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Risk factors and impact on bone mineral density in postmenopausal Mexican mestizo women

Rojano-Mejía, David MsC1,2; Aguilar-Madrid, Guadalupe PhD3; López-Medina, Guillermo MD1; Cortes-Espinosa, Leticia MD4; Hernández-Chiu, Maria C. MD5; Canto-Cetina, Thelma PhD6; Vergara-López, Alma MD7; Coral-Vázquez, Ramon M. PhD8; Canto, Patricia MD, MSc, PhD1

doi: 10.1097/gme.0b013e3181f2d3fb
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Objective: Considering that the Mexican mestizo population seems to be the result of a genetic admixture, we proposed that further research is needed to evaluate the role of ethnicity in conjunction with health-related factors to better understand ethnic differences in bone mineral density (BMD). The aim of this study was to analyze several risk factors related to the development of osteoporosis in postmenopausal Mexican mestizo women.

Methods: We included 567 postmenopausal Mexican mestizo women. A structured questionnaire for risk factors was applied and BMD was measured in total hip and lumbar spine by dual-energy x-ray absorptiometry. Nonconditional logistic regression was used to estimate crude and adjusted odds ratio.

Results: Using World Health Organization criteria, 28.7% of postmenopausal women had osteoporosis, 46.4% had osteopenia, and 24.9% had normal BMD. Each clinical risk factor had a different significance for osteopenia/osteoporosis; however, duration of total breast-feeding, body mass index, and number of years since menopause remained significantly associated with osteopenia/osteoporosis after bone density was added to the nonconditional model. Interestingly, extended periods of accumulated breast-feeding for 24 and 36 months were, in both cases, significantly associated with osteopenia/osteoporosis.

Conclusions: Our results confirm the importance of considering the duration of breast-feeding as an important risk factor for osteopenia/osteoporosis. In addition, we find that body mass index is positively associated with BMD. Because of the heterogeneity of the Mexican mestizo population, the risk factor for osteoporosis may not be the same in different ethnic groups.

From the 1División de Investigación Biomédica, Subdirección de Enseñanza e Investigación, Centro Médico Nacional 20 de Noviembre, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, México, D.F., México; 2Unidad de Medicina Física y Rehabilitación Región Norte, UMAE Magdalena de las Salinas, Instituto Mexicano del Seguro Social, México, D.F., México; 3Unidad de Investigación en Salud del Trabajo, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, México, D.F., México; 4Servicio de Ginecología y Obstetricia, Hospital Regional Tacuba, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, México, D.F., México; 5Unidad de Medicina Familiar No. 20, Instituto Mexicano del Seguro Social, México, D.F., México; 6Laboratorio de Biología de la Reproducción, Departamento de Salud Reproductiva y Genética, Centro de Investigaciones Regionales "Dr. Hideyo Noguchi," Mérida Yucatán, México; 7Servicio de Endocrinología del Centro Médico Nacional 20 de Noviembre, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, México, D.F., México; and 8Sección de Posgrado, Escuela Superior de Medicina, Instituto Politécnico Nacional, and División de Medicina Genómica, Centro Médico Nacional 20 de Noviembre Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, México, D.F., México.

Received June 7, 2010; revised and accepted July 8, 2010.

Funding/support: This work was supported by a grant from the Instituto de Ciencia y Tecnología del Distrito Federal (PICDS08-34, México). D.Rojano-Mejía was supported by Consejo Nacional de Ciencia y Tecnología and by a fellowship award from the Coordinación de Investigación en Salud, Instituto Mexicano del Seguro Social. G. López-Medina was supported by a fellowship award from the Instituto de Ciencia y Tecnología del Distrito Federal.

Financial disclosure/conflicts of interest: None reported.

Address correspondence to: Ramón M. Coral-Vázquez, PhD, Sección de Posgrado, Escuela Superior de Medicina, Instituto Politécnico Nacional,Plan de San Luis y Díaz Mirón s/n, Col. Casco de Santo Tomas, CP 11340, México. E-mail: rmcoralv@prodigy.net.mx and Patricia Canto, MD, MSc, PhD, División de Investigación Biomédica C.M.N. 20 de Noviembre, ISSSTE, San Lorenzo No. 502, 2nd piso. Col. del Valle, Delegación Benito Juárez,CP 03100, México, D.F., Mexico. E-mail: ipcanto@yahoo.com.mx

©2011The North American Menopause Society