FREQUENCY OF OSTEOMALACIA IN PERIMENOPAUSAL WOMEN

Abstract

Background: Osteomalacia is a metabolic bone disorder characterized by defective mineralization of osteoid, primarily resulting from vitamin D deficiency. Perimenopausal women are particularly susceptible because of hormonal changes and disturbances in calcium-phosphate metabolism. This study aimed to determine the frequency of biochemical osteomalacia and evaluate its associated biochemical predictors among perimenopausal women. Methods: A hospital-based observational cross-sectional study was conducted among 113 perimenopausal women aged 45–55 years attending the Orthopaedics Outpatient Department of a tertiary care hospital. Clinical assessment and biochemical evaluation, including serum vitamin D, calcium, phosphorus, and alkaline phosphatase (ALP), were performed. Biochemical osteomalacia was diagnosed using standard Nasser’s criteria. Statistical analysis was carried out using SPSS version 26.0. Results: Biochemical osteomalacia was identified in 54 (47.8%) participants. Vitamin D deficiency was present in 70.8% of women. Patients with osteomalacia had significantly lower serum vitamin D (20.8 ± 6.5 vs. 26.9 ± 8.2 ng/mL), calcium (8.86 ± 0.89 vs. 9.63 ± 0.72 mg/dL), and phosphorus (3.36 ± 0.78 vs. 3.92 ± 0.65 mg/dL), with significantly higher ALP levels (152.4 ± 88.3 vs. 103.6 ± 52.7 U/L) (all p<0.05). Multivariate analysis identified hypophosphatemia (AOR=6.75), elevated ALP (AOR=5.96), vitamin D deficiency (AOR=5.82), and hypocalcemia (AOR=4.21) as significant independent predictors. Vitamin D deficiency demonstrated the highest diagnostic sensitivity (100%) with  AUC (0.82). Conclusion: Biochemical osteomalacia is highly prevalent among perimenopausal women. Routine assessment of vitamin D, calcium, phosphorus, and ALP may facilitate early diagnosis and timely management, thereby reducing long-term skeletal complications.