# Prevalence and Predictors of Osteoporosis Among the Chinese Population in Klang Valley, Malaysia
###### Abstract  
The prevalence of osteoporosis is forecasted to escalate in Malaysia with an increasing elderly population. This study aimed to analyze the prevalence and the risk factors of osteoporosis among middle-aged and elderly Chinese Malaysians. Three hundred sixty seven Malaysian Chinese aged \(\geq\)40 years in Klang Valley, Malaysia, were recruited. All subjects completed a structured questionnaire comprised of demographic details, medical history, diet, and lifestyle practices. Body anthropometry and bone mineral density measurements were also performed. The relationship between bone health status and risk factors was determined using multivariate logistic regression. Fifteen-point-three percent of the overall study population and 32.6% of those aged \(\geq\)71 years had osteoporosis. The prevalence of osteoporosis among women (18.9%) was higher than men (11.5%). The significant predictors of osteoporosis were age, body weight, and low monthly income. Lean mass, low education level, and being underweight predicted osteoporosis in women. Lean mass was the only significant predictor of osteoporosis in men. Overall, 15.3% of the Malaysian Chinese aged \(\geq\)40 years from Klang Valley, Malaysia, had osteoporosis. Osteoporosis was associated positively with increased age and low monthly income and negatively with body weight. Therefore, osteoporosis preventive strategies targeting Chinese elderly from a low socioeconomic background is necessary. bone mineral density; calcium; exercise; osteoporosis; osteogenic; sex +
Footnote †: journal: Medical  
projection in Asia revealed that Malaysia will experience a 3.55-fold increase in hip fracture incidence by 2050 compared to 2018 [5]. Currently, bone mineral density (BMD) determination using dual-energy X-ray absorptiometry (DXA) remains as the gold standard in the diagnosis of osteoporosis [6; 7]. According to the World Health Organization, a BMD value \(\leq\)-2.5 standard deviations (SD) of young adult mean (or a T-score \(\leq\)-2.5) indicates osteoporosis, while a T-score between \(\leq\)-1.0 and \(>\)-2.5 indicates osteopenia [6]. The prevalence of osteoporosis is not well documented in Malaysia. A large retrospective study by [PERSON] and [PERSON] (1997) reported that the hip fracture incidence in 1996-1997 among Malaysians aged \(\geq\)50 years was 90 per 100,000 individuals per year. In addition, Malaysian Chinese were found to have the highest incidence of hip fractures [8]. [PERSON] et al. reported that the prevalence of osteoporosis among postmenopausal women (n = 514, mean age: 51.07 \(\pm\) 5.28 years) in central Malaysia was 24.1% [9]. Several small-scale studies revealed that the prevalence of osteopenia/osteoporosis in Chinese (62%) was higher compared to other ethnicities [10], and 2.7% of pre-menopausal Chinese women had osteoporosis [11]. Considering the previous evidence, Chinese are the most vulnerable ethnic group suffering from osteoporosis in Malaysia. Further investigations into the risk factors predisposing Malaysian Chinese to osteoporosis are warranted. In Malaysia, some studies have reported the risk factors associated with osteoporosis. A local study reported that parity, habitual tea consumption, and body mass index (BMI) were the positive predictors of osteoporosis, while the duration of sleep was a negative predictor of osteoporosis among postmenopausal women aged \(\geq\)50 years [10]. [PERSON] et al. (2005) found that increased age and longer years since menopause were positively associated with the occurrence of osteoporosis, while body weight, BMI, and waist and hip circumference were negatively associated with osteoporosis among healthy Malaysian women [9]. Studies involving both sexes are very limited, yet they are important because the risk factors may differ between men and women. This study aimed to determine the prevalence and predictors associated with osteoporosis among Malaysian Chinese aged \(\geq\)40 years.