Disclosures: The authors report no relevant financial disclosures.
August 17, 2021
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Lifestyle factors associated with osteoporosis and fracture among postmenopausal women

Disclosures: The authors report no relevant financial disclosures.
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Researchers found that osteoporosis and fracture were associated with certain lifestyle factors among postmenopausal women, although no factors correlated with an increase in both osteoporosis and fracture.

The findings were published in Menopause.

The researchers selected 4,427 postmenopausal women in Japan without a history of osteoporosis or fracture at baseline who were enrolled in the Kyushu University Fukuoka Cohort Study on lifestyle-related diseases between February 2004 and August 2007. The women were followed up between February 2010 and December 2012.

The study looked at numerous lifestyle factors, including BMI, smoking and drinking status, sleep regularity, sleep sufficiency and breakfast habits, as well as time and frequency spent in three types of work-related activities and three types of leisure activities.

The researchers also assessed the women’s personalities using a brief inventory of eight items. Participants additionally rated their subjective health status and life satisfaction. The researchers conducted venous blood sampling to measure HbA1c, high-sensitivity C-reactive protein, and eight items of serum biochemistry.

The participants had a mean age of 61.8 years and a mean duration after menopause of 11.7 years. They were categorized into four groups: no osteoporosis or fracture; osteoporosis present but no fracture; fracture present but no osteoporosis; and both osteoporosis and fracture.

The researchers found numerous associations between certain factors and osteoporosis or fracture. Among them, skipping breakfast was negatively associated with osteoporosis without fracture (OR = 0.4; P = .009) but positively associated with fracture without osteoporosis (OR = 2.3; P = 0009). Additionally, HbA1c levels were negatively associated with osteoporosis without fracture (OR = 0.81; P = .0003) but positively associated with fracture without osteoporosis (OR = 1.18; P = .03).

“Parental history of fracture and extraversion personality trait were both associated with fracture without osteoporosis,” the researchers said.

Participants with poor sleep tended to experience fractures as well. The study also showed significant associations between fracture and total cholesterol and parental history of fracture, but the researchers noted that there is a need to assess the risk of these factors after carefully considering possible confounders.

Additional limitations include the study’s use of self-reporting and its potential for recall bias. There also was a lack of information about when osteoporosis and fracture were detected as well as what caused the fracture.

Finally, the researchers also were concerned about representation among the participants and with the study’s relatively short follow-up duration.

However, the researchers maintained that these associations between osteoporosis, fractures and lifestyle factors underscore why it is important for postmenopausal women to routinely connect with their doctors, maintain a regular lifestyle and avoid strenuous activities beyond their capacity to avoid fractures.