OP2026 Oral Communications Oral Communications 1: Research 1 (7 abstracts)
Lifestyle and clinical factors associated with femoral neck bone mineral density in African adults: findings from the fracture-E3 study
Camille Pearse 1 , Lucy Gates 1 , Anya Burton 2 , Tadios Manyanga 3 , Momodou Jallow 4 , Chris Grundy 5 , Nicola Crabtree 6 , Emma Clark 2 , Hann Wilson 2 , Tafadzwa Madanhire 2 , Anthony Manyara 2 , Bilkish Cassim 7 , Rashid Ferrand 8,3 , Celia Gregson 2,3 & Kate Ward 1,4
1University of Southampton, Southampton, United Kingdom;2University of Bristol, Bristol, United Kingdom;3The Research Unit Zimbabwe, Harare, Zimbabwe;4MRC Unit The Gambia, Banjul, Gambia;5London School of Hygiene and Tropical Medicine, London, United Kingdom;6Birmingham Women and Children’s Hospital NHS Trust, Birmingham, United Kingdom;7University of KwaZuluNatal, Durban, South Africa;8London School of Hygiene and Tropical Medicine, London, United Kingdom
Objective: To identify clinical, nutritional and lifestyle factors associated with femoral neck bone mineral density (FN-BMD) in women and men in Africa.
Methods: A population-based sample of adults aged ≥40 years, stratified by sex- and age-bands, were recruited in The Gambia and Zimbabwe. FN-BMD was measured using DXA, with vertebral fractures (VF) identified using Genant semiquantitative methods. Linear regression explored associations between demographic, nutritional, lifestyle and clinical risk factors and femoral neck T-scores, stratified by sex and adjusted for age (age-adjusted results shown in the figure). Factors assessed included underweight (BMI 18.5kg/m2), low mid-upper arm circumference (MUAC, 23cm), HIV (Zimbabwe only), diabetes, glucocorticoid use, fracture history, rheumatoid arthritis (RA), secondary osteoporosis, smoking and alcohol intake.
Results : The study included 2181 participants (53% women), mean age 61.4 years; 5.8% were underweight and 6% had MUAC 23 cm. After adjustment for age, markers of undernutritionlow BMI and low MUAC ( coefficient ()0.7 and 0.6, respectively)and previous major osteoporotic fracture (MOF) and VF (Coef X) were associated with lower FN-BMD in both sexes. HIV infection was independently associated with lower BMD in men only ( 0.4), while type 2 diabetes was associated with lower BMD in women only ( 0.3). Associations for smoking, alcohol intake and secondary osteoporosis seen in unadjusted models were attenuated after age adjustment. Several traditional osteoporosis risk factors, including glucocorticoid use and rheumatoid arthritis, showed no significant associations, partly due to low prevalence (4.4% and 0.6% respectively).
Conclusion : Undernutrition indicators (low BMI and MUAC23cm) and prior fractures (MOF and VF) were the strongest correlates of lower FN-BMD, with additional sex-specific associations for HIV (men) and diabetes (women). The absence of associations with several conventional risk factors suggests that in African settings, nutritional status and fracture history may be more informative. Given the limited access to DXA in many African countries, integrating simple anthropometric measures with fracture history may offer a more practical approach to identifying adults at increased fracture risk.
Volume 8
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