WASHINGTON — Obese women are less likely to be screened for osteoporosis than are normal- or overweight women, according to a study of more than 140,000 patients in an integrated health care plan database.
Previous studies showed mixed results on the disparity in preventive health care for obese patients, compared with normal-weight patients, said Kristi Reynolds, Ph.D., and colleagues, of Kaiser Permanente, Pasadena, Calif.
“It is largely unknown whether obesity is associated with the quality of care for osteoporosis, which is both preventable and treatable but is often undiagnosed and untreated,” the researchers said. Physicians may be less inclined to screen obese women for osteoporosis because body weight is associated with higher bone density, they noted.
Data from 146,975 health care provider visits between July 1, 2007, and June 30, 2008, were reviewed.
Average age was 73 years; 35% were normal weight; 35% were overweight; and 19%, 7%, and 4% fell into obesity categories I, II, and III, respectively. Normal weight body mass index was defined as 18.5-24.9 kg/m
About 67% of the women had undergone bone mineral density testing within 4 years of the study, the criteria by which participants were considered “screened.” Only 52% of women with a BMI of 40 kg/m
After adjustment for age, race, and income, the odds ratio of osteoporosis screening for overweight women was 0.99, while the ratios for women in obese classes I, II, and III were 0.90, 0.77, and 0.60, respectively. The findings were presented in a poster at the the annual meeting of the Obesity Society.
The results suggest that many overweight and obese women aren't screened for osteoporosis, said the researchers, who reported having no conflicts of interest.