Chronic joint pain and handgrip strength correlates with osteoporosis in mid-life women: a Singaporean cohort

• Published in: Osteoporosis international 2017-09, Vol.28 (9), p.2633-2643
• Main Authors: Logan, S., Thu, W. P. P., Lay, W. K., Wang, L. Y., Cauley, J. A., Yong, E. L.
• Format: Article
• Language: English
• Subjects: Absorptiometry, Photon - methods; Aged; Anthropometry; Arthralgia - epidemiology; Arthralgia - etiology; Arthralgia - physiopathology; Bone Density - physiology; Bone mass; Bone mineral density; Chronic pain; Chronic Pain - epidemiology; Chronic Pain - etiology; Chronic Pain - physiopathology; Cross-Sectional Studies; Endocrinology; Female; Fractures; Gynecology; Hand Strength - physiology; Health risk assessment; Humans; Life Style; Lumbar Vertebrae - physiopathology; Mass Screening - methods; Medical screening; Medicine; Medicine & Public Health; Middle Aged; Multivariate analysis; Original Article; Orthopedics; Osteoporosis; Osteoporosis, Postmenopausal - complications; Osteoporosis, Postmenopausal - diagnosis; Osteoporosis, Postmenopausal - epidemiology; Osteoporosis, Postmenopausal - physiopathology; Osteoporotic Fractures - prevention & control; Pain; Post-menopause; Prevalence; Reproductive History; Rheumatology; Risk assessment; Risk Assessment - methods; Risk Factors; Singapore - epidemiology; Socioeconomic Factors; Spine (lumbar); Statistical analysis
• ISSN: 0937-941X; 1433-2965
• DOI: 10.1007/s00198-017-4095-z

Summary This study aimed to identify novel correlates which may relate to low bone mass at lumbar spine in mid-life Asian women. The possibility of developing a prediction model for osteoporosis (OP) was explored which resulted in a risk assessment tool that performed better than currently available tools. Introduction In order to identify novel correlates associated with low spinal bone mineral density (BMD) in mid-life women, we examined a large number of lifestyle and medical and performance measurements and developed a prediction model for triage to BMD scanning. Methods Women ( n  = 512) aged 45–69 years (mean 57.0 ± 6.3) attending gynecology clinics for “well woman” visits were recruited for this cross-sectional study from 2014 to 2015. We assessed symptoms, medical history, anthropometry, and physical performance. Stepwise multinomial logistic regressions were performed to examine significant associated covariates for pre-specified outcomes (normal [T-score ≥ −1.0], low bone mass [T-score between −1 and −2.5], and OP [T-score ≤ −2.5] at the lumbar spine). A new screening model was developed, and its performance was compared with the OP Screening Tool for Asians (OSTA) and Fracture Risk Assessment Tool (FRAX®). Results Spinal OP was found in 6.8%. Multivariate analysis indicated that chronic joint pain, the most common symptom reported by 37.5% of the women, was significantly associated with OP. Only age (Relative Risk Ratio [RRR] 1.63; 95%CI, 1.03–2.60), weight (RRR 0.14; 95% CI, 0.07–0.27), postmenopausal status (RRR 11.59, 95%CI, 1.15–116.73), chronic joint pain (RRR, 4.12; 95% CI, 1.53–11.07), and right handgrip strength (RRR 0.50; 95% CI, 0.31–0.80) were independently associated with spinal OP. Combining these five variables, our final model’s area under curve (AUC) was significantly higher at 84% than both the OSTA [AUC; 79% ( p value