{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T04:44:44Z","timestamp":1793681084196,"version":"4.5.1"},"reference-count":28,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2022,3,4]],"date-time":"2022-03-04T00:00:00Z","timestamp":1646352000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001409","name":"Department of Science and Technology","doi-asserted-by":"publisher","award":["EMR\/2016\/0061"],"award-info":[{"award-number":["EMR\/2016\/0061"]}],"id":[{"id":"10.13039\/501100001409","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>The prevalence and predictors of osteoporosis and osteopenia remain to be examined in the postmenopausal women of Punjab, India. The present cross-sectional study screened 1628 postmenopausal women during September 2019 to March 2020. Osteoporosis and osteopenia were confirmed on the basis of T-scores using dual energy X-ray absorptiometry (DXA) at the hip (femoral neck) and lumbar spine regions (L1\u2013L4 vertebrae). The prevalence of osteoporosis and osteopenia was observed to be 30.50% and 44.20%, respectively, in postmenopausal women of Punjab. In univariable and multivariable regression analysis, variables independently influencing the risk of osteoporosis and osteopenia were: higher systolic blood pressure (95%CI: 1.22\u20133.11 &amp; 1.08\u20132.49), triglyceride levels (95%CI: 1.21\u20133.10 &amp; 1.42\u20132.51), poor sleep quality (95%CI: 1.91\u20132.47 &amp; 1.76\u20133.47) and C-reactive protein levels (95%CI: 2.18\u20133.56 &amp; 1.03\u20132.18). Years since menopause &gt;10 years was observed to be an independent predictor for the risk of osteopenia but not for osteoporosis. Higher body mass index (&gt;30 kg\u00b7m\u22122) was observed to be a significant protective factor against the risk of osteoporosis (95%CI: 0.26\u20130.68) and osteopenia (95%CI: 0.19\u20130.52). The higher prevalence rates of osteoporosis and osteopenia in postmenopausal women of Punjab are alarming, which solicits awareness and earlier testing of those women who are approaching menopause.<\/jats:p>","DOI":"10.3390\/ijerph19052999","type":"journal-article","created":{"date-parts":[[2022,3,6]],"date-time":"2022-03-06T20:38:16Z","timestamp":1646599096000},"page":"2999","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":49,"title":["Prevalence and Predictors of Osteoporosis and Osteopenia in Postmenopausal Women of Punjab, India"],"prefix":"10.3390","volume":"19","author":[{"given":"Rubanpal","family":"Khinda","sequence":"first","affiliation":[{"name":"Department of Human Genetics, Punjabi University, Patiala 147002, Punjab, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Srishti","family":"Valecha","sequence":"additional","affiliation":[{"name":"Department of Human Genetics, Punjabi University, Patiala 147002, Punjab, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nitin","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Human Genetics, Punjabi University, Patiala 147002, Punjab, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. P. S.","family":"Walia","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Aggarsain Charitable Hospital, Patiala 147002, Punjab, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kuldeep","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Government Medical College and Hospital, Patiala 147002, Punjab, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sudhir","family":"Sethi","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Mata Kaushalya Hospital, Patiala 147002, Punjab, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Avtar","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Amandeep Hospital, Amritsar 143001, Punjab, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Human Genetics, Punjabi University, Patiala 147002, Punjab, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2154-4261","authenticated-orcid":false,"given":"Puneetpal","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Human Genetics, Punjabi University, Patiala 147002, Punjab, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarabjit","family":"Mastana","sequence":"additional","affiliation":[{"name":"Human Genomics Lab, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough LE11 3TU, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,3,4]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"462","DOI":"10.1038\/nrrheum.2015.48","article-title":"A look behind the scenes: The risk and pathogenesis of primary osteoporosis","volume":"11","author":"Hendrickx","year":"2015","journal-title":"Nat. Rev. Rheumatol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1281","DOI":"10.1007\/s00198-015-3440-3","article-title":"The National Osteoporosis Foundation\u2019s position statement on peak bone mass development and lifestyle factors: A systematic review and implementation recommendations","volume":"27","author":"Weaver","year":"2016","journal-title":"Osteoporos. Int."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1726","DOI":"10.1007\/s00198-006-0172-4","article-title":"An estimate of the worldwide prevalence and disability associated with osteoporotic fractures","volume":"17","author":"Johnell","year":"2006","journal-title":"Osteoporos. Int."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"368","DOI":"10.1007\/BF01622200","article-title":"Assessment of fracture risk and its application to screening for postmenopausal osteoporosis: Synopsis of a WHO report","volume":"4","author":"Kanis","year":"1994","journal-title":"Osteoporos. Int."},{"key":"ref_5","first-page":"673","article-title":"Geographic differences in fractures among women","volume":"8","author":"Litwic","year":"2012","journal-title":"Women\u2019s Health"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1678S","DOI":"10.1093\/ajcn\/80.6.1678S","article-title":"Sunlight and vitamin D for bone health and prevention of autoimmune diseases, cancers, and cardiovascular disease","volume":"80","author":"Holick","year":"2004","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_7","first-page":"965","article-title":"Osteoporosis\u2014Approach in Indian scenario","volume":"46","author":"Joshi","year":"1998","journal-title":"J. Assoc. Physicians India"},{"key":"ref_8","first-page":"150","article-title":"Osteoporosis\u2014Incidence and implications","volume":"50","author":"Krishna","year":"2000","journal-title":"J. Obstet. Gynecol. India"},{"key":"ref_9","first-page":"365","article-title":"Drugs for the management of osteoporosis: A review","volume":"51","author":"Khajuria","year":"2011","journal-title":"Rev. Bras. Reumatol."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"World Health Organization (WHO) (1993). Consensus development conference, diagnosis, prophylaxis and treatment of osteoporosis. Am. J. Med., 94, 646\u2013650.","DOI":"10.1016\/0002-9343(93)90218-E"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1016\/0165-1781(89)90047-4","article-title":"The Pittsburgh Sleep Quality Index: A new instrument for psychiatric practice and research","volume":"28","author":"Buysse","year":"1998","journal-title":"Psychiatry Res."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Turcotte, A.F., O\u2019Connor, S., Morin, S.N., Gibbs, J.C., Willie, B.M., Jean, S., and Gagnon, C. (2021). Association between obesity and risk of fracture, bone mineral density and bone quality in adults: A systematic review and meta-analysis. PLoS ONE, 16.","DOI":"10.1371\/journal.pone.0252487"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"2414","DOI":"10.1210\/jc.2011-0076","article-title":"Study of Osteoporotic Fractures. Risk factors for non-vertebral fracture in obese older women","volume":"96","author":"Premaor","year":"2011","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Kim, J., Lee, S., Kim, S.S., Lee, J.P., Kim, J.S., Jung, J.G., Yoon, S.J., Kim, K.P., Park, C.K., and Kim, Y.H. (2021). Association between body mass index and fragility fracture in postmenopausal women: A cross-sectional study using Korean National Health and Nutrition Examination Survey 2008\u20132009 (KNHANES IV). BMC Womens Health, 21.","DOI":"10.1186\/s12905-021-01209-4"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1699","DOI":"10.1007\/s00198-011-1768-x","article-title":"The effects of adiponectin and leptin on changes in bone mineral density","volume":"23","author":"Barbour","year":"2012","journal-title":"Osteoporos. Int."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"885","DOI":"10.1007\/s00296-008-0784-4","article-title":"Serum lipid profile: Its relationship with osteoporotic vertebrae fractures and bone mineral density in Turkish postmenopausal women","volume":"29","author":"Sivas","year":"2009","journal-title":"Rheumatol. Int."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"421","DOI":"10.1007\/s00296-010-1449-7","article-title":"SNP-SNP interactions within APOE gene influence plasma lipids in postmenopausal osteoporosis","volume":"31","author":"Singh","year":"2011","journal-title":"Rheumatol. Int."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"680","DOI":"10.1161\/01.ATV.17.4.680","article-title":"Lipid oxidation products have opposite effects on calcifying vascular cell and bone cell differentiation. A possible explanation for the paradox of arterial calcification in osteoporotic patients","volume":"17","author":"Parhami","year":"1997","journal-title":"Arterioscler. Thromb. Vasc. Biol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"2218","DOI":"10.1016\/S0140-6736(00)02408-9","article-title":"Oral statins and increased bone-mineral density in postmenopausal women","volume":"355","author":"Edwards","year":"2000","journal-title":"Lancet"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"3205","DOI":"10.1001\/jama.283.24.3205","article-title":"HMG-CoA reductase inhibitors and the risk of fractures","volume":"283","author":"Meier","year":"2000","journal-title":"JAMA"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"2309","DOI":"10.1007\/s00198-017-4050-z","article-title":"Meta-analysis of hypertension and osteoporotic fracture risk in women and men","volume":"28","author":"Li","year":"2017","journal-title":"Osteoporos. Int."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1042\/cs0650137","article-title":"Abnormalities of calcium metabolism in essential hypertension","volume":"65","author":"Strazzullo","year":"1983","journal-title":"Clin. Sci."},{"key":"ref_23","first-page":"497","article-title":"Hypertension and osteoporosis","volume":"23","author":"Nakagami","year":"2013","journal-title":"Clin. Calcium."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"727","DOI":"10.5665\/sleep.1846","article-title":"Boards of Directors of the American Academy of Sleep Medicine and the Sleep Research Society. Sleep: A health imperative","volume":"35","author":"Luyster","year":"2012","journal-title":"Sleep"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1062","DOI":"10.1016\/j.bone.2011.08.008","article-title":"Association between sleep duration and bone mineral density in Chinese women","volume":"49","author":"Fu","year":"2011","journal-title":"Bone"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"2624","DOI":"10.1002\/art.34474","article-title":"Association between bone mineral density and C-reactive protein in a large population-based sample","volume":"64","author":"Cooper","year":"2012","journal-title":"Arthritis Rheum."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1563","DOI":"10.1016\/j.jacc.2004.12.077","article-title":"The effects of physical activity on serum C-reactive protein and inflammatory markers: A systematic review","volume":"17","author":"Kasapis","year":"2005","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1263","DOI":"10.1007\/s00198-005-1840-5","article-title":"Higher circulating hsCRP levels are associated with lower bone mineral density in healthy pre- and postmenopausal women: Evidence for a link between systemic inflammation and osteoporosis","volume":"16","author":"Koh","year":"2005","journal-title":"Osteoporos. Int."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/5\/2999\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T22:31:56Z","timestamp":1760135516000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/5\/2999"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3,4]]},"references-count":28,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2022,3]]}},"alternative-id":["ijerph19052999"],"URL":"https:\/\/doi.org\/10.3390\/ijerph19052999","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,3,4]]}}}