Prevalence and Determinants of Osteoporosis Among Patients Undergoing Dual-Energy X-ray Absorptiometry (DXA) Scanning at a Tertiary Hospital in Damascus, Syria: A Cross-Sectional Study

Background: This study aimed to determine the prevalence of osteoporosis and identify factors associated with osteoporosis among adult patients undergoing dual-energy X-ray absorptiometry (DXA) at the National Hospital in Damascus, Syria. Methods: A cross-sectional study was conducted at the National Hospital in Damascus, Syria, enrolling 158 adult patients referred for DXA evaluation. Bone mineral density (BMD) was classified according to World Health Organization (WHO) criteria based on the lowest T-score from lumbar spine or femoral neck measurements. Data on demographic characteristics, reproductive history, lifestyle factors, comorbidities, and medication use were collected from structured clinical evaluation forms. Statistical analyses included chi-square tests (with Fisher’s exact or Monte Carlo correction when appropriate) and Spearman’s correlation. Results: The mean age was 60.79 ± 6.56 years, and 86.7% of the participants were female. Osteoporosis was the most prevalent diagnosis, affecting 53.2% (n = 84) of participants, followed by osteopenia in 36.7% (n = 58), while 10.1% (n = 16) had normal BMD. Female sex was significantly associated with osteoporosis (χ²(2) = 11.65, p = 0.003). Hyperthyroidism was also significantly associated with osteoporosis (p = 0.025). Body mass index (BMI) showed a significant negative correlation with femoral T-score (r = -0.257, p = 0.001). No significant associations were observed with age, smoking, diabetes mellitus, hypertension, or steroid use; however, marital status, cervical disc disease, and lumbar disc disease showed significant associations with osteoporosis classification. Conclusions: Osteoporosis was identified in more than half of the patients undergoing DXA evaluation in this study, while osteopenia affected 36.7% of participants, highlighting the need for early identification and preventive strategies. Female sex and hyperthyroidism were significantly associated with osteoporosis. These findings may help characterize osteoporosis among patients referred for DXA evaluation at this center and may support future screening and preventive strategies.