.54%) were Non- Menopausal. Of the Osteoporotic women, 11.11%   Menopausal and of the  osteopenic women, 14.285% were menopausal. Among menopausal women,6 (31.5%) were osteopenic and 1 (5.2%) were Osteoporotic .In non-Menopausal 36 (58.06%) were osteopenic and 8 (12.09%) were

Table 5

 Age and Sex wise Distribution of cases with  abnormalormal BMD

(Abnormal=abnormal BMD includes both osteoporosis and osteopenia)
The above table ( table V ) shows that among females, Osteopenic and Osteoporosis started at an early age as compared to males. In females, in all age group, >40% showed  abnormal BMD, but in males abnormal BMD with >40% is seen in the 35-55 years age group.

Discussion

                          In the present, study there were  81 (63.77%) females and 46 (36.22%) males.  Maximum  no.   ( 19.685%)  of  subjects  were in the age group 36-50 years  and only 1 person was above 60 years. Minimum  age  group was 21-25 years.  There were 48.03%below 40years and 51.97%above 40years.
                            Out of Osteoporotic  cases, a maximum (31.25%) were in age group of 46-50 years and  among osteopenic cases,  26.56% were in age group of 36-40 years. This is in  contrast with study done by  H Rao (4), where Osteoporosis commenced in a younger age group (31-40) .
                          37.00% had N BMD as per WHO criteria (T>-1SD), 12.59% had osteoporosis (T<-2.5SD) and 50.39% had osteopenia(T<I SD to -2.5SD. Among  male patients , N BMD was seen in 36.95% and among female patients in 63.83% cases in a study done by H Rao (4).  In a study done by Gandhi A (5),58% women had N BMD, 34% had osteopenia and 8% had osteoporosis.
                             Once a women is  in her 4th decade, there is gradual loss of BMD. It is seen that there is considerable increase in bone loss immediately   following menopause. Out of 81 women, 62 (76.54%) were Non- Menopausal . Of the osteoporotic women, 11.11%   Menopausal and of the  osteopenic women, 14.3% were menopausal. Among menopausal women ,6(31.5%) were osteopenic and1 (5.2%) were Osteoporotic . In non-Menopausal 36(58.06%) were osteopenic and 8 (12.09%) were Osteoporotic. These findings point to other factors in the causation of osteopenia and osteoporosis in females.
                              Among females, Osteopenic and Osteoporosis started at an early age as compared to males. In females, in all age group, >40% showed  abnormal BMD, but in males abnormal BMD with >40% is seen in the 35-55 years age group

Acknowledgement

We give an especially high acknowledgement to all staff of Station Medicare Centre , Air Force Station, Lucknow where this study was carried out for their valuable assistance.