Background/Purpose: Low socioeconomic status is associated with.an increase in osteoporosis and fracture risk respectively. A multitude of factors have been proposed including income, educational attainment and cohabitation status. However, the mechanisms that drive the disparity between social deprivation and osteoporosis remain unclear. We aim to identify key socioeconomic factors that could explain the association between deprivation and osteoporosis.

Methods: We conducted a retrospective cohort study on 31,170 patients referred for Dual-Energy X-ray Absorptiometry (DEXA) between April 2006 and February 2024 in the North West of England. The cohort was divided into deciles based on the Index of Multiple Deprivation (IMD). The 3 most deprived deciles were compared to the 3 least deprived deciles respectively. Patient demographics, risk factors for fracture risk and bone mineral density from the femoral neck and lumbar spine were recorded. Data was analysed using chi-squared and two-sample t-test. P values of less than 0.05 were considered statistically significant.

Results: The least deprived cohort had a greater steroid use (26.98%), excess alcohol intake (7.77%) and had ever smoked (45.3%). The more deprived had a higher family history of fracture (17.83%) but a lower BMI and percentage body fat. There were no differences in bone density and total fracture rates, however, the more deprived cohorts had a greater rate of radius fracture (17.83%).

Conclusion: These results suggest that whilst there are differences in traditional risk factors for developing fractures between the most and least deprived in society, however, this does not translate towards an increase in total fracture risk nor a reduction in bone mineral density in the least deprived. This supports the evidence that there are unmeasured confounders that could predict fracture risk in groups with greater deprivation. Some limitations include that this is data on referrals to a regional scanner and not population data. Further research is needed to clarify the mechanisms between deprivation and socioeconomic status and fracture risk.

Table 1 outlines baseline demographics, risk factors for fragility fracture and bone mineral density between the least and most deprived cohorts.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/association-between-deprivation-and-fracture-risk-in-a-regional-uk-cohort/