Osteoporotic hip fractures in low-income group population, hospital based case control study from India

Abstract

Context: Osteoporosis is a public health problem in India with high incidence of fractures. Aim: The aim of the study w to know the profile of bone parameters and its factors associated with hip fractures in osteoporotic men and women living in low socioeconomic conditions. Settings and Design: A hospital-based case-control study was carried out in Orthopedics ward of the Osmania General Hospital (OGH), Hyderabad, Andhra Pradesh, India. Materials and Methods: A total of 72 men and 72 women aged 35-70 years admitted in OGH with hip fractures during April 2005 to March 2008 were recruited. Age, gender and socioeconomic background matched controls (men: 72 and women: 46) living in Hyderabad were employed. Clinical examination, bone mineral density (BMD), anthropometric measurements, and biochemical markers of bone metabolism were analyzed. Statistical Analysis Used: Descriptive and inferential statistics were carried using SPSS. Results: The mean age of men with fractures was 59.1+or-9.42 years while, in women, it was 63.6+or-9.97 years. BMD at the hip (P<0.001) and calcium (P<0.05), Vitamin D (P<0.001), total alkaline phosphatase levels (P<0.05) were significantly lower in the cases. While, paratharmone activity and urinary calcium excretion (P<0.001) were found to be high in cases compared to controls. Gender, body mass index, serum Vitamin D explained variation in BMD at all the sites. Conclusion: The high prevalence of Osteoporotic fracture rates in Indians at an early age compared to developed countries highlights the need for dietary diversification, physical activity, self-care management, among the low-income group population to reduce the risk of osteoporosis and its associated risk factors.