Bone mineral density in midlife women: the Study of Women's Health in Qatar

Alendronate for Effective Treatment of Male Osteoporosis: An Insight

Osteoporosis is a major global health problem. The increase in the incidence of osteoporosis in the elderly poses a challenge to treat and also results in an economic burden for the nation. Osteoporosis has been given more importance in females, and there is an urgent need to address this disease in males. Various drugs, such as nitrogen-containing bisphosphonates, RANK ligand inhibitors, parathormones, and alendronate, have been used for effective treatment of osteoporosis. Alendronate (alendronic acid), a nitrogen-containing bisphosphonate that inhibits bone resorption by osteoclasts, was synthesized during the 1970s. In the present review, we discuss the pharmacokinetics, mechanism of action, adverse effects, contraindications, and toxicity monitoring of alendronate. The drug may be effectively used for the treatment of male osteoporosis in order to increase bone mineral density and prevent fractures.

A study on anxiety and depression symptoms among menopausal women: a web based cross sectional survey

Background

An essential part of aging is menopause, which indicates the final phase of the female reproductive cycle. The objective of this research was to assess anxiety and depressive symptoms among menopausal women in Asir region, Saudi Arabia.

Methods

The cross-sectional survey was carried out in February to June 2024, using a random sampling procedure, study participants were selected. All menopausal women including <50 and ≥60 years old, were included, and symptoms of depression and anxiety were collected using Patient Health Questionnaire-9 (PHQ-9) Generalized Anxiety Disorder-7 (GAD-7) respectively.

Results

Of the 396 menopausal women, the majority 170 (42.9%) were <50 years old and 92 (23.2%) were between 50 and 54 years old. Two hundred eighty-one were married (71%) and 273 (68.9%) were literate. Most of them, 229 (57.8%) got married at <18 years and 196 (49.5%) have a parity of 3-5 and 189 (47.7%) women attained menopause at <50 years old. In terms of menopausal symptoms, 268 (67.7%) women experienced hot flushes; 252 (63.6%) had night sweats and were more irritable 256 (64.6%) followed by 244 (61.6%) had decreased sexual desire. In general, 258 (65.2%) and 206 (52.02%) menopausal women reported having depression and anxiety symptoms, respectively. Married (OR = 0.317; 95% CI = 0.182-0.551, p = 0.000) and literate (OR = 0.518; 95% CI = 0.309-0.868, p = 0.013) are less likely to be in depression compared to widowed/separated individuals. Literates (OR = 0.271; 95% CI = 0.165-0.443, p = 0.000), are less likely to have anxiety compared to illiterates.

Conclusion

The study found that a significant percentage of menopausal women had depression and anxiety symptoms. These results emphasize the significance of screening and assessing women experiencing anxiety and depression symptoms throughout the menopausal transition. To alleviate menopausal symptoms, it is also suggested to conduct activities to educate menopausal women, such as a health awareness program in shopping centers and other public places, etc.

Bothersome symptoms at midlife in relation to body fat percentage

OBJECTIVES

Increasing obesity has been associated with a higher frequency of symptoms at midlife. Bothersomeness represents an important measure of perceived symptom severity, but has received relatively little consideration, and relationships between symptom bothersomeness and obesity are not known. We evaluated the association between body fat percentage (%BF) and the bothersomeness of symptoms at midlife.

METHODS

This cross-sectional study included women aged 40-60 in Qatar (n = 841). Participants reported frequency and bothersomeness of midlife symptoms hypothesized to be related to body composition. Initially, we characterized the relationship between continuous %BF and presence (yes/no) and bothersomeness (yes/no) for each symptom using restricted cubic spline (RCS) models to test nonlinearity. Subsequently, we used multinomial logistic regressions to evaluate associations between %BF and multilevel symptom outcomes, where categories were: (a) no symptoms or bother, (b) symptoms without bothersomeness, and (c) symptoms with bothersomeness.

RESULTS

The highest frequency of bothersomeness was reported for aches/stiffness in joints (51%), followed by trouble sleeping (34%), night sweats (21%), urinary incontinence (18%), hot flashes (16%), and shortness of breath (15%). In unadjusted multinomial logistic regressions, aches/stiffness in joints with and without bothersomeness had the same significant relationship with %BF. Bothersome night sweats, urinary incontinence, and hot flashes were significantly associated with %BF (p < .05), but those same symptoms without bothersomeness were not significantly associated with %BF.

CONCLUSIONS

Our findings suggest that bothersomeness is an important variable that tracks with body fat and gives different information than report of the presence/absence of a symptom alone.

Limited evidence of a threshold effect for increasing adiposity on risk of symptoms at midlife

OBJECTIVE

To assess the nature of relationships between increasing body mass index (BMI) and the prevalence of midlife symptoms in a population with high adiposity.

METHODS

In the cross-sectional Study of Women's Health in Qatar, 841 participants aged 40 to 60 years were recruited from nine primary health centers in Doha. Face-to-face interviews collected demographic, menopause, and symptom information. BMI (kg/m 2 ) was categorized as healthy, overweight, or class I, II, or III obesity. Multivariate logistic regression models were used to examine aches/stiffness in joints, trouble sleeping, shortness of breath, urinary incontinence, and hot flashes with BMI categories. Restricted cubic splines (RCSs) were used to estimate relationships between continuous BMI and each symptom and to conduct formal tests of nonlinearity.

RESULTS

Mean BMI was 34.3 kg/m 2 (SD, 6.0 kg/m 2 ). Women with class II and III obesity had higher odds of reporting aches/stiffness than women with a healthy BMI, and the odds of reporting urinary incontinence were three times higher among women with class III obesity (odds ratio, 3.08; 95% confidence interval, 1.17-8.14). Using restricted cubic spline models, a significant nonlinear association ( P = 0.002) was observed between aches/stiffness and BMI with an apparent threshold of 38 kg/m 2 . Linear relationships were observed with BMI for urinary incontinence ( P < 0.001 for linear trend) and shortness of breath ( P = 0.005 for linear trend). Trouble sleeping and hot flashes were not associated with BMI.

CONCLUSIONS

Even at very high levels of BMI, likelihood of urinary incontinence and shortness of breath increases with BMI. In contrast, likelihood of aches/stiffness has a nonlinear relationship with BMI, increasing to a threshold level.

Global, regional prevalence, and risk factors of osteoporosis according to the World Health Organization diagnostic criteria: a systematic review and meta-analysis

This systematic review and meta-analysis estimated the global, regional prevalence, and risk factors of osteoporosis. Prevalence varied greatly according to countries (from 4.1% in Netherlands to 52.0% in Turkey) and continents (from 8.0% in Oceania to 26.9% in Africa). Osteoporosis is a common metabolic bone disorder in the elderly, usually resulting in bone pain and an increased risk of fragility fracture, but few summarized studies have guided global strategies for the disease. Therefore, we pooled the epidemiologic data to estimate the global, regional prevalence, and potential risk factors of osteoporosis. We conducted a comprehensive literature search through PubMed, EMBASE, Web of Science, and Scopus, to identify population-based studies that reported the prevalence of osteoporosis based on the World Health Organization (WHO) criteria. Meta-regression and subgroup analyses were used to explore the sources of heterogeneity. The study was registered in the PROSPERO database (CRD42021285555). Of the 57,933 citations evaluated, 108 individual studies containing 343,704 subjects were included. The global prevalence of osteoporosis and osteopenia was 19.7% (95%CI, 18.0%-21.4%) and 40.4% (95%CI, 36.9%-43.8%). Prevalence varied greatly according to countries (from 4.1% in Netherlands to 52.0% in Turkey) and continents (from Oceania 8.0% to 26.9% in Africa). The prevalence was higher in developing countries (22.1%, 95%CI, 20.1%-24.1%) than in developed countries (14.5%, 95%CI, 11.5%-17.7%). Our study indicates a considerable prevalence of osteoporosis among the general population based on WHO criteria, and the prevalence varies substantially between countries and regions. Future studies with robust evidence are required to explore risk factors to provide effective preventive strategies for the disease.

The effect of educational intervention based on theory of planned behavior on behavioral responses of premenopausal women in prevention of osteoporosis

BACKGROUND

Osteoporosis is one of the most prevalent bone diseases which is preventable. Implementing educational programs is an important step in prevention of chronic diseases in the community setting. One of the theories used for predicting behavior and performing educational intervention is theory of planned behavior (TPB) which predicts the intention of an individual toward doing a specific behavior. This study was conducted to assess the effect of educational intervention based on TPB on behavioral responses of premenopausal women in prevention from osteoporosis in Fasa city, Iran.

METHODS

This study is a quasi-experimental study performed on 200 women aging from 35 and 55 years who referred to health centers in Fasa city; iran in 2019. Simple random sampling was applied to assign participants to control and intervention groups (100 participant for each group). Data were gathered by a "valid" and "reliable" questionnaire arranged based on the constructs of TPB, nutrition performance and physical activity. An educational program on osteoporosis prevention was conducted. educational intervention was performed in six sessions through group discussions and educational films and booklet for experimental group and then the changes in the scores of the two groups were evaluated and compared. Obtained data were analyzed by SPSS-22 software through Chi-square, independent t-test, paired t-test and ANOVA tests.

RESULTS

The mean ages of studied participants in experimental and control groups were respectively 43.39 [Formula: see text] 5.20 and 42.94 [Formula: see text] 5.52. In experimental group, the average scores of knowledge [2 weeks (31.12 [Formula: see text] 4.20) and 2 months (39.04 [Formula: see text] 4.10) after educational intervention (p < 0.001)], constructs of theory of planned behavior [attitude construct: 2 weeks (89.32 [Formula: see text] 9.22) and 2 months (98.57 [Formula: see text] 9.13) after educational intervention (p < 0.001), Subjective norms construct: 2 weeks(88.39 [Formula: see text] 8.84) and 2 months (122.57 [Formula: see text] 8.58) after educational intervention (p < 0.001), Perceived behavioral control construct: 2 weeks (88.56 [Formula: see text] 8.38) and 2 months (120.15 [Formula: see text] 8.33) after educational intervention (p < 0.001), Behavioral intention construct: 2 weeks (54.44 ± 4.72) and 2 months (60.26 [Formula: see text] 4.12) after educational intervention (p < 0.001)], nutrition performance [2 weeks (19.88 ± 2.56) and 2 months (24.14 [Formula: see text] 2.36) after educational intervention (p < 0.001)] and physical activity [2 weeks (16.75 [Formula: see text] 1.42) and 2 months (18.94 [Formula: see text] 1.68) after educational intervention (p < 0.001)] had more significant enhancement than control group 2 weeks and 2 months after educational intervention.

DISCUSSION

TPB was effected in nutrition performance and physical activity in osteoporosis prevention of subjects. This theory can be used as a framework for designing and performing educational intervention for preventing osteoporosis and promoting women's health.

Blood lipid levels in patients with osteopenia and osteoporosis:a systematic review and meta-analysis

INTRODUCTION

Considering the controversial relationship between blood lipid levels and osteopenia and osteoporosis (OP), we performed this meta-analysis.

MATERIALS AND METHODS

Using specific keywords and related words, we searched PubMed, Embase, and Cochrane Library databases. The Newcastle-Ottawa Scale form was used to evaluate the quality of the literature. According to the inclusion and exclusion criteria, we systematically screened the literature to extract relevant information and data. ReVman 5.3 and Stata 13.0 software were used for statistical analysis. Results were expressed as the mean difference (MD) and 95% confidence interval (95% CI). The heterogeneity test was conducted according to I² and Q tests. Egger's test was used to quantitatively evaluate publication bias.

RESULTS

This analysis involved 12 studies (12,395 subjects). The quality of the literature was acceptable. Among subjects who were not taking lipid-lowering drugs, total cholesterol (TC) (MD = 0.11 mmol/L, 95%CI: - 0.03, 0.25; I² = 21%; P = 0.36), triglycerides (TG) (MD =  - 0.01 mmol/L, 95%CI: - 0.09, 0.07; I² = 6%; P = 0.34), and low-density lipoprotein cholesterol (LDL-C) (MD = 0.10 mmol/L, 95%CI: 0.00, 0.19; I² = 0%; P = 0.74) in the osteopenia were not significantly increased/decreased. There were no significant differences in LDL-C (MD = 0.02 mmol/L, 95%CI: - 0.09, 0.13; I² = 0%; P = 0.74) in postmenopausal women in osteopenia. TG (MD =  - 0.04 mmol/L, 95%CI: - 0.14,0.07; I² = 49%; P = 0.07) was unchanged in the osteoporosis (OP) group in subjects without taking lipid-lowering drugs. HDL-C was elevated in OP group (MD = 0.05 mmol/L, 95%CI: 0.03, 0.07; I² = 31%; P = 0.15) but not in osteopenia group (MD = 0.01 mmol/L, 95%CI: - 0.01, 0.02; I² = 38%; P = 0.14) in all subjects.

CONCLUSION

HDL-C was elevated in patients with OP.

Relationship between vitamin D receptor gene polymorphisms (BsmI, TaqI, ApaI, and FokI) and calcium intake on bone mass in young Japanese women

Background

The high prevalence of low bone mass in young women in Japan has emerged as a serious health issue in recent years. Therefore, the aim of the present study was to reevaluate the relationship between genetic and dietary factors, as well as its influence on bone mass in young Japanese women, with particular emphasis on vitamin D receptor (VDR) gene polymorphisms and calcium intake.

Methods

A total of 499 Japanese women aged 20–24 years were enrolled in the study. The bone mass of the calcaneus was assessed using the quantitative ultrasound method and expressed as the osteo sono-assessment index (OSI). VDR gene polymorphisms (BsmI, TaqI, ApaI, and FokI) were analyzed using DNA extracted from saliva. Calcium intake was assessed using the Food Frequency Questionnaire based on food groups (FFQg) and adjusted with the energy intake. Participants were divided into two groups based on the median calcium intake (250 mg/1000 kcal).

Results

Consequently, bone mass was significantly different among the BsmI and TaqI genotypes after adjusting for body mass index (BMI) (p = 0.030 and 0.019, respectively). In addition, the BsmI AA and ApaI GT genotypes showed significant differences in bone mass between the calcium-intake groups, with low OSI in the low-calcium intake group and high OSI in the high-calcium intake group, respectively, even after adjusting for BMI (p = 0.020 and 0.038, respectively).

Conclusions

These findings may prove instrumental in developing a logical approach towards preventing bone loss in young Japanese women.

The relation of body mass index, menopausal symptoms, and lipid profile with bone mineral density in postmenopausal women

OBJECTIVE

We aimed to evaluate the relationship of menopausal symptoms, body mass index (BMI), and serum lipid profile with Bone Mineral Density (BMD) levels.

MATERIALS AND METHODS

452 postmenopausal women were included in this case-control study at our outpatient clinic between January 2012 and January 2015. The patients were stratified according to their BMD, based on dual-energy X-ray absorptiometer (DXA) results, as the normal group (-1 ≤ T-score), osteopenia group (-2.5 < T-score < -1), and osteoporosis group (T-score ≤ -2.5). High Density Lipoprotein (HDL), Low Density Lipoprotein (LDL), total cholesterol (TC), and triglycerides (TG), fasting plasma glucose (FPG) levels were measured. To assess the menopausal symptoms, the Menopause Rating Scale (MRS) questionnaire was used.

RESULTS

Waist circumference (WC) and BMI were significantly lower in the osteoporosis group than in normal and osteopenia groups (p: 0.001, p: 0.001, respectively). L2-L4 measurements were negatively correlated with Low Density Lipoprotein (LDL) levels, but positively correlated with WC. BMI showed significant positive correlation with Femur Neck (FN), L1-L2, and L2-L4 measurements. Among menopausal symptoms, there was a significant negative correlation between heart discomfort and L1-L2 levels. On multiple regression analysis, a relation between FN scores and somatic symptom scores was identified.

CONCLUSION

Hyperlipidemia, lower BMI, lower WC, and severe somatic symptoms may be associated with decreased BMD.

Association Between Bone Mineral Density and Lipid Profile in Chinese Women

Purpose

Atherosclerotic cardiovascular disease may share the risk factors for low bone mineral density (BMD), one of which is dyslipidemia. The association between serum cholesterol and BMD remains controversial. Thus, the correlation between serum lipids and BMD in women was explored in the current study.

Materials and Methods

This cross-sectional study included 1116 Chinese female participants. Serum samples were collected to evaluate total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and other laboratory markers. Dual-energy X-ray absorptiometry was used to assess lumbar spine, femoral neck, and total hip BMD.

Results

In the postmenopausal women, a non-linear relationship was detected between TC, LDL-C, HDL-C, and lumbar spine BMD. Using segmented linear regression, the inflection points were 5.86 mmol/L, 3.52 mmol/L, and 2.37 mmol/L, respectively. To the left of the inflection point, the higher the serum lipid level, the lower the value for lumbar spine BMD. To the right of the inflection point, the higher the serum level of TC and LDL-C, the higher the value for lumbar spine BMD. In the premenopausal women, the association between HDL-C and femoral neck BMD was non-linear. In addition, LDL-C had a positive association with BMD of the femoral neck and HDL-C had an inverse association with BMD of the femoral neck in postmenopausal women.

Conclusion

In postmenopausal women, the relationship between TC, LDL-C, HDL-C, and lumbar spine BMD was non-linear. TC, LDL-C, and HDL-C were negatively associated with lumbar spine BMD when the values were less than 5.86 mmol/L, 3.52 mmol/L, and 2.37 mmol/L, respectively. The mechanisms of the association were unclear, and further research is warranted to clarify the relationship.

The Application of PRECEDE Model on Preventing Osteoporosis in Women

The aim of this study is investigating the efficiency of educational intervention based on PRECEDE model on promotion of osteoporosis prevention behaviors in women. This quasi-experimental study was conducted on 200 women registered in two health centers of Fasa city, Fars province, Iran in 2017 to 2018. A questionnaire including items evaluating demographic information and PRECEDE model constructs was used for measuring nutrition and walking performance of studied women in osteoporosis prevention before and 12 months after intervention. Bone mineral density (BMD) was recorded at the lumbar spine and femur before and 12 months after intervention. One year after intervention, the intervention group showed a significant increase in knowledge, attitude, self-efficacy, reinforcing factors, enabling factors, nutrition, and walking performance compared to the control group. Also, the value of lumbar spine and hip BMD T-Score of the intervention group was increased, while this value was reduced in the control group. Our findings showed that educational interventions based on PRECEDE model can positively affect prevention behaviors from osteoporosis by improving subjects' knowledge, attitude, enabling factors (resources such as health care access and services that can provide motivation for prevention behaviors from osteoporosis in women), self-efficacy, and reinforcing factors.

Prevalence of osteoporosis and related lifestyle and metabolic factors of postmenopausal women and elderly men: A cross-sectional study in Gansu province, Northwestern of China

The aim of this study was to investigate the osteoporosis prevalence and the risks of postmenopausal women and elderly men in Gansu province.This cross-sectional study involved 3359 postmenopausal women and 3205 elderly males who were randomly selected from 7 areas in Gansu province. Areal bone mineral density (BMD) (g/cm) was measured at the distal one-third radius of the nonstressed forearm using dual-energy X-ray absorptiometry (DXA: Osteometer MediTech). Factors related to osteoporosis were analyzed.The prevalence of osteoporosis in the entire study population was 9.65% for postmenopausal women and 8.08% for elderly males by WHO criteria, while the rate of osteopenia were 27.09% for postmenopausal women and 26.68% for elderly males. Risk of osteoporosis was significantly associated with age, menopause age, duration of menopause, body mass index (BMI), educational level, and alcohol consumption in postmenopausal women. In elderly men, age, BMI, current smoking, alcohol consumption, physical activity, and sun exposure were associated with osteoporosis. The bone turnover markers osteocalcin (OC) and C-terminal cross-linked telopeptides of type I collagen (β-CTX) were inversely correlated with BMD in both genders; serum P and 25(OH)D found no significant correlation with BMD. Serum Ca showed a positive effect on BMD in elderly men only.The osteoporosis prevalence of postmenopausal women and the men aged over 60 years in Gansu province is presented. Risk of osteoporosis was significantly associated with age, menopause age, year since menopause, BMI, and educational level in postmenopausal women. In elderly men, age, BMI, and current smoking were associated with osteoporosis. This study also found that higher OC and β-CTX level were associated with lower BMD. Poor 25(OH)D, Ca, P status were not associated with an increased risk of low BMD.

Depressive symptoms and bone mineral density in menopause and postmenopausal women: A still increasing and neglected problem

Background:

The association between depression and loss of bone mineral density (BMD) has been reported as controversial.

Objective:

The objectıve of the current study was to investigate whether an association exists between depression and low BMD during the menopausal and postmenopausal period.

Materials and Methods:

A cross-sectional descriptive study was used to generate menopause symptoms experienced by Arabian women at the Primary Health Care Centers in Qatar. A multi-stage sampling design was used, and a representative sample of 1650 women aged 45–65 years were included during July 2012 and November 2013. This prospective study explored the association between bone density and major depressive disorder in women. Bone mineral densitometry measurements (BMD) (g/m²) were assessed at the BMD unit using a lunar prodigy DXA system (Lunar Corp., Madison, WI). Data on body mass index (BMI), clinical biochemistry variables including serum 25-hydroxyvitamin D were collected. The Beck Depression Inventory was administered for depression purposes.

Results:

Out of 1650 women 1182 women agreed to participate in the study (71.6%). The mean age and standard deviation (SD) of the menopausal age were 48.71 ± 2.96 with depressed and 50.20 ± 3.22 without depressed (P < 0.001). Furthermore, the mean and SD of postmenopausal age were 58.55 ± 3.27 with depression and 57.78 ± 3.20 without depression (P < 0.001). There were statistically significant differences between menopausal stages with regards to a number of parity, and place of living. There were statistically significant differences between menopausal stages with regards to BMI, systolic and diastolic blood pressure, Vitamin D deficiency, calcium deficiency and shisha smoking habits. Overall, osteopenia and osteoporosis and bone loss were significantly lower in postmenopausal women than in menopausal women (P < 0.001). Similarly, T-score and Z-score were lower with depression menopause and postmenopausal women (P < 0.001). The multivariate logistic regression analyses revealed that the depression, the mean serum Vitamin D deficiency, calcium level deficiency, less physical activity, comorbidity, number of parity, systolic and diastolic blood pressure and shisha smoking habits were considered as the main risk factors associated with bone mineral loss after adjusting for age, BMI and other variables.

Conclusion:

Depression is associated with low BMD with a substantially greater BMD decrease in depressed women and cases of clinical depression. Depression should be considered as an important risk factor for osteoporosis.

Association of physical fitness, body composition, cardiometabolic markers and adherence to the Mediterranean diet with bone mineral density in perimenopausal women. The FLAMENCO project

This study aimed to analyse the association of different components of physical fitness, body composition, cardiometabolic markers and the Mediterranean diet with bone mineral density (BMD) in perimenopausal women, and to test which of these components are independently associated with BMD. The sample comprised 197 perimenopausal women (52.6 ± 4.5 years). Physical fitness was assessed with the "Senior Fitness Test" battery and the handgrip strength and Bruce tests. Fat and lean mass and BMD were measured using dual-energy X-ray absorptiometry. We analysed the markers of metabolic syndrome, C-reactive protein, and components of the Mediterranean diet. Handgrip muscle strength (β = 0.212, P = 0.005), body weight (β = 0.244, P = 0.001), BMI (β = 0.180, P = 0.011) and lean mass (β = 0.379, P < 0.001) were positively associated with BMD. No associations were observed between cardiometabolic markers or the Mediterranean diet with BMD (all P > 0.05). When all relevant indicators of BMD were simultaneously considered, lean mass was the only 1 showing an independent association with BMD (β = 0.392, P < 0.001), explaining 14% of the BMD variability. In conclusion, muscle strength might be a marker of BMD in perimenopausal women. However, lean mass was the only factor independently associated with BMD. Future research to determine whether increasing lean mass through specific exercise-based interventions contributes to increasing BMD is warranted.

Depression, Anxiety, and Stress Symptoms in Menopausal Arab Women: Shedding More Light on a Complex Relationship

Background:

The association between depression, anxiety, and stress among Arab menopause and postmenopausal women have been explored in detailed.

Aim:

The objective of this study was to determine the correlation between depression, anxiety, and stress in menopausal and postmenopausal women and shedding more light on a complex relationship.

Subjects and Methods:

A cross-sectional descriptive study was used to generate menopause symptoms experienced by Arabian women at the primary health care centers in Qatar. A representative sample of 1468 women aged 45–65 years were approached during July 2012 and May 2014 and 1101 women agreed to participate (75.0%) and responded to the study. Depression, anxiety, and stress were measured using the Depression Anxiety Stress Scales 21. Data on body mass index (BMI), clinical and other parameters were used. Univariate, multivariate, and matrix correlation analysis were performed for statistical analysis.

Results:

A total of 1101 women agreed to participate after informed consent was obtained. The mean age and standard deviation (SD) of the menopausal age were 49.55 (3.12), the mean and SD of postmenopausal age was 58.08 (3.26) (P < 0.001). There were statistically significant differences between menopausal stages with regards to age, ethnicity, educational status, occupation status, and place of living. Furthermore, there were statistically significant differences between menopausal stages with regards to BMI, systolic and diastolic blood pressure (BP), Vitamin D deficiency, and diseases. Depression and anxiety were more common among postmenopause women. Furthermore, there were no differences between the groups regarding the frequency of certain levels of stress among menopause and postmenopause. The multivariate regression analyses revealed that age in years, diastolic BP, consanguinity, regular exercise were a predictor for depression. Meanwhile, diastolic BP, occupation, and physical activity considered the main risk factors for anxiety. Furthermore, age in years, occupation, and sheesha smoking habits were considered as the main risk factors associated with stress.

Conclusion:

A large number of factors were associated with experiencing menopausal and psycho-social problems and which had negative effects on the quality of life among Arabian women. Depression, anxiety, and stress should be considered as important risk factors for osteoporosis.

Physical Activity, Bone Health, and Obesity in Peri-/Pre- and Postmenopausal Women: Results from the EPIC-Potsdam Study

Physical activity (PA) is suggested to increase the peak bone mass and to minimize age-related bone loss, and thereby to reduce the risk of osteoporosis. However, the relation between PA and bone health considering the obesity status is unclear so far. The present study examines the association between PA levels and calcaneal broadband ultrasound attenuation (BUA), particularly under consideration of obesity. Data from a population-based sample of 6776 German women from the EPIC-Potsdam cohort were analyzed. Calibrated PA data were used. Statistical analyses were stratified by menopausal and obesity status. Multiple linear regression was used to model the relationship between PA and BUA levels after adjustment for age, body mass index (BMI), smoking status, education, alcohol and calcium intake, and hormone use. Peri-/premenopausal had higher BUA levels (112.39 ± 10.05 dB/MHz) compared to postmenopausal women (106.44 ± 9.95 dB/MHz). In both groups, BUA levels were higher in the fourth compared to the lowest quartile of PA (p for trend < 0.05). In women with BMI < 30, but not BMI ≥ 30 kg/m(2), PA remained positively associated with BUA levels (p for interaction = 0.03). However, when waist circumference higher than 88 cm or body fat percentage (BF%) measures above the median were used to define obesity, a significant positive relationship was also observed in women with BMI < 30 kg/m(2) but with higher waist circumference or BF%. In conclusion, our results strengthen the hypothesis that PA has a positive influence on BUA levels, though dependent on weight.