Prevalence, family history, and prevention of reported osteoporosis in US women

Background: Osteoporosis is a major public health concern and has been associated with a family history positive for the condition. However, data on the behaviors of individuals with such a family history are scarce. The objectives of this study were to assess the relationship between the prevalence of reported physician-diagnosed osteoporosis and family history in a representative sample of U.S. women, examine whether osteoporosis risk factors account for this relationship, and evaluate the likelihood that women at high risk of osteoporosis due to family history report preventive behaviors. Methods: The prevalence of reported osteoporosis was estimated in 8073 women aged >= 20 years in the National Health and Nutrition Examination Survey, 1999-2004. Information on osteoporosis in first-degree relatives and grandparents was obtained during interviews. Results: The prevalence of osteoporosis in participants was 7.94%. In 19.8% of them, a positive family history was reported and was significantly and independently associated with osteoporosis (AOR 2.35, 95% CI = 1.87, 2.96). This association was stronger when two or more relatives were affected (AOR 8.48, 95% CI = 4.50, 15.99). After stratification by age, the association was observed only in women aged >= 35 years. Women with a family history of osteoporosis were more likely than those with none to report preventive behavior, such as taking supplements of calcium, vitamin D, or both; physical activity; and estrogen use. Conclusions: These findings indicate that family history is a significant, independent risk factor for osteoporosis in U.S. women aged >= 35 years. Further studies are warranted to evaluate family history as a convenient and inexpensive tool for identifying women at risk of osteoporosis and for promoting the adoption of preventive behaviors.