Risk Prediction Model for Osteoporosis Disease Based on a Reduced Set of Factors

Introduction

Osteoporosis is a real public health problem because of its increasing frequency over the countries. It is considered as one of the major problems among women and older people. However, it becomes an essential index of health and economics in every country. Osteoporosis disease is a chronic complex health problem for millions of women worldwide, 80% of whom are postmenopausal, unless prevented or treated, this silent disease will continue to limit both the quantity and the quality of many older women and significantly add to health care cost for this group (Taylor, Schreiner, Stone, 2004; Kanis, 2002). This disease infects 30% of women after 50 years and 70% after 80 years. Osteoporosis prevention is complicated but it holds promise as the best way to decrease future fractures (Kanis, Johansson, Johnell, 2005). Looking around the world, we see that osteoporosis occurs in some areas much more than in others — just as the incidence of cancer, heart disease, and diabetes varies from one culture to another. This clarifies that the development of weak bones is not a natural artifact of aging. While the United States has one of the highest osteoporosis rates in the world, there are other areas where this disorder is relatively rare, even among the older segments of the population (Dawson-Hughes, Tosteson, Melton, et al., 2008). For example, the inhabitants of Singapore, Hong Kong, and certain sectors of former Yugoslavia, as well as the Bantu of South Africa have traditionally held extremely low rates of osteoporotic fracture. In Japan, vertebral compression fractures among women between ages 50 and 65 were so rare that many physicians doubt their existence, and the incidence of hip fractures among the elderly Japanese historically has been much less than half that of Western countries (Koh, Sendrine, Torralba, et al. 2001; Sen, Rives, Messina, et al., 2005). Africans and native peoples living traditional lifestyles have been classified as “almost immune” to osteoporosis (De Laet, Kanis, Oden, et al., 2005). Interestingly enough, as these less technologically advanced countries become more Westernized, their rates of osteoporotic fracture are steadily increasing (Taylor, Schreiner, Stone, 2004). We note that some Lebanese studies have showed that the mean BMD for the Lebanese female is lower than that of the European woman. Another Lebanese study showed that the hip fractures occur at a younger age in Lebanon (between 65 and 75) compared to western population (above 75) and that 60% of patients with hip fractures have osteopenia rather than osteoporosis (Taylor, Schreiner, Stone, 2004; Kanis, 2002). The social economic burden of osteoporosis is so large that its etiology, prevention and treatment have become an urgent issue that needs to be coped with worldwide. The disease may continue its progress until even a slight twisting or bending motion may cause bones to fracture and break. Risk factors for developing osteoporosis include controllable factors such as nutrition, physical activity level, smoking, and consumption of alcohol, and uncontrollable factors like sex, family history, and ethnicity. Many people in any ages appear to be unaware of the risk factors and preventive behaviors. Preventing osteoporosis, and subsequent fractures, had become a goal of many health care practitioners.