To determine the cardio-metabolic risk profile and incidence of low bone mineral density in
African and Indian postmenopausal women attending the IALCH menopause clinic and to
determine whether there is a correlation between cardio-metabolic parameters and low bone
A retrospective, descriptive study involving all Indian and African postmenopausal women,
above the age of 40, referred to the menopause outpatient clinic at IALCH from 01 July 2009
to 31 December 2010 was conducted.
Data was collected from the medi-com database using a structured questionnaire.
Cardio-metabolic data was analysed as continuous variables and summarized using means
and standard deviations. Bone mineral density was treated as a quantitative variable and
correlation analysis was used to assess relationships between the variables. This was done for
each race group separately. The Students T-test was used to compare cardio-metabolic
variables between the two ethnic groups. SPSS version 18.0 was used to analyse data.
The records of 106 women were analysed (51 African and 55 Indian). In African and Indian
women, the prevalence of hypertension was 54.9% vs 65.5%, the prevalence of diabetes was
31.4% vs 56.4%, the prevalence of dyslipidaemia was 17.6% vs 32.7% and the prevalence of
ischaemic heart disease was 5.9% vs 14.9% respectively. The prevalence of low bone mineral
density was higher in Indian women (40%) compared to African women (23.5%). The mean
body mass index (BMI) of African women was significantly higher than Indian women, (33
vs 29). There were no significant differences between African and Indian postmenopausal
women regarding their lipid profile, fasting glucose, fasting insulin and thyroid profile.
The mean bone mineral density (BMD) in the hip and spine was lower in Indian women
compared to African women, however the prevalence of osteopaenia and osteoporosis, as
defined by T-scores, was not statistically significant.
Statistically significant positive correlations were observed between an increasing BMI and
BMD (p<0.001) and increases in weight and BMD (p<0.001). A statistically significant
correlation were observed between serum LDL-cholesterol values and BMD (p=0.03), where
serum LDL-cholesterol values were inversely proportional to BMD. There were no
significant correlations between BMD and the remaining cardio-metabolic variables (ie blood
pressure; waist-hip ratio; clinical stigma of dyslipidaemia; clinical stigma of insulin
resistance; cholesterol; HDL; triglycerides; fasting glucose; fasting insulin and thyroid
There is a high prevalence of cardiovascular risks and low BMD amongst the local
menopausal population, irrespective of ethnicity. African and Indian postmenopausal women
had a high prevalence of hypertension (60%), diabetes (44%), dyslipidaemia (25%) and
obesity (54%). In African women, the incidence of low BMD was 35% in the hip, 53% in the
neck of femur and 55% in the lumbar spine. In Indian women, the incidence of low BMD
was 55% in the hip, 67% in the neck of femur and 69% in the lumbar spine. BMI and weight
showed a positive correlation with bone mineral density. Regarding the cardio-metabolic
variables, an increasing LDL value was negatively correlated with bone mineral density. It
thus is apparent that a screening lipid profile during the peri-menopausal years, coupled with
early and appropriate lifestyle management regarding body mass index/ weight may limit the
burden of morbidity in later life.||en