An update in bone mineral density status in Spain: the OsteoSER study

Bone mineral density (BMD) reference data for the Spanish population come from the Multicenter Research Project on Osteoporosis (MRPO) in 1989. The OsteoSER study updated Spanish BMD reference data, showing similarities with MRPO and NHANES III. Peak bone mass occurred at 20-39 years, positively associated with physical activity and negatively with smoking. Osteopenia affected 54.4%, and osteoporosis 10.7% of adults >= 50 years, with higher prevalence in women and increasing with age. Purpose This study aimed to estimate the distribution of BMD in lumbar spine, femoral neck, and total hip in the Spanish population aged >= 20 years and compare it with MRPO and NHANES III data. Methods A multicenter cross-sectional observational study was conducted in a White Spanish population aged 20-80 years across 12 urban and rural municipalities. Participants were selected by primary care physicians based on inclusion criteria (stratified by sex, age, and BMI) and exclusion criteria (artifacts in BMD imaging in participants of all ages and conditions affecting bone density in younger participants). A vehicle with a Hologic (R) Horizon W densitometer traveled to each municipality. Results A total of 1522 participants underwent densitometry (51.8% men). Peak bone mass is reached at ages 20-39 years in both sexes at all sites. BMD was positively associated with height, BMI, and physical activity and negatively with smoking (p < 0.05). The distribution of BMD by age and sex was comparable to MRPO and NHANES III. We found that 54.4% of postmenopausal women and men >= 50 years had osteopenia, while osteoporosis was observed in 10.7%, with higher prevalence in women (18.6% vs. 2.6%) and increasing with age. Using MRPO criteria, osteoporosis prevalence rose to 14.8%. Conclusion The BMD of the OsteoSER study population is similar to that of MRPO and NHANES III. Physical activity positively influences peak bone mass, while smoking has detrimental effects.