The correlation between self-assessment of osteoporosis and handgrip strength among patients visiting referral hospitals in Ulaanbaatar: A study of findings

Abstract

Background: Osteoporosis is a major global health issue, affecting over 200 million individuals and accounting for significant morbidity and mortality. In the United States, the cost associated with osteoporosis-related fractures reached approximately $17 billion in 2005, predominantly affecting women. While dual-energy X-ray absorptiometry (DXA) is the gold standard for diagnosing osteoporosis, its limitations in cost and accessibility have led to the development of the Osteoporosis Self-Assessment Tool (OST), which uses age and weight for screening. Recent studies have established a correlation between handgrip strength (HGS) and osteoporosis risk, making HGS a valuable, cost-effective indicator of muscle quality. However, no research has yet explored the association between OST and HGS in the Mongolian population, prompting this study among individuals aged 40 and over in Ulaanbaatar. Aim: The aim of this study is to investigate the association between the Osteoporosis Self-Assessment Tool (OST) and handgrip strength among clients aged 40 and over visiting the Ulaanbaatar city’s health units. Materials and Methods: The study was conducted from June to September 2024 using a cross-sectional design. Participants included individuals aged 40 and over attending health units in the Chingeltei and Songinokhairkhan districts. The Osteoporosis Self-Assessment Tool (OSTA) score was calculated by subtracting age from weight and multiplying the result by 0.2. An OSTA score ranging from -20 to -4 was classified as high risk, from -4 to -1 as moderate risk, and from -1 to 20 as low risk. Handgrip strength (HGS) was measured using a dynamometer (TKK-5101; Takei Scientific Instruments, Tokyo, Japan) manufactured in Japan. HGS was considered weak if it was below 28 kg for men and below 18 kg for women. Results: A total of 356 participants (200 men and 156 women) were included in the study. Among the participants, 272 had a low risk of osteoporosis (OSTA score greater than -1), while 84 had a high risk (OSTA score less than -1). The participants’ gender, age group, education level, and BMI were statistically significant in relation to bone density assessment (p=0.001). Additionally, factors such as smoking status, hypertension, rheumatoid arthritis, and ocular disorders were statistically significant in relation to bone density assessment (p=0.001). To identify the risk factors affecting bone density, logistic regression analysis was conducted, revealing that age (OR 1.320, 95% CI 1.22-1.426, p=0.001), overweight (OR 1.031; p=0.001; 95% CI 0.009-1.101), smoking (OR 1.328, 95% CI 0.469-3.765, p=0.593), regular physical activity (OR 1.123, 95% CI 0.423-2.981, p=0.815), arterial pressure (OR 1.006, 95% CI 0.316-3.202, p=0.992), and handgrip strength (OR 1.849, 95% CI 1.595-2.742, p=0.002) were significant predictors. Conclusion: The average hand grip strength of the right and left hands among study participants varied across age groups, with a decline observed as age increased. Additionally, age, gender, BMI, and weakened grip strength were identified as risk factors for osteoporosis among the participants.