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Urban–Rural Differences in Bone Mineral Density and its Association with Reproductive and Menstrual Factors Among Older Women

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Abstract

Purpose

This study aimed to compare the bone mineral density (BMD) of older women living in rural and urban areas, and evaluate the potential factors affecting the risk of osteoporosis.

Methods

We recruited 574 women aged 65 years or older from rural areas and 496 from urban areas in Shanghai, China. The BMD values of the lumbar vertebrae and total left hip were measured by a dual energy X-ray absorptiometry densitometer. We also recorded information about education level, family income, medications, reproductive and menstrual history, diet, smoking, and alcohol consumption.

Results

Women in urban areas had significantly higher BMD in their lumbar spine, and there was a dramatic increase in the proportion of women with osteoporosis in rural areas. The age at menarche was significantly higher among women living in rural areas, and there were more years from menarche to menopause among urban women. Rural women had significantly higher numbers of both pregnancies and parity, and a significantly lower age at first parity. In multiple linear regression analyses, years from menarche to menopause was independently related to high lumbar spine BMD, while age at menarche and parity was independently related to low lumbar spine BMD.

Conclusion

More older women in rural areas had osteoporosis. Later menarche, less years from menarche to menopause and higher parity might partially contribute to decreased BMD among women in rural areas. More attention should be paid to women in rural areas to prevent bone loss and further bone and health impairment.

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Funding

This work was partially supported by the National Key R&D Program of China (Grant No. 2018YFC1704300), the National Natural Science Foundation of China (Grant Nos. 81730107, 81973876), Shanghai TCM Medical Center of Chronic Disease (2017ZZ01010) and Three Years Action to Accelerate the Development of Traditional Chinese Medicine Plan (ZY(2018–2020)-CCCX-3003), the Program for Innovative Research Team of Ministry of Education of China (IRT1270), the Program for Innovative Research Team of Ministry of Science and Technology of China (2015RA4002) and Sanming Project of Medicine in Shenzhen (SZSM201808072).

Author information

Author notes

  1. Jing Wang, Weiqiang Zhang and Xiaoyun Wang have contributed equally to this work.

Authors and Affiliations

  1. Longhua Hospital, Shanghai University of Traditional Chinese Medicine, 725 South Wanping Road, Shanghai, 200032, China

    Jing Wang, Weiqiang Zhang, Xiaoyun Wang, Chenguang Li, Jinlong Li, Yongjian Zhao, Lin Chen, Xiaofeng Qi, Liang Qiao, Weiwei Da, Li Liu, Chongqing Xu, Sen Zhu, Yimian Li, Hao Zhang, Nannan Sha, Qiang Wang, Yin Zhu, Jianxing Luo, Xuejun Cui, Qianqian Liang, Sheng Lu, Qi Shi, Yongjun Wang & Bing Shu

  2. Key Laboratory, Ministry of Education of China, Shanghai, 200032, China

    Jing Wang, Weiqiang Zhang, Chenguang Li, Jinlong Li, Yongjian Zhao, Lin Chen, Xiaofeng Qi, Liang Qiao, Weiwei Da, Li Liu, Chongqing Xu, Sen Zhu, Yimian Li, Hao Zhang, Nannan Sha, Qiang Wang, Yin Zhu, Jianxing Luo, Xuejun Cui, Qianqian Liang, Sheng Lu, Qi Shi, Yongjun Wang & Bing Shu

  3. Shanghai University of Traditional Chinese Medicine, 1200 Cailun Road, Shanghai, 201203, China

    Qi Shi & Yongjun Wang

Authors
  1. Jing Wang
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Contributions

Yongjun Wang, Bing Shu and Qi Shi designed the work; Jing Wang, Bing Shu, Weiqiang Zhang, Xiaoyun Wang, Chenguang Li, Jinlong Li, Yongjian Zhao, Lin Chen, Xiaofeng Qi, Liang Qiao, Weiwei Da, Li Liu, Chongqing Xu, Sen Zhu, Yimian Li, Hao Zhang, Nannan Sha, Qiang Wang, Yin Zhu, Jianxing Luo, Xuejun Cui, Qianqian Liang, Sheng Lu performed the clinical investigations and data acquisition; Jing Wang, Xiaoyun Wang and Weiqiang Zhang undertook the analyses; Jing Wang, Bing Shu, Xiaoyun Wang and Weiqiang Zhang wrote the initial draft; Bing Shu and Yongjun Wang critically revised the manuscript.

Corresponding authors

Correspondence to Yongjun Wang or Bing Shu.

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Conflict of interest

Jing Wang, Weiqiang Zhang, Xiaoyun Wang, Chenguang Li, Jinlong Li, Yongjian Zhao, Lin Chen, Xiaofeng Qi, Liang Qiao, Weiwei Da, Li Liu, Chongqing Xu, Sen Zhu, Yimian Li, Hao Zhang, Nannan Sha, Qiang Wang, Yin Zhu, Jianxing Luo, Xuejun Cui, Qianqian Liang, Sheng Lu, Qi Shi, Yongjun Wang and Bing Shu declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

The study was approved by the Ethics Board of Longhua Hospital, Shanghai University of Traditional Chinese Medicine, and performed in accordance with the Declaration of Helsinki. All the involved participants signed the informed consent forms before inclusion in this study.

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Wang, J., Zhang, W., Wang, X. et al. Urban–Rural Differences in Bone Mineral Density and its Association with Reproductive and Menstrual Factors Among Older Women. Calcif Tissue Int 106, 637–645 (2020). https://doi.org/10.1007/s00223-020-00681-8

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