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The prevalence of osteoporosis is about 40%-50% in postmenopausal women and 20% in older men. The limited availability of dual-energy X-ray absorptiometry (DXA) scanners across the country calls for the presence of alternate risk assessment tools to identify those at high risk for osteoporosis. Some of the screening tools available for osteoporosis include Simple Calculated Osteoporosis Risk Estimation and Osteoporosis Risk Assessment Tool for Asians (OSTA), and Fracture Risk Assessment Tool to assess fracture risk. Clinical parameters that may serve as surrogates include dentition and anthropometric indices. Although screening tools do not supplant the assessment of bone mineral density by DXA, they help identify individuals at high risk for osteoporosis who may be selectively referred for confirming the same., Competing Interests: There are no conflicts of interest., (Copyright: © 2022 Journal of Mid-life Health.)

The last three decades have witnessed considerable progress in the field of bone densitometry. Osteoporosis may be diagnosed in postmenopausal women and in men aged 50 and older if the bone mineral density (BMD) T-scores of the lumbar spine, total hip, or femoral neck are -2.5 or less. For reporting T-scores, the Hologic dual-energy X-ray absorptiometry (DXA) scanner uses the Caucasian (nonrace adjusted) female normative database for women and men of all ethnic groups although reference database used does have an impact on the categorization of BMD and must be chosen judiciously considering the regional and ethnic characteristics of the population. The quality control for DXA systems should be periodically done in accordance with manufacturer guidelines for DXA. Beyond conventional BMD assessment, DXA may also be utilized to assess the trabecular bone score, hip structural analysis, vertebral fractures, and body composition., Competing Interests: There are no conflicts of interest., (Copyright: © 2022 Journal of Mid-life Health.)

Objective: Vitamin D deficiency is widely prevalent worldwide. This has led to a significant surge in referrals for vitamin D assessment in recent years. The cost-effectiveness and rationalization of this practice is uncertain. This study aimed to evaluate the referral pattern for vitamin D testing from a tertiary center in southern India., Materials and Methods: This was a cross-sectional study done over a period of one year (2017). A total of 95,750 individuals, referred for vitamin D screening were included in this study. Details regarding referring departments and indications for referral were obtained from the computerized hospital information processing system (CHIPS)., Results: The study population exhibited a female preponderance (54.1%) with mean (SD) age of 40.3 (18.5) years. Overall, 44% were found to have vitamin D deficiency. Most of the referrals were from nephrology (15.4%), neurology (10.1%), and orthopedics (9.1%). Nevertheless, dermatology, the staff-clinic, and hematology which contributed to 3.3%, 1.7%, and 1.7% of referrals, had a higher proportion of vitamin D deficiency of 59.1%, 57.7%, and 64.6%, respectively. Although the most common indications for referral were generalized body aches (20.5%) and degenerative bone disorders (20.1%), the proportion of subjects with vitamin D deficiency referred for these indications were 46.1% and 41.6%, respectively. In contrast, chronic steroid use that accounted for 3.3% of the referrals had 59.1% of subjects who were deficient in vitamin D., Conclusion: To ensure a rational approach to vitamin D testing, clinicians ought to use their discretion to screen those truly at risk for vitamin D deficiency on a case to case basis and avoid indiscriminate testing of the same., Competing Interests: None

Background: The incidence of postmenopausal osteoporosis continues to rise, as population ages. The morbidity and mortality associated with osteoporotic fractures have a significant negative impact on the economy and quality of life of the affected individual and the community, at large., Objectives: We aimed to study the prevalence of osteoporosis in ambulant rural postmenopausal women, and to look at their dietary calcium intake (DCI) and Vitamin D status., Subjects and Methods: This was a cross-sectional study conducted in 1565 ambulant South Indian rural postmenopausal women. Bone mineral density was estimated by a dual-energy X-ray absorptiometry scan at the femoral neck (FN) and lumbar spine (LS). DCI was calculated by recall for the previous week, and the blood bone biochemical profile was measured., Results: The mean standard deviation (SD) age and body mass index of this population were 60.7 (7.2) years and 26.2 (4.8) kg/m 2 , respectively. The prevalence of osteoporosis was 22% at the FN and 39% at the LS. An increase in the prevalence of osteoporosis was noted at both sites, in successive age categories. Mean (SD) DCI was 420 (282) mg/24 h. Fifty-four percent had Vitamin D deficiency (VDD) (<20 ng/ml) and 6% had severe VDD (<10 ng/ml)., Conclusion: A significant proportion of this large cohort of south Indian healthy rural postmenopausal women had osteoporosis at either site with advancing age. Most of them had a suboptimal DCI, and over half of them had VDD., Competing Interests: There are no conflicts of interest., (Copyright: © 2019 Indian Journal of Community Medicine.)

Objectives: The objective was to compare body composition, metabolic characteristics, and insulin resistance between obese (body mass index [BMI] ≥25 kg/m 2 ) polycystic ovary syndrome (PCOS) and nonobese PCOS (BMI <25 kg/m 2 ) women and their age- and BMI-matched controls., Materials and Methods: A total of 81 PCOS women (Rotterdam criteria) (obese - 42; nonobese - 39) and 86 controls (obese - 42; nonobese -44) were recruited in this cross-sectional study. All women underwent a detailed assessment of clinical, anthropometric, and metabolic parameters, insulin resistance indices, and body composition measurements with visceral adipose tissue assessment (VAT) (dual-energy X-ray absorptiometry scan)., Results: Of PCOS women, 27% (80% - obese PCOS; 20% - nonobese PCOS) were diagnosed with metabolic syndrome (International Diabetes Federation criteria), 35% of PCOS women (46% - obese PCOS; 54% - nonobese PCOS) had impaired glucose tolerance, and 7% of PCOS women (2/3 rd - obese PCOS; 1/3 rd - nonobese PCOS) had diabetes mellitus. Insulin resistance was seen in about 80% in obese PCOS women and 20% in nonobese PCOS women based on various insulin resistance indices such as fasting insulin (≥12.2 μU/ml), Homeostasis Model Assessment-Insulin Resistance (≥2.5), and Quantitative Insulin Sensitivity Check Index (<0.33). Total body fat, estimated (Est.) VAT, and corrected Est. VAT (corrected for body weight) were significantly increased ( P = 0.0001) in both obese and nonobese PCOS women when compared to those of their age- and BMI-matched controls. However, corrected Est. VAT (corrected for body weight) was not significantly different between obese and nonobese PCOS women., Conclusion: Both obese and nonobese PCOS women when compared with their age- and BMI-matched controls were metabolically worse and had more visceral adiposity. Nonobese PCOS poses similar risk as that of obese PCOS in having similar amount of VAT (corrected for body weight)., Competing Interests: There are no conflicts of interest.

Aim: This study aims to objectively assess the dentition status in South Indian postmenopausal women and compare the dental health of osteoporotic participants with nonosteoporotic individuals., Materials and Methods: A total of 150 consecutive ambulatory South Indian postmenopausal women (>50 years of age) were assessed for their dental health using an internationally validated scoring system. Bone mineral density (BMD) was assessed using a dual-energy X-ray absorptiometry scanner., Results: About 39% of the participants were found to have osteoporosis and 23% had osteopenia at any site. More than half of them (57%) had poor dental health, and the predominant problems were cavities (43.5%) and loss of teeth (75%). Among 112 women who had tooth loss, the mean tooth loss was 4.8. The mean tooth loss among patients with normal BMD was 1.09 ± 1.2, in osteopenia was 2.1 ± 2, and in osteoporosis was 5.4 ± 2.8 ( P < 0.01). The odds of having osteoporosis among the patients with three or more tooth loss were found to be 4.2 (95% confidence interval = 2.4-7.3)., Conclusion: Postmenopausal women with osteoporosis had significantly higher number of tooth loss. Tooth loss may thus be used as a surrogate marker to predict osteoporosis., Competing Interests: There are no conflicts of interest.