Men's Osteoporosis Support Group

Indian physicians' bone mineral density

J Postgrad Med. 2010 Apr-Jun;56(2):65-70. Study of bone mineral density in resident doctors working at a teaching hospital. Multani SK and others. PMID: 20622382. This study done in India correlated 214 young, healthy medical residents' bone mineral density (BMD) with various factors. These included: weight, height, body mass index (BMI), sun exposure, physical activity, parathyroid hormone, vitamin D, and dietary factors. They found almost 60% of the males and 67.5% of the females had osteopenia. Additionally, over 18% of the males and 12.5% of the females had osteoporosis. They found that 87.5% of the group had low levels of serum 25-(OH)D (vitamin D), yet this didn't correlate with BMD. The authors concluded, "Young healthy resident doctors had significantly lower BMD, contributors being lower BMI, lower height, reduced bioavailability of dietary calcium and inadequate physical activity. Deficiency of vitamin D did not contribute to low BMD."

Editor's comments. These results are hard to believe. Nearly all the medical residents were either osteopenic or had osteoporosis by standard definitions of those conditions. I would assume these were generally healthy individuals in their 20s, 30s or 40s. It is nearly unheard of for individuals of that age to have osteoporosis-related fractures. Whereas in older individuals, with equal BMD, we would expect a significant number to have fractures, particularly low-trauma fractures. If low BMD is the defining term for osteoporosis, that should mean equal fracture risk at any age. That doesn't appear to be the case in this instance. Is that true in others, too?

The standards we use to determine osteoporosis and osteopenia are suspect when results such as this are published. Perhaps the standard measurement group used when determining normal BMD for a population is not accounting for enough individuals of smaller stature and lower BMI, with these individuals having lower "normal" BMD. Either that or this group of physicians is virtually malnourished and under exercised due to their hard work schedule. The dietary problems thus leading to low calcium intake, and probably other nutrients that are important to bone health. It would have been interesting to have a comparative control group of non-physicians of similar age, weight, etc. I hope additional studies will be done to make clear the meaning of these problematic results.

The finding that low BMD didn't correlate with low vitamin D is interesting, too. Low vitamin D is often touted as one of the most important issues regarding BMD.

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