CLINICAL CHARACTERISTICS OF OSTEOPOROSIS IN WOMEN OVER 50 YEARS WITH METABOLIC SYNDROME AT 199 HOSPITAL

Abstract

Introduction: Osteoporosis is characterized by reduced in bone mass and deterioration of bone microarchitecture, rendering fragile and more susceptible to fractures. Women are four times more likely to develop osteoporosis than men due to lower peak bone mass and a rapid decline in bone density after the age of 50, mainly caused by estrogen deficiency—an essential factor for maintaining bone health. In 1999, the prevalence of osteoporosis among American women over 50 years old was 19.6% (compared to 3.1% in men), contributing to fractures, disability, and increased mortality. Metabolic syndrome (central obesity, hypertension, dyslipidemia, and insulin resistance) accelerates bone loss through chronic inflammation associated with visceral adipose tissue. With population aging, osteoporosis is becoming an increasing healthcare burden in Vietnam; however, domestic research on this issue remains limited. This study aimed to determine the prevalence of osteoporosis and its associated factors among women aged over 50 years with metabolic syndrome at 199 Hospital. Methods: A cross-sectional descriptive study using convenience sampling was conducted on 264 women aged over 50 years who attended 199 Hospital from October 2024 to December 2025. Participants were divided into two equal groups: 132 women with metabolic syndrome (meeting ≥3/5 criteria of the AHA/NHLBI 2009 Asian guidelines) and 132 without metabolic syndrome. Exclusion criteria included patients using hormone replacement therapy, long-term corticosteroids, history of oophorectomy, or acute medical illnesses. Data were collected through interviews using the FRAX 2008 fracture risk assessment tool. Body mass index (BMI) was classified according to WHO Asian criteria (2000), waist circumference and blood pressure were measured following Vietnamese Hypertension Society guidelines (2015). Blood glucose and lipid profiles were measured. Bone mineral density was measured by DEXA (ALOKA) at the lumbar spine and femoral neck, and classified by T-score according to WHO 1994 criteria. Data were analyzed using SPSS 20.0 with Student’s t-test and χ² test (p<0.05). Results: Among 132 women aged over 50 years with metabolic syndrome, the prevalence of osteoporosis was 51.5%. Specifically, femoral neck osteoporosis accounted for 49.2% (compared with 23.5% in the control group, p<0.001) and lumbar spine osteoporosis accounted for 20.5% (compared with 6.8%, p<0.05).. Age showed a strong negative correlation with femoral neck bone mineral density (r = −0.492, p<0.01). Not consuming milk was associated with increased risk (p<0.01). Disussion: The study demonstrated that metabolic syndrome significantly increases the prevalence of osteoporosis in women over 50 years old: femoral neck osteoporosis 49.2% vs. 23.5% (p<0.001), and lumbar spine osteoporosis 20.5%, 6.8% (p<0.05). Age showed a strong negative correlation with femoral neck bone mineral density (r = −0.492; p<0.01). Central obesity (OR = 3.06; p = 0.006), type 2 diabetes (OR = 2.14; p = 0.034), and high cholesterol (OR = 2.20; p = 0.036) were identified as independent risk factors. Higher BMI had a protective effect (OR = 0.42; p = 0.015), while not consuming milk increased risk (p<0.01). These findings are consistent with previous studies, highlighting that metabolic syndrome contributes to bone loss through chronic inflammation and insulin resistance, even in individuals with normal BMI. Conclusion: The study found an osteoporosis prevalence of 51.5% among 132 women aged over 50 years with metabolic syndrome, including 49.2% with femoral neck osteoporosis and 20.5% with lumbar spine osteoporosis. Independent risk factors included central obesity (OR = 3.06), type 2 diabetes (OR = 2.14), and high cholesterol (OR = 2.20). Age showed a strong negative correlation with bone mineral density (r = −0.492). Higher BMI and milk consumption had protective effects (p<0.01).