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The epidemiology of osteoporosis in Italian postmenopausal women according to the National Bone Health Alliance (NBHA) diagnostic criteria: a multicenter cohort study

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Abstract

Purpose

The study was aimed at evaluating the prevalence of osteoporosis, defined by BMD and the National Bone Health Alliance (NBHA) criteria, and the prevalence of clinical risk factors for fractures in Italian postmenopausal women.

Methods

This is a cross-sectional, multicenter, cohort study evaluating 3247 postmenopausal women aged ≥ 50 and older in different areas of Italy in the period 2012–2014. All the participants were evaluated as far as anthropometrics; questionnaires for FRAX® and DeFRA calculation were administered and bone mineral density was measured at lumbar spine, femoral neck and total hip by DXA.

Results

The prevalence of osteoporosis, as assessed by BMD and NBHA criteria was 36.6 and 57%, respectively. Mean ± SD values of FRAX® and DeFRA were: 10.2 ± 7.3 and 11 ± 9.4 for major fractures, and 3.3 ± 4.9 and 3.9 ± 5.9 for hip fractures, respectively. Among clinical risk factors for fracture, the presence of previous fracture, particularly non-spine/non-hip fracture, parental history of hip fracture and current smoking were the most commonly observed.

Conclusions

Our study showed that more that the half of postmenopausal women aged 50 and older in Italy has osteoporosis on the basis of the NBHA criteria. There is a relevant high risk of femur fracture, as assessed by the FRAX® and DeFRA and previous fracture, parental history of hip fracture and current smoking are the most common risk factors. The data should be considered particularly in relation to the need to increase prevention strategies on modifiable risk factors and therapeutic intervention.

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Acknowledgements

The authors thank the Società Italiana dell’Osteoporosi, del Metabolismo Minerale e delle Malattie dello Scheletro (SIOMMMS) for funding the project.

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Authors and Affiliations

  1. Department of Internal Medicine and Medical Disciplines, “Sapienza” University of Rome, Viale del Policlinico 155, 00161, Rome, Italy

    C. Cipriani, J. Pepe & S. Minisola

  2. Internal Medicine, Department of Medicine, University of Verona, p.le L. Scuro 2, 37134, Verona, Italy

    F. Bertoldo

  3. Division of Rheumatology, Department of Locomotor System, ASL3-Azienda Sanitaria Genovese, Genoa, Italy

    G. Bianchi & G. Girasole

  4. Rheumatologic Clinic “M. Carrozzo”, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy

    F. P. Cantatore & A. Corrado

  5. Gerontology and Bone Metabolic Disease Section, Molinette Hospital, University of Turin, 10126, Turin, Italy

    M. Di Stefano & G. Isaia

  6. Department of Rheumatology, Policlinico Le Scotte, University of Siena, Siena, Italy

    B. Frediani

  7. Rheumatology Section, Department of Medicine, University of Verona, Piazzale L. Scuro 10, 37134, Verona, Italy

    D. Gatti & M. Rossini

  8. Vita-Salute University San Raffaele Milan, Milan, Italy

    A. Giustina

  9. Presidio Ospedaliero di Montichiari, Via G. Ciotti, 154, 25018, Montichiari, Brescia, Italy

    T. Porcelli

  10. Faculty of Economics, UNINT University, Via Cristoforo Colombo 200, 00147, Rome, Italy

    L. Nieddu

  11. Department of Clinical and Experimental Medicine, University of Parma, Via Gramsci 14, 43126, Parma, Italy

    M. Pedrazzoni

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  1. C. Cipriani
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  2. J. Pepe
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Corresponding author

Correspondence to C. Cipriani.

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Conflict of interest

Francesco Bertoldo declares the following conflicts of interest: advisory board, consulting fees: Abiogen, Amgen, Bayer, Italfarmaco; lecture fees: Abiogen, Amgen, Lilly. Gerolamo Bianchi has received honoraria and/or consulting fees from Abbvie, Abiogen, Alfa-Sigma, Amgen, BMS, Celgene, Chiesi, Eli Lilly, GSK, Janssen, Medac, Merck Sharp & Dohme, Novartis, Pfizer, Roche, Sanofi Genzyme, and Servier. Andrea Giustina: Abiogen, IPSEN, Pfizer. Salvatore Minisola served as speaker for Abiogen, Amgen, Bruno Farmaceutici, Diasorin, Eli Lilly, Fujii and in advisory board of Abiogen. He received consultancy from Bruno Farmaceutici. Cristiana Cipriani, Jessica Pepe, Francesco Paolo Cantatore, Addolorata Corrado, Marco Di Stefano, Bruno Frediani, Davide Gatti, Teresa Porcelli, Giancarlo Isaia, Maurizio Rossini, Luciano Nieddu, Giuseppe Girasole, Mario Pedrazzoni declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Cipriani, C., Pepe, J., Bertoldo, F. et al. The epidemiology of osteoporosis in Italian postmenopausal women according to the National Bone Health Alliance (NBHA) diagnostic criteria: a multicenter cohort study. J Endocrinol Invest 41, 431–438 (2018). https://doi.org/10.1007/s40618-017-0761-4

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