SAT-517 Analysis of Risk Factors for Low Bone Mineral Density in Patients Who Visited a Department of General Medicine

Osteoporosis is known as a disease that can increase the risk of fracture because of low bone mineral density (BMD). Bone fracture is associated with an increase in mortality in the elderly. It has been reported that femoral bone fracture occurred in 11,578 people in Japan every year during the period from 2008 to 2013. However, in the Japanese population, the average rate of osteoporosis examination is less than 5%. Because of the low rate of consultation for bone examination, it is difficult for general practitioners to detect an early stage of osteoporosis. According to the Ministry of Health, Labour and Welfare, in the current super-aged society in Japan, escalating healthcare costs over the past few decades have been a major problem for maintaining the universal health insurance coverage. Approximately 60% of the total national medical care expenditure is for people over 65 years of age. In Japan, there are about 13 million osteoporosis patients. This causes an increase in medical expenses for elderly and bone fractures lead to an increase in the risk of mortality. In order to reduce the incidence of bone fractures, efforts should be made to reduce the number of patients with low BMD. If physicians can pay attention to the influencing factors in losing BMD, they should be able to detect osteoporosis in an early stage. Earlier detection of low BMD and its treatment would result in reduction in the incidence of bone fractures in elderly patients. In the present study, we attempted to clarify the risk factors that are involved in lowered BMD for patients with various clinical backgrounds who visit Department of General Medicine of a University Hospital, Japan. We retrospectively reviewed medical records for 149 patients who visited our department in our hospital and underwent a BMD examination by the dual energy X-ray absorbance method during the period from 2014 to 2015. We analyzed various physical and laboratory factors that might be associated with lowered BMD. There were 39 patients diagnosed with osteoporosis based on the T-score. Adjusted analysis showed that female gender, aging and increased levels of serum calcium were statistically related to lowered femoral BMD, whereas body mass index was associated with an increase in femoral BMD. In conclusion, it is important for general practitioners to examine BMD in patients who may have low BMD in the viewpoints of gender and aging. Attention should also be given to the possibility of low BMD, patients with high serum calcium levels, patients with anorexia and malnutrition, and patients taking antipsychotic/sleeping drugs or proton pump inhibitors.