Beyond Bone Mineral Density: Real-World Fracture Risk Profiles and Therapeutic Gaps in Postmenopausal Osteoporosis

<b>Background/Objectives</b>: Osteoporosis remains a leading cause of morbidity in postmenopausal women, yet many high-risk individuals remain undiagnosed or untreated. This study aimed to assess the prevalence of osteoporosis and osteopenia, treatment patterns, and skeletal fragility in...

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Main Authors: Anamaria Ardelean, Delia Mirela Tit, Roxana Furau, Oana Todut, Gabriela S. Bungau, Roxana Maria Sânziana Pavel, Bogdan Uivaraseanu, Diana Alina Bei, Cristian Furau
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Language:English
Published: MDPI AG 2025-08-01
Series:Diagnostics
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Online Access:https://www.mdpi.com/2075-4418/15/15/1972
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author Anamaria Ardelean
Delia Mirela Tit
Roxana Furau
Oana Todut
Gabriela S. Bungau
Roxana Maria Sânziana Pavel
Bogdan Uivaraseanu
Diana Alina Bei
Cristian Furau
author_facet Anamaria Ardelean
Delia Mirela Tit
Roxana Furau
Oana Todut
Gabriela S. Bungau
Roxana Maria Sânziana Pavel
Bogdan Uivaraseanu
Diana Alina Bei
Cristian Furau
author_sort Anamaria Ardelean
collection DOAJ
description <b>Background/Objectives</b>: Osteoporosis remains a leading cause of morbidity in postmenopausal women, yet many high-risk individuals remain undiagnosed or untreated. This study aimed to assess the prevalence of osteoporosis and osteopenia, treatment patterns, and skeletal fragility indicators in a large cohort of postmenopausal women undergoing DXA screening. <b>Methods</b>: We analyzed data from 1669 postmenopausal women aged 40–89 years who underwent DXA evaluation. BMD status was categorized as normal, osteopenia, or osteoporosis. Treatment status was classified based on active antiosteoporotic therapy, calcium/vitamin D supplementation, hormonal therapy (historical use), or no treatment. Logistic regression models were used to explore independent predictors of osteoporosis and treatment uptake. <b>Results</b>: A total of 45.0% of women had osteoporosis and 43.5% had osteopenia. Despite this, 58.5% of the population, over half of women with osteoporosis, were not receiving any active pharmacologic treatment. Bisphosphonates were the most prescribed therapy (17.9%), followed by calcium/vitamin D supplements (20.6%). A prior history of fragility fractures and radiological bone lesions were significantly associated with lower BMD (<i>p</i> < 0.05). Historical hormone replacement therapy (HRT) use was not associated with current BMD (<i>p</i> = 0.699), but women with HRT use reported significantly fewer fractures (<i>p</i> < 0.001). In multivariate analysis, later menopause age and low BMD status predicted higher odds of receiving active treatment. <b>Conclusions</b>: Our findings highlight a substantial care gap in osteoporosis management, with treatment primarily initiated reactively in more severe cases. Improved screening and earlier intervention strategies are urgently needed to prevent fractures and reduce the long-term burden of osteoporosis.
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spelling doaj-art-79c0fa16f09f499c916988b76ff3f1552025-08-20T03:02:55ZengMDPI AGDiagnostics2075-44182025-08-011515197210.3390/diagnostics15151972Beyond Bone Mineral Density: Real-World Fracture Risk Profiles and Therapeutic Gaps in Postmenopausal OsteoporosisAnamaria Ardelean0Delia Mirela Tit1Roxana Furau2Oana Todut3Gabriela S. Bungau4Roxana Maria Sânziana Pavel5Bogdan Uivaraseanu6Diana Alina Bei7Cristian Furau8Multidisciplinary Doctoral School, “Vasile Goldis” Western University of Arad, 310414 Arad, RomaniaDoctoral School of Biological and Biomedical Sciences, University of Oradea, 410087 Oradea, RomaniaDepartment Medicine, Faculty of Medicine, “Vasile Goldis” Western University of Arad, 310414 Arad, RomaniaDepartment of Pathophysiology, Faculty of Medicine, “Vasile Goldis” Western University of Arad, 310414 Arad, RomaniaDoctoral School of Biological and Biomedical Sciences, University of Oradea, 410087 Oradea, RomaniaDoctoral School of Biological and Biomedical Sciences, University of Oradea, 410087 Oradea, RomaniaDepartment of Psycho-neurosciences and Recovery, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, RomaniaDepartment of Medical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, RomaniaMultidisciplinary Doctoral School, “Vasile Goldis” Western University of Arad, 310414 Arad, Romania<b>Background/Objectives</b>: Osteoporosis remains a leading cause of morbidity in postmenopausal women, yet many high-risk individuals remain undiagnosed or untreated. This study aimed to assess the prevalence of osteoporosis and osteopenia, treatment patterns, and skeletal fragility indicators in a large cohort of postmenopausal women undergoing DXA screening. <b>Methods</b>: We analyzed data from 1669 postmenopausal women aged 40–89 years who underwent DXA evaluation. BMD status was categorized as normal, osteopenia, or osteoporosis. Treatment status was classified based on active antiosteoporotic therapy, calcium/vitamin D supplementation, hormonal therapy (historical use), or no treatment. Logistic regression models were used to explore independent predictors of osteoporosis and treatment uptake. <b>Results</b>: A total of 45.0% of women had osteoporosis and 43.5% had osteopenia. Despite this, 58.5% of the population, over half of women with osteoporosis, were not receiving any active pharmacologic treatment. Bisphosphonates were the most prescribed therapy (17.9%), followed by calcium/vitamin D supplements (20.6%). A prior history of fragility fractures and radiological bone lesions were significantly associated with lower BMD (<i>p</i> < 0.05). Historical hormone replacement therapy (HRT) use was not associated with current BMD (<i>p</i> = 0.699), but women with HRT use reported significantly fewer fractures (<i>p</i> < 0.001). In multivariate analysis, later menopause age and low BMD status predicted higher odds of receiving active treatment. <b>Conclusions</b>: Our findings highlight a substantial care gap in osteoporosis management, with treatment primarily initiated reactively in more severe cases. Improved screening and earlier intervention strategies are urgently needed to prevent fractures and reduce the long-term burden of osteoporosis.https://www.mdpi.com/2075-4418/15/15/1972postmenopausal osteoporosisbone mineral densityDXAfracture risktreatment gap
spellingShingle Anamaria Ardelean
Delia Mirela Tit
Roxana Furau
Oana Todut
Gabriela S. Bungau
Roxana Maria Sânziana Pavel
Bogdan Uivaraseanu
Diana Alina Bei
Cristian Furau
Beyond Bone Mineral Density: Real-World Fracture Risk Profiles and Therapeutic Gaps in Postmenopausal Osteoporosis
Diagnostics
postmenopausal osteoporosis
bone mineral density
DXA
fracture risk
treatment gap
title Beyond Bone Mineral Density: Real-World Fracture Risk Profiles and Therapeutic Gaps in Postmenopausal Osteoporosis
title_full Beyond Bone Mineral Density: Real-World Fracture Risk Profiles and Therapeutic Gaps in Postmenopausal Osteoporosis
title_fullStr Beyond Bone Mineral Density: Real-World Fracture Risk Profiles and Therapeutic Gaps in Postmenopausal Osteoporosis
title_full_unstemmed Beyond Bone Mineral Density: Real-World Fracture Risk Profiles and Therapeutic Gaps in Postmenopausal Osteoporosis
title_short Beyond Bone Mineral Density: Real-World Fracture Risk Profiles and Therapeutic Gaps in Postmenopausal Osteoporosis
title_sort beyond bone mineral density real world fracture risk profiles and therapeutic gaps in postmenopausal osteoporosis
topic postmenopausal osteoporosis
bone mineral density
DXA
fracture risk
treatment gap
url https://www.mdpi.com/2075-4418/15/15/1972
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