National Osteoporosis Awareness Campaign

Based on the WHO standards, and taking on the T-score measurements, the results were as follows:

• The results of 203 cases (42%) were normal (BMD: 1.098 + 0.109). The average T-score was: 0.513, which is the deviation standard, where as the Z-score was 0.434.
• The results of 164 cases (34%) showed that they suffered from osteomalacia. The BMD was ranging between 0.893 and 1. The T-score was 2.36 and the Z-score was 1.15.
• The results of 116 cases (24%) showed that they osteoporosis patients (BMD was ranging between 0.795 and 0142. The average T-score was 3.2, whereas the Z-score was 1.76.

Summary:

• Osteomalacia and osteoporosis are common among Saudi premenopausal women. These diseases, therefore, should be paid through attention by the Saudi society as a whole.
• The bone density tests are crucial to be able to classify patients and treat them soundly.
• We are in need of more studies to find out the other causes of osteoporosis, as well as the required quantity of Vitamin D.
   

Results:

• The examination of the multiple linear regressior analysis of the bone density (in accordance with the age, weight and body mass), by using the equation (age: y=a+b), showed a significant increase in the bone density at the age of 7-8, and 13-14 years old, for both genders.
  
• The bone density of the lumbar region of Saudi children is less than that of the white American children, especially at the age of 5-6 (-10% for males, and -14% for females), and at the age of 11-12 (-17% for males, and -12% for females.

• The average bone density (BMD) of Saudi children and adolescents is less than that of the white American children.
• It is important to conduct more studies in this field, to discover the influence of the lifestyle, exposure to the sunlight, physical activity and drinking milk and milk products, as well as the geographical aspect on the bone density.

The relation between the BMD of the spine and femur bones of Saudi women and the status of Vitamin D in pregnant and breastfeeding women

The study is conducted by Dr. Ghannam, Dr. Khan, Dr. Bekheet and Dr. Hamami

• Measuring the BMD of the bones of the spine and the hip, by using the dual-energy x-ray absorptiometry, and the clinical indications, as well as the biochemical parameter, for 321 Saudi women, so as to determine a standard BMD, and study the influence of the lifestyle and physical activity on the BMD.
• The average age, the BMI, the number of pregnant women and the breastfeeding period were (35.4 + 11.3 years, 26.5 + 5.2 kg/m, 3.1 +3.1, and 23.7 + 42.4 months) respectively.
• The average of calcium, hydroxide Vitamin D (250HD) and the PTH were (2.37 + 0.09 m-mole/L, 24.5 + 17.2 nanomole/L, 52.0 + 30.8 pg/ml).
• The highest  BDM was detected in at the age of 35 years old. Compared to American women, the results showed that the lowest spinal Z-score (p<‎‏- 0.269 + 1.015, 0.0001). The incidence of osteomalacia and osteoporosis in women under 31 years old was 18-41% and 7% respectively.
• A sever hypovitaminosis D [20 nanomole/L > 250HD] has been noticed in 52% of the patient. And the rate of Vitamin D was by no means related to the BMD.
• The rate of the parathyroid hormone (PTH) is clearly related to Vitamin D (250HD) [‏r=0.28, p > 0.0001].
• Weight is related to the back bones [r = 0.17, p = 0.0005], and neck bones.
• To know the BMD, I would suggest measuring the (250HD) of the skeleton, from the shoulders downwards.
• At a relevant context, the number of pregnant and breastfeeding women is related to the BMD, in terms of the Z-score of the spinal bones (r=0.17, p=0.0003, r=-0.1, p=0.08, respectively).

• Osteoporosis is remarkably connected to age, and, in most cases, it is the cause of older persons' fractures, especially postmenopausal women.
• Outside Saudi Arabia, in various locations, several fracture accidents have taken place.
• A number of Saudi citizens, aged at least 40 years old, who have been received by the hospital while suffering from critical conditions in the course of 12 months (July 1990 – 1991), were found to have proximal femur fractures (PFF).
• A number of 103 patients were found to have PFF; out of which 52 patients (50%) are men, and 51 patients (50% are women).
• 85% of the fractures are caused by bruises and trauma (41 men and 47 women).
• The average age is 73-75 years old (+/- 14 years). Both men's and women's injuries are alike.
• In 100.000 PFF accidents afflicting men aged 40-49 years old, 50-59 years, 60-69 years, and 70 years or over, the incidence was as follows: 7, 22, 63 and 251 fractures respectively.
• In 100.000 PFF accidents afflicting women of the same age, the incidence was as follows: 4.5, 14.6, 7.9, and 394 fractures respectively.
• The female:male ratios for the same age groups were 0.6, 0.7, 2.2, and 1.6. The incidence of PFF for male and female patients over the age of 50 years was 71 and 100, respectively, with a female:male ratio of 1:4.
• The anticipated incidence of osteoporotic fracture in Saudi Arabia is expected to be higher than the present one with the population's anticipated increase in life expectancy.

Summary:

• For the sake of confirming these results, we are in desperate need for a comparison with other accidents taking place in various sectors throughout the Kingdom, through the research centers, and recording the PFF accidents.
• It is important to conduct periodic studies to record the PFF accidents taking place over the years. Such studies are effective in reducing the fractures related to osteoporosis.

• Hyperthyroidism can alter bone metabolism by increasing both bone resorption and formation. The increase in bone resorption predominates, leading to a decrease in bone mass.
• To assess the effect of hyperthyroidism on bone and mineral metabolism, we measured bone density using single photon absorptiometry in 30 untreated hyperthyroid patients.
• Patients were categorized into three groups based on sex and alkaline phosphatase levels: 44 sex- and age-matched subjects were used as controls.
• Bone densities were significantly lower in all patient groups compared with controls.
• Alkaline phosphatase was found to be a useful marker for assessing severity of bone disease in hyperthyroid patients.
• There is significant bone density among patients with higher alkaline phosphatase value.
• Hyperthyroidism should be considered in the differential diagnosis of unexplained alkaline phophatase activity.

Results:

• During the growth years, there is a yearly increase (10%) in the BMD of the spine, and 6% in the neck bones.
• The climax of the bone mineral density of Saudi women (>40 years) is 5% less than that of American women.

Summary:

• The BMD of Saudis is relatively low.
• Conducting intensive studies on the relation between the physical activity, lifestyle, food, exposure to the sun and location.