title: Prevalence of osteoporosis, vertebral fractures and hypovitaminosis D in postmenopausal women living in a rural environment.
abstract: OBJECTIVE
  First, to study the difference between two groups of postmenopausal women living in different population centres (rural vs urban) in the prevalence of osteoporosis, fragility fractures and factors which may influence them: hypovitaminosis D, bone mineral density, coexistence of other diseases which predispose to their appearance; secondly, to observe the influence of low socioeconomic status, categorised as poverty.
  
  
  METHODS
  1229 postmenopausal women were studied, of whom 390 (31.7%), were living in rural areas and 839 (68.3%), in urban areas. Data regarding risk factors related to osteoporosis were obtained, and, among other biochemical measures, 25 hydroxyvitamin D and parathyroid hormone were determined. Bone densitometry was carried out in the lumbar spine and proximal femur, as well as lateral X-rays of the dorsal and lumbar spine.
  
  
  RESULTS
  The women who lived in rural areas were older, shorter, heavier and had a higher body mass index than those from urban areas. Among the women from rural areas there was a higher prevalence of poverty, and higher levels of obesity, arterial hypertension and diabetes mellitus were observed, as well as a higher prevalence of densitometric osteoporosis. The rural women had lower values of bone mineral density in the lumbar spine and a higher prevalence of vertebral fractures and hypovitaminosis D. The variables which were associated independently with living in rural areas were poverty, obesity, vertebral fractures, BMD in the lumbar spine and levels of 25 hydroxyvitamin D.
  
  
  CONCLUSIONS
  In our study, postmenopausal women who live in rural populations have more poverty, lower values of vitamin D, lower BMD in the lumbar spine and a higher prevalence of vertebral fractures and of osteoporosis. The higher prevalence of obesity, arterial hypertension and diabetes mellitus observed in these women may be adjuvant factors, all fostered by their socioeconomic state of poverty.
authors: Department of Medicine, University of Sevilla, Sevilla, Spain.
authors: María-Jesús
authors: MJ
authors: Gómez-de-Tejada Romero
authors: Research Group into Education and Health Promotion, University of Las Palmas de Gran Canaria, Spain.
authors: María-del-Carmen
authors: MD
authors: Navarro Rodríguez
authors: Department of Mathematics, University of Las Palmas de Gran Canaria, Spain.
authors: Pedro
authors: P
authors: Saavedra Santana
authors: Endocrinology Service, Reina Sofía Hospital, Córdoba, Spain.
authors: José-Manuel
authors: JM
authors: Quesada Gómez
authors: Endocrinology Service, Hospital Quirón, Madrid, Spain.
authors: Esteban
authors: E
authors: Jódar Gimeno
authors: Research Group into Osteoporosis and Mineral Metabolism, University of Las Palmas de Gran Canaria, Spain; Bone Metabolism Unit, Internal Medicine Service, University Insular Hospital, Las Palmas de Gran Canaria, Spain. Electronic address: msosa@ono.com.
authors: Manuel
authors: M
authors: Sosa Henríquez
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D015519:Bone Density; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D008159:Lumbar Vertebrae / Q000378:metabolism; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology; D015663:Osteoporosis, Postmenopausal / Q000453:epidemiology* / Q000378:metabolism; D017698:Postmenopause; D011203:Poverty; D015995:Prevalence; D012423:Rural Health; D012424:Rural Population; D016103:Spinal Fractures / Q000453:epidemiology* / Q000378:metabolism; D014505:Urban Population; D014807:Vitamin D / Q000031:analogs & derivatives / Q000097:blood; D014808:Vitamin D Deficiency / Q000097:blood / Q000453:epidemiology*
chemical_list: D014807:Vitamin D; C104450:25-hydroxyvitamin D
keywords: Environment; Fractures; Osteoporosis; Poverty; Rural; Urban; Vitamin D