Osteoporosis incidence rising in Latin America

In a related study, investigators confirmed smoking as a risk factor for osteoporosis.

Issue: Issue 4 2004

IOF meeting [logo] Osteoporosis is more common in Latin America than many health officials once claimed, with family history a main risk factor, according to the findings of a recent multinational study.

Patricia Clark, MD, of Mexico City, presented outcomes for the initial national subset of the Latin American Vertebral Osteoporosis Study (LAVOS) at the International Osteoporosis Foundation (IOF) World Congress on Osteoporosis in Rio de Janeiro.

Investigators examined the bone health of 400 randomly selected women in six Latin American countries: Mexico, Brazil, Argentina, Bolivia, Puerto Rico and Colombia. Groups were divided by age, consisting of 100 participants each in their 50s, 60s, 70s and older.

Results comparable in other regions

“It was assumed that vertebral fracture rates might be lower in Latin American countries compared with [those of] North America or Europe, so the primary goal of the study was to define the prevalence of vertebral fractures in various countries in our region,” Clark told Orthopaedics Today. “Secondary objectives were to define the bone mass density and conventional risk factors for osteoporosis, [since] no previous study of this kind has been carried out.”

The researchers discovered that 19.5% of the women in the Mexican segment had suffered vertebral fractures, and the incidence increased exponentially with age. This percentage is similar to that found in some European countries, she said, but is higher than rates in China and in American women of African descent.

The LAVOS study also revealed that 33.6% of the Brazilian women surveyed suffer from osteoporosis. Investigators found that the risk increases with family history of the disease, yielding a 44% increased risk of vertebral osteoporosis among Brazilian women. Hereditary tendencies should be considered when looking for risk factors of osteoporosis and fractures, Clark said.

Clark is hoping that the results will increase awareness of osteoporosis in Latin America, which in turn will boost the amount of resources funding agencies spend on research. So far, two additional studies have been funded in Mexico.

“One [study] is very similar to LAVOS, but deals with the prevalence of vertebral fractures in males. The second will determine the economic impact of osteoporosis in Mexico,” she said.

Smokers at risk

A related survey in also showed that smoking increases the probability of developing the disease.

A parallel meta-analysis comparing information from over 59,000 people (74% women) at 10 sites throughout Europe determined that smoking, whether in the past or present, is a risk factor for fractures.

“A smoking history was associated with a significantly increased risk of fracture compared with individuals with no smoking history,” said John A. Kanis, FRCS, who presented the results at the IOF World Congress.

Kanis, the director of the World Health Organization Collaborating Centre for Metabolic Bone Disease at England’s Sheffield University, contends that smoking can be considered a major predictor of fracture risk. Its negative effects include the lowering of bone mineral density (BMD) and diminishing of muscle strength. Other smoke-related diseases also reduce physical activity and increase the chances of falling.

“We conclude that a history of smoking confers that a history of fracture of substantial importance beyond that explained by measurement of BMD,” Kanis said. “Its validation on an international basis permits the use of this risk factor in case-finding strategies.”

For more information:

Clark P, Deleze M, Cons-Molina F, et al. Prevalence of vertebral fractures in Mexico: a population-based study. #P198MO. Presented at the International Osteoporosis Foundation World Congress on Osteoporosis. May 14-18, 2004. Rio de Janeiro.

Ragi Eis S, Albergaria BH, Clark P, et al. The influence of family history of osteoporotic fracture of the risk of vertebral osteoporosis in women. #P207MO. Presented at the International Osteoporosis Foundation World Congress on Osteoporosis. May 14-18, 2004. Rio de Janeiro.

Kanis JA, Johnell O, Oden A, et al. Smoking and fracture risk: a meta-analysis. #OC17. Presented at the International Osteoporosis Foundation World Congress on Osteoporosis. May 14-18, 2004. Rio de Janeiro.