The relationship of absolute poverty and bone mineral density in postmenopausal Iranian women
It is increasingly recognized that socioeconomic inequalities play an important role in bone health, with significantly higher fracture rates being reported in lower income groups. But the relationship between absolute poverty and bone mineral density (BMD) and/or osteoporosis has not been investigated. A total of 1135 postmenopausal women under absolute poverty lines who received financial support from the Imam Khomeini Relief Foundation (IKRF) and 406 randomly selected healthy postmenopausal women were screened for osteoporosis using BMD testing. At all BMD sites, women under the absolute poverty lines had the lowest mean BMD values (p < 0.0001). According to the WHO criteria, 252 subjects under absolute poverty lines (22.4%) and 35 healthy postmenopausal women from the general population (8.7%) were considered osteoporotic (p < 0.0001). After adjustment for lifestyle factors for osteoporosis in logistic regression models, absolute poverty was associated with the age-adjusted prevalence of femoral neck osteoporosis and lumbar osteoporosis [OR = 2.50 (CI, 1.38-4.51; p = 0.002); OR = 2.40 (CI, 1.56-3.70; p < 0.0001), respectively]. Postmenopausal women under the absolute poverty lines had lower BMDs at all skeletal sites, independent of established osteoporosis risk factors.