Osteoporosis is one of the most pressing healthcare issues for postmenopausal women. Prevention is possible but there are many risk factors needing attention. Predicting those women more likely to develop osteoporosis is important because most patients will not know they have the disease until a bone fracture occurs.
What are the risk factors? Does it matter where postmenopausal women live? For women in Indonesia, the answers correlate with traditional findings but also show some new discoveries in a tailor-made research study.
While osteoporosis does not discriminate and affects women
in all corners of the globe, there are particular groups more susceptible to bone fractures. Caucasian and Asian women have traditionally been more prone to osteoporosis. But few comparative studies have been conducted outside of the Western medical sphere. Are there differences between associative osteoporosis risk factors for women around the world?
For women in Indonesia, the risk factors are recognizable to Western women. Decreasing estrogen levels during and after menopause contribute to osteoporosis, as do lighter body mass index measurements, low calcium levels, and increased age levels.
But most studies focus on women living in the Northern Hemisphere and in particular those countries with limited sun exposure, meaning little natural Vitamin D levels, during much of the year. These studies limited the true understanding of the total risk factor package for women living in the equatorial regions with the greatest exposure to Vitamin D from sunlight.
Applying Western criteria to other regions ends up a little like trying to force a puzzle piece where it does not fit. Missing the full picture for menopausal health results in a misguided understanding of women’s healthcare and shortchanges women living in nations in transition.
Researchers set out to create a customized model to get a better idea of Indonesian women and their risks for osteoporosis. A recent case control study examined several Indonesian women aged 45-90 who were diagnosed as postmenopausal.
Through a combination of questionnaires and objective measurements, doctors created a set of osteoporosis criteria specifically addressing Indonesian women. Estrogen and calcium level measurements, as well as bone density measurements, gave solid objective information. Age and body mass index added extra evidence.
The most important piece of information concentrated on the amounts of physical activity and especially the duration of sunlight exposure. In a nation with regular measured daylight for at least 12 hours throughout the entire year, researchers essentially worked in reverse to the current Western study models. This small difference speaks volumes in understanding the significance of addressing menopause at a localized level rather than attempting to measure women across the globe with the same Western yardstick.
Researchers no longer need to rely on outside investigations that fall short of separating the cultural and physical menopause story.
Indonesian women get a more personalized view of their healthcare. This further pushes a greater movement for improving quality of life and medical treatments for women everywhere.
‘Potential factors to predict osteoporosis risk in Indonesian postmenopausal women’ Kusdhany Linda Soetanto (ID) Faculty of Dentistry Universitas Indonesia, Elza Ibrahim, Tri Budi Rahardjo, Eef Hogervorst Prosthodontic Department Faculty of Dentistry Universitas Indonesia, Oral Biology Department Faculty of Dentistry Universitas Indonesia, Center of Aging Studies Universitas Indonesia, Loughborough University, UK, as presented at the 13th Menopause Congress, Rome, 2011.
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