Effect Of Sleep Status On Osteoporosis In Postmenopausal Women And Analysis Of Risk Factors

Objective:With an aging population,the prevalence of osteoporosis(OP)is increasing in China,among which the postmenopausal women are the most prominent.The increasing pressure of life and the diversification of entertainment have caused women’s sleep problems.Currently,national and international studies have shown a correlation between sleep and osteoporosis.Therefore,in this study,Pittsburgh Sleep Quality Index(PSQI)was used to investigate the sleep status of postmenopausal women admitted to hospital for bone density examination,so as to explore the influence of sleep status on postmenopausal women’s osteoporosis and analysis of risk factors,and further guide the prevention and treatment of postmenopausal women’s osteoporosis.Methods:In this study,209 postmenopausal women who met the inclusion and exclusion criteria admitted to the First Affiliated Hospital of Chengdu Medical College from July 2022 to December 2022 were selected.They were divided into normal bone mass group,reduced bone mass group and osteoporosis group according to the results of bone mineral density examination(T value).All medical histories of the included study subjects were collected,including general information(age,age at menarche,age at menopause,length of menopause),physical examination findings(height,weight),lifestyle and habits(exercise,smoking,alcohol consumption,snoring),and co-morbidities(hypertension,diabetes,hyperlipidemia).At the same time,all subjects were investigated by Pittsburgh Sleep Quality Index Scale(PSQI)questionnaire to evaluate their sleep status.The collected data were organized and entered into an Excel sheet,and statistical analysis was performed using the statistical software R(Version 4.1.1;R Core Team,2021)to produce the corresponding results.Results:(1)A total of 209 postmenopausal women who met the inclusion and exclusion criteria were included in this study,including 49 cases in the group with normal bone mass,63 cases in the group with reduced bone mass,and 97 cases in the group with osteoporosis.Baseline data were compared between the three groups,and the results showed that:There were significant differences in age,age of menarche,duration of menopause,diabetes,hyperlipidemia,hypertension,snoring and exercise among the three groups(P<0.05).Age of menopause,BMI,smoking and alcohol consumption were not statistically significant among the three groups.(2)There were statistically significant differences between the three groups of PSQI seven factor scores(P<0.05).The difference in the total PSQI score between the three groups was statistically significant(P<0.05),and the osteoporosis group had the highest total score of 11.94±3.98.In terms of PSQI evaluation grade,the differences among the three groups were statistically significant(P<0.05).(3)To assess the correlation between sleep status and the degree of bone lesions in patients,Spearman’s rank correlation analysis revealed that the seven PSQI factor scores,total PSQI score,and PSQI evaluation grade were positively correlated with bone lesions in postmenopausal women(P<0.05),Among them,PSQI sleep quality score,sleep duration score,PSQI total score and PSQI evaluation grade were moderately correlated with the degree of bone mass lesion in postmenopausal women.(4)Patients were divided into non-osteoporosis and osteoporosis groups according to the presence or absence of osteoporosis,and a one-way logistic regression model was constructed for the empirical study.The results showed that age,age at menarche,length of menopause,diabetes,hyperlipidemia,hypertension,exercise,snoring,seven factors of PSQI score,total PSQI score,and PSQI evaluation grade were all associated with osteoporosis in postmenopausal women,and the results were statistically significant(P<0.05).Smoking,drinking,BMI and age of menopause were not statistically significant.(5)Based on the results of one-way logistic regression between the osteoporosis and non-osteoporosis groups and the combination of clinically important variables,a multifactorial logistic regression model was constructed to further explore the factors associated with the development of osteoporosis in patients.The results showed that:the poorer the sleep quality,the shorter the sleep duration,the longer the sleep latency time,the higher the PSQI total score,the worse the PSQI evaluation grade,the older the age,the later the age of menarche,diabetes,hyperlipidemia and hypertension all increased the risk of osteoporosis in postmenopausal women,and the difference was statistically significant(P<0.05).For those who did not exercise,exercise reduced the risk of osteoporosis in postmenopausal women,with a statistically significant difference(P<0.05),indicating that exercise was a protective factor.Sleep efficiency scores,sleep disorder scores,hypnotic medication scores,daytime dysfunction scores,snoring and length of menopause were not statistically significant.(6)Subgroup analysis was performed according to age group,age at menarche group,age at menopause group,length of menopause group,BMI level group,diabetes,hyperlipidemia,hypertension,exercise,smoking,alcohol consumption,and snoring.The results showed that:the total score of PSQI in smoking group and menarche age>16 was not associated with osteoporosis in postmenopausal women and the increase of total score of PSQI in other groups increased the risk of osteoporosis in postmenopausal women.(P<0.05).(7)The generalized propensity score weighted results showed that the higher the total PSQI score,the higher the risk of osteoporosis in postmenopausal women,and the results were statistically significant(OR=1.247,95%CL:1.167-1.333,P<0.001).Conclusion:(1)This study found that poorer sleep quality,shorter sleep duration and longer sleep latency were independent risk factors for osteoporosis in postmenopausal women.In addition,this study found that increasing age,later age at menarche,diabetes,hypertension,and hyperlipidemia were all associated with osteoporosis in postmenopausal women,and that exercise was a protective factor for osteoporosis in postmenopausal women.(2)This study found that the worse the sleep status,the higher the risk of osteoporosis in postmenopausal women.Therefore,it is important to improve sleep conditions to prevent osteoporosis in postmenopausal women.