Association between Bone Mineral Density and Clinical Consequences: Cross-Sectional Study of Korean Postmenopausal Women in an Orthopaedic Outpatient Clinic

This study is to identify the characteristics of BMD and the related clinical consequences through a nationwide, consecutive, cross-sectional study. A total of 1,281 postmenopausal women was enrolled nationwide and underwent measurement for BMD using dual energy x-ray absorptiometry. Following the T-spine and L-spine plane radiography, they were evaluated for vertebral fracture by a semi-quantitative method using the Genant's method. Relationship between BMD and osteoporotic fracture and a degree of deformity in vertebral fracture, treatment history in osteoporosis and the EQ-5D was analyzed. The distribution of the normal, osteopenia and osteoporosis group was 25.9%, 37.0%, and 37.2% in lumbar spine, and 31.4%, 45.3%, and 23.3% in femur neck, respectively. BMD in subjects with symptomatic or asymptomatic vertebral fracture was significantly lower than those without fracture. The femur neck and total hip BMDs were significantly lower in hip fracture group (0.646 g/cm(2) and 0.643 g/cm(2), respectively) and wrist fracture group (0.661 g/cm(2) and 0.712 g/cm(2), respectively) than in subjects without fracture (0.721 g/cm(2) and 0.712 g/cm(2), respectively). The BMD was significantly lower with more severe degree of deformity in vertebral fracture and lower scores in mobility, usual activities and pain/discomfort of the EQ-5D. In Korean postmenopausal women, the prevalence of osteoporosis and vertebral, hip and wrist fracture increase and quality of life decreases with lower BMD.