Prevalence of risk factors for referring post-menopausal women for bone densitometry. The INSTANT study

BackgroundMeasurement of bone density by densitometry is an appropriate public health strategy for prevention of osteoporotic fractures in at-risk individuals, and physicians are encouraged to screen for these risk factors in post-menopausal women.ObjectiveTo determine the frequency of risk factors for osteoporosis in a representative sample of the French general population in order to estimate the number of women eligible for bone densitometry.MethodsA cross-sectional epidemiological survey of osteoporosis in 2081 post-menopausal women over 45 years in the general population was conducted using a stratified random sampling method and face-to-face interviews. Information was collected on personal or family history of vertebral fracture or limb fracture, endocrine disorders, corticosteroid use, and early menopause. Body mass index was determined during the interview by measuring height and weight.ResultsA total of 1041 women interviewed (51.8%) reported at least one risk factor for osteoporosis and would thus be eligible for densitometry. The most frequently reported risk factor was vertebral fracture or collapse (20.8%), followed by endocrine disorders (10.5%) and long-term corticosteroid treatment (10.5%). The prevalence of vertebral and limb fracture increased with age. Multiple risk factors were reported by 381 women and the proportion of women presenting multiple risk factors increased with age.ConclusionsExtrapolated to the general population, over five million women in France would be eligible for densitometry. Since only a small proportion of these currently receive a diagnosis of osteoporosis, a considerable number of women could thus potentially benefit from more widespread use of densitometry.