Medicine & Health

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  • (2023) Mahmud, Mafruha
    Osteoporosis is a progressive bone disease characterised by low bone density and micro-architectural deterioration of bone tissue. Socioeconomic deprivation is associated with increased fracture risk. There is, however, a scarcity of, or inconclusive, research on deprivation and total bone health. Thus, in my first study, the role of deprivation on bone health, including low bone density, falls, and fractures was examined. Vitamin D is important for bone health, and humans synthesise it through exposure to solar radiation. Nowadays, although vitamin D supplementation is considered a standard way to effectively treat osteoporosis, it remains unclear whether vitamin D from sunshine has health advantages over supplements. In my second study, the relationship between exposure to average annual ambient ultraviolet B (UVB) radiation across the lifetime, measured by satellite observation, and osteoporosis was investigated. The two studies applied cross-sectional methods to baseline measures from the United Kingdom (UK) Biobank cohort, which includes 502,682 participants aged 40-69 years at recruitment from 2006 through 2010. Univariate and multivariable logistic regression models were built to estimate odds ratios for the associations between exposure and outcome while adjusting for possible confounders. Deprivation was associated with falls (odds ratio for the most deprived quintile compared to the least deprived was 1.46; 95% CI 1.42-1.49), fracture from simple fall (odds ratio for the most deprived category compared to least deprived was 1.16; 95% CI 1.13-1.19), and low bone mineral density (odds ratio for the most deprived quintile compared to least deprived was 1.31; 95% CI 1.26-1.36). The presence of a positive trend towards increasing bone health with declining deprivation suggests a dose-response relationship. No association was found between average lifetime ambient solar UVB radiation and osteoporosis. For osteopenia, only a weak protective association was found between the lowest quantile of UVB and osteopenia. In conclusion, from this large cohort, we found that material deprivation was associated with poor bone health. Using satellite observations of UVB exposure, we did not find evidence of an association between lifetime UVB exposure and the presence of osteoporosis in the UK.