Risk of low bone density in women attending menopause clinics in Italy

NOTA IMPORTANTE: Autore dello studio è il “Progetto Menopausa Italia Study Group”. Umberto Omodei è Coordinatore Nazionale, membro dello Steering Committee e partecipante al Progetto. La pubblicazione riporta come co-autori l’elenco dei partecipanti suddivisi per incarico specifico. La pubblicazione non viene quindi individuata automaticamente inserendo il nome dell’autore nei motori di ricerca in rete. Il Progetto Menopausa Italia, del quale Umberto Omodei è co-fondatore, è un grande studio epidemiologico che aveva come obiettivo la raccolta di informazioni sulla menopausa e le condizioni cliniche correlate, basato su un network nazionale connesso in rete di 268 Centri per la Menopausa, con circa 1.500 operatori sanitari coinvolti. Il Progetto si è svolto dal 1997 al 2004 ed ha reclutato un campione di circa 130.000 pazienti seguite per oltre 5 anni. OBJECTIVE: In order to offer data on the epidemiological profile of women with low bone density (LBD), we have considered information collected in the framework of a large cross-sectional study conducted on women around menopause attending a network of first level outpatients menopause clinics in Italy. METHODS: During 1997 and 2000, a large cross sectional study was conducted on the characteristics of women around menopause attending a network of first level outpatients menopause clinics in Italy for general counseling about menopause or treatment of menopausal symptoms. Eligible for the study were women consecutively observed during the study period. Up to March 2000 a total of 42464 women (mean age 53 years) were observed at the 268 participating centers. Bone mass density was measured in 25113 cases, which are considered in this analysis. LBD (i.e. osteopenia or osteoporosis) was defined according to WHO classification. RESULTS: The frequency of LBD increased with age: in comparison with women aged < or =51 years, the odds ratio (OR) of LBD was 1.5 and 2.2, respectively, in women aged 52-55 and > or =56. No association emerged between LBD and parity: in comparison with nulliparae, the OR of LBD were 1.1 and 1.0, respectively, in women reported 1 or 2 or more full term pregnancies. Smokers were at increased risk of LBD, the corresponding OR being for smokers, in comparison with non smokers, 1.2 (95% confidence interval, CI, 1.1-1.3). In comparison with women in the lower tertile of body mass index, the OR of LBD decreased in subsequent tertiles, being, respectively, 0.9 and 0.7 in the middle and highest tertile. The OR of LBD was 2.2 in postmenopausal women, in comparison with premenopausal ones and the OR decreased increasing age at menopause. Ever OC users were at slightly decreased risk of LBD: in comparison with never OC users, the OR was 0.9 (95% CI 0.8-1.0) in ever OC users. CONCLUSION: The results of this large study confirm, in a Southern European population, the association of age at menopause and body mass on the risk of LBD, and suggest that ever OC women are at decreased risk of LBD.