Original Article

Risk Factors of Osteoporosis in Females: A Hospital-Based Case-Control Study, Yazd, Iran


Background: The aim of this study was to evaluate the predictors of osteoporosis in women in Yazd, Iran.

Methods: This hospital-based case-control study was performed on 270 women 35-65 yr old (135 case and 135 control) from Mar 2016 to Mar 2017. Case and control were matched in terms of age ± 2 (year) as a group matching. Osteoporosis is defined as a T-score of bone mineral density (BMD) below –2.5 SD. Data were analyzed using SPSS 20 software. Statistical tests included chi-square, student t test and Mann Whitney test .Multiple logistic regression (MLR) which forward method was used for modeling.

Results: Odds ratio (OR) of osteoprosis were menarche age>12 yr (OR=3.37, CI:2.29-15.89), history of hysterectomy (OR=13, CI:3.81-44.82), rheumatoid arthritis (RA) (OR=6.58, CI:2.29-18.91) calcium supplements (OR=0.14, CI:0.04-0.41), menopause age <40 (OR=11.84, CI:1.54-90), second smoking (OR=3.38, CI:1.16-9.81) and increase of weight (OR=0.86, CI:0.80-0.94).

Conclusion: Predictors of osteoporosis was menarche age >12 yr (3 times), history of hysterectomy (13 times), RA (6.5 times), menopause age <40 (12 times), second smoking (more than 3 times), calcium supplements and weight (protective).


1. Ensrud KE (2013). Epidemiology of fracture risk with advancing age. J Gerontol A Biol Sci Med Sci, 68(10):1236-42.
2. Holroyd C, Cooper C, Dennison E (2008). Epidemiology of osteoporosis. Best Pract Res Clin Endocrinol Metab, 22(5):671-85.
3. Koga T, Takayanagi H (2015). On" 2015 Guidelines for Prevention and Treatment of Osteoporosis". Cellular mechanism and etiology of osteoporosis. Clin Calcium, 25(9):1293-300.
4. McLean RR, Kiel DP, Berry SD, et al (2018). Lower lean mass measured by dual-energy X-ray absorptiometry (DXA) is not associated with increased risk of hip fracture in women: the Framingham osteoporosis study. Calcif Tissue Int, 103(1):16-23.
5. Rossini M, Adami S, Bertoldo F, et al (2016). Guidelines for the diagnosis, prevention and management of osteoporosis. Reumatismo,68(1):1-39.
6. Sözen T, Özışık L, Başaran NÇ (2017). An overview and management of osteoporosis. Eur J Rheumatol, 4(1): 46–56.
7. Wade S, Strader C, Fitzpatrick L, et al (2014). Estimating prevalence of osteoporosis: examples from industrialized countries. Arch Osteoporos, 9:182.
8. Abolhassani F, Moayyeri A, Naghavi M, et al (2006). Incidence and characteristics of falls leading to hip fracture in Iranian population. Bone, 39(2):408-13.
9. Ahmadi-Abhari S, Moayyeri A, Abolhassani F (2007). Burden of hip fracture in Iran. Calcif Tissue Int, 80(3):147-53.
10. Jafari N, Abolhasani F, Naghavi M, et al (2009). National burden of disease and study in Iran. Iran J Public Health, 38 (1) : 71-73.
11. Chen S-J, Liao W-C, Huang K-H, et al (2015). Chronic obstructive pulmo-nary disease and allied conditions is a strong independent risk factor for os-teoporosis and pathologic fractures: a population-based cohort study. QJM, 108(8):633-40.
12. Demirtaş Ö, Demirtaş G, Hurşitoğlu B, et al (2014). Is grand multiparity a risk factor for osteoporosis in postmenopausal women of lower socioeconomic status? Eur Rev Med Pharmacol Sci, 18(18):2709-14.
13. Pisani P, Renna MD, Conversano F, et al (2016). Major osteoporotic fragility fractures: Risk factor updates and societal impact. World J Orthop, 7(3):171-81.
14. Willson T, Nelson SD, Newbold J, et al (2015). The clinical epidemiology of male osteoporosis: a review of the recent literature. Clin Epidemiol, 7: 65–76.
15. Naz MSG, Ozgoli G, Aghdashi MA, et al (2016). Prevalence and risk factors of osteoporosis in women referring to the bone densitometry academic center in Urmia, Iran. Glob J Health Sci, 8(7): 135–145.
16. Hamidi Z, Majdzadeh SR, Soltani A, et al (2006). Generalized impact fraction of risk factors in burden of osteoporosis. Journal of Medical Council of Iran, 24 (4):381-392.
17. Lotfi MH, Fallahzadeh H, Owlia MB, et al (2018). Socioeconomic Status and Osteoporosis Risk: A Case-control Study in Outpatient Women in Yazd. Journal of Community Health Research, 7:105-111.
18. Esfahani FH, Asghari G, Mirmiran P, et al (2010). Reproducibility and relative validity of food group intake in a food frequency questionnaire developed for the Tehran Lipid and Glucose Study. J Epidemiol, 20(2):150-8.
19. Moghaddam MB, Aghdam FB, Jafarabadi MA, et al (2012). The Iranian Version of International Physical Activity Questionnaire (IPAQ) in Iran: content and construct validity, factor struc-ture, internal consistency and stability. World Appl Scie J , 18:1073-1080.
20. Golob AL, Laya MB (2015). Osteoporosis: screening, prevention, and management. Med Clin North Am, 99(3):587-606.
21. Parker SE, Troisi R, Wise LA, et al (2014). Menarche, menopause, years of menstruation, and the incidence of osteoporosis: the influence of prenatal exposure to diethylstilbestrol. J Clin Endocrinol Metab, 99:594-601.
22. Silva ACV, da Rosa MI, Fernandes B, et al (2015). Factors associated with osteopenia and osteoporosis in women undergoing bone mineral density test. Rev Bras Reumatol, 55(3):223-8.
23. Sasaki S, Yanagibori R (2001). Association between current nutrient intakes and bone mineral density at calcaneus in pre-and postmenopausal Japanese women. J Nutr Sci Vitaminol (Tokyo), 47(4):289-94.
24. Bayat N, Einollahi B, Pourfarzian V, et al (2007). Bone mineral density changes within 11 months of renal transplantation in Iranian patients. Transplantation Proceedings, 39 (4). 1039-1043.
25. Azad S, Golestan B, Bakhsh J (2008). Determination of the Relation between Osteoporotic and Osteopenic Risk Factors among Women Referring to BMD Center. RJMS, 14(57): 91-99.
26. Keramat A, Patwardhan B, Larijani B, et al (2008). The assessment of osteoporosis risk factors in Iranian women compared with Indian women. BMC Musculoskelet Disord, 9:28.
27. Sioka C, Fotopoulos A, Georgiou A, et al (2010). Age at menarche, age at menopause and duration of fertility as risk factors for osteoporosis. Climacteric, 13(1):63-71.
28. Keramat A, ADIBI H, Hosseinnezhad A, et al (2007). Risk factors for osteo-porosis in urban Iranian postmeno-pausal women (A center-based study). J Knowledge Health, 2 (3):36.
29. Kim KH, Lee CM, Park S, et al (2013). Secondhand smoke exposure and osteoporosis in never-smoking postmenopausal women: the Fourth Korea National Health and Nutrition Examination Survey. Osteoporos Int, 24:523-32.
30. Mellström D, Vandenput L, Mallmin H, et al (2008). Older men with low serum estradiol and high serum SHBG have an increased risk of fractures. J Bone Miner Res, 23(10):1552-60.
31. Sharma S, Tandon VR, Mahajan S, et al (2014). Obesity: Friend or foe for osteoporosis. J Midlife Health, 5(1):6-9.
IssueVol 51 No 6 (2022) QRcode
SectionOriginal Article(s)
DOI https://doi.org/10.18502/ijph.v51i6.9693
Osteoporosis Women Case-control study Iran

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
Askari M, Lotfi MH, Azimi SM, Ostovarfar M, Fallahzadeh H, Mehrabbeik A, Hamedi A. Risk Factors of Osteoporosis in Females: A Hospital-Based Case-Control Study, Yazd, Iran. Iran J Public Health. 2022;51(6):1371-1380.