Endocrine Abstracts

Introduction: Osteoporosis is a silent disease and fractures pose enormous medical and financial burden on ageing individuals. Also subjects of younger age are at risk for subnormal bone mineral density when they have systemic disorders like rheumatoid arthritis or on long-term medications like corticosteroids. Preventive measures can be initiated if osteoporosis is diagnosed and treated before any fracture occurs. Even after the first fracture has occurred, there are effective treatments to decrease the risk of further fractures and associated morbidity and mortality.

Objective: To evaluate the current use of bone densitometry, referral pattern, and prevalence of osteoporosis in patients referred for DXA in a tertiary care centre.

Methods: Bone densitometry data of all the patients (n=1480) referred for DXA from 1 Aug to 31 Oct 2012 was collected. Their demography and biochemical data were recorded from Computerized Hospital Information Processing System network.

Results: The mean age (±S.D.) was 49.9 (±13.1) and 47% of subjects (n=695) was below 50 years. Steroid use was documented in 25% (n=370) of the patients, and among them, 12.5% had osteoporosis and 60% had osteopenia. In those above 50 years of age (n=785), 42% had osteoporosis and 44% had osteopenia. Calcium profile was evaluated in only 65.6% and vitamin D in 75.6% of the patients. Vitamin D deficiency (<20 ng/ml) was present in 61%. The most common referrals were from Rheumatology (28%), followed by Internal Medicine (25%), Endocrinology (21%) and Orthopedics (16%). The most common reasons for referral were for postmenopausal state and inflammatory arthritis.

Conclusion: Utilization of DXA scanning as a tool for diagnosis of osteoporosis is restricted to only few specialties. A large section of women and men with osteoporosis who need preventive measures, vitamin D and calcium supplements still remain undiagnosed.