The prevalence of osteopenia and osteoporosis in out-patients above 40 years of a tertiary care hospital in Delhi


  • Ananya Sharma Department of Orthopaedics, Indira Gandhi ESI Hospital, New Delhi, Delhi, India
  • Alok Garg Department of Orthopaedics, Indira Gandhi ESI Hospital, New Delhi, Delhi, India
  • Binit Singh Department of Orthopaedics, Indira Gandhi ESI Hospital, New Delhi, Delhi, India



Osteoporosis, Osteopenia, Bone mass density, QUS


Background: Osteoporosis is a common bone disorder among Indian population but is still underdiagnosed. Being a treatable disease, early diagnosis can significantly reduce osteoporotic fractures and other morbidities. Despite multiple studies globally regarding the prevalence of osteoporosis and osteopenia, the data about Indian population especially in males is limited. In this study, we aim to calculate the prevalence of osteoporosis in patients over 40 years of age attending the out-patients department of a tertiary care hospital in New Delhi.

Methods: A cross-sectional study was done including 231 patients (147 females and 84 males) over the age of 40 years. Calcaneal quantitative ultrasonography (QUS) was used to measure the bone mineral density and the results were divided into normal, osteopenic and osteoporotic groups on the based on equivalent heel T score.

Results: Of the total 231 patients, 78 patients had a normal bone mass density as measured by calcaneal QUS. 123 patients (53.2%) were found to be osteopenic while 30 patients (13.1%) were osteoporotic. Of the 147 females, 84 (57%) were osteopenic while 27 (18%) patients were found to be osteoporotic. Among the 84 males, 39 (46%) were osteopenic and 3 (4%) were found to be osteoporotic.

Conclusions: The prevalence of osteoporosis and osteopenia in outpatients over 40 years was high in our study and similar in values with other studies involving the Indian population. Hence, we recommend regular screening and early detection of osteoporosis to reduce the burden of the disease.


World Health Organization. Assessment of Fracture Risk and Its Application to Screening for Postmenopausal Osteoporosis. Report of a WHO Study Group. Geneva: World Health Organization. 1994.

Hunter DJ, Sambrook PN. Bone loss. Epidemiology of bone loss. Arthritis Res Ther. 2000;2:441-5.

Riggs BL, Melton LJ 3rd .Evidence for two distinct syndromes of involutional osteoporosis. :The American Journal of Medicine. 1983;75(6):899-901.

Warming L, Hassager C, Christiansen C. Changes in bone mineral density with age in men and women: A longitudinal study. Osteoporos Int. 2002;13:105-12.

Mithal A, Kaur P. Osteoporosis in Asia: A Call to Action. Curr Osteoporos Rep. 2012;10:245-7 .

Khanna P, Bhargava S. Roentgen assessment of bone density in North Indian population. Indian J Med Res. 1971;59:1599-609.

Marwaha RK, Tandon N, Garg MK, Kanwar R, Narang A, Sastry A, et al. Bone health in healthy Indian population aged 50 years and above. Osteoporos Int. 2011;22:2829-36.

Cilotti A, Falchetti A. Male osteoporosis and androgenic therapy: From testosterone to SARMs. Clin Cases Miner Bone Metab. 2009;6:229-33.

Agrawal NK, Sharma B. Prevalence of osteoporosis in otherwise healthy Indian males aged 50 years and above. Arch Osteoporos. 2013;8:116.

Sharma B, Prakash V, Agrawal N, Singh S. Prevalence of male osteoporosis in India. Indian J Endocrinol Metab. 2012;16:S519.

World Health Organization: WHO scientific group on the assessment of osteoporosis at the primary health care level. Summary Meeting Report;Brussels, Belgium. 5–7 May 2004; World Health Organization. 2007.

Anburajan M, Ashok KD, Sapthagirivasan V. Vol. 5. Singapore: IACSIT Press; 2011. Evaluation of osteoporosis in Indian women and men using peripheral dual-energy X-ray absorptiometry (pDXA) IPCBE.

Malhotra N, Mithal A. Osteoporosis in Indians. Indian J Med Res. 2008;127:263-8.

Laugier P. An overview of bone sonometry. Int Congr Ser. 2004;1274:23-32.

Bauer DC, Gluer CC, Cauley JA, Vogt TM, Ensrud KE, Genant HK et al. Broadband ultrasound attenuation predicts fractures strongly and independently of densitometry in older women. A prospective study of osteoporotic fractures research group. Arch Intern Med. 1997;157:629-34.

Khow KT, Reeve J, Luben R, Bingham S, Welch A, Wareham N et al. Prediction of total hip fracture risk in men and women by quantative ultrasound of the calcaneus: EPIC-Norfolk prospective population study. Lancet. 2004;363:197-202.

Diez-Perez A, Marin F, Vila J, Abizanda M, Cervera A, Carbonell C, et al. Evaluation of calcaneal quantitative ultrasound in a primary care setting as a screening tool for osteoporosis in postmenopausal women. J Clin Densitom. 2003;6:237-45.

Knapp KM, Blake GM, Spector TD, Fogelman I. Can the WHO definition of osteoporosis be applied to multi-site axial transmission quantitative ultrasound? Osteoporos Int. 2004;15:367-74.

Jin NN, Lin SQ, Zhang Y, Chen FL. Assess the discrimination of Achilles InSight calcaneus quantitative ultrasound device for osteoporosis in Chinese women: Compared with dual energy X-ray absorptiometry measurements. Eur J Radiol. 2010;76:265-8.

Gandhi AB, Shukla AK. Evaluation of BMD of women above 40 years of age. J Obstet Gynecol India. 2005;55(3):265-7.

Sharma S, Tandon VR, Mahajan A, Kour A, Kumar D. Preliminary screening of osteoporosis and osteopenia in urban women from Jammu using calcaneal QUS. Indian J Med Sci. 2006;60(5):183-9.

Unni J, Garg R, Pawar R. Bone mineral density in women above 40 years. J Midlife Health. 2010;1(1):19-22.

Shetty S, Kapoor N, Naik D, Asha HS, Prabu S, Thomas N, et al. Osteoporosis in healthy South Indian males and the influence of life style factors and vitamin d status on bone mineral density. J Osteoporos. 2014;2014:723238

Vaishya R, Vijay V, Agarwal AK, Maheshwari P. Assessment of osteoporotic fracture risk in urban Indian population using quantitative ultrasonography & FRAX tool. Indian J Med Res. 2017;146(8):51-6.

Baran DT, Kelly AM, Karellas A, Gionet M, Price M, Leahey D, Steuterman S, McSherry B, Roche J. Ultrasound attenuation of the os calcis in women with osteoporosis and hip fractures. Calcif Tissue Int. 1988;43(3):138-42.






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