Gender and Age-specific Patterns of Osteopenia and Osteoporosis in Urban and Rural Bangladesh

<i>Background: </i>Osteoporosis and osteopenia represent major yet underrecognized public health challenges in low- and middle-income countries. In South Asia, demographic aging, nutritional inadequacies, sedentary lifestyles, and limited access to diagnostic facilities have contributed to a rising burden of bone mineral disorders. Bangladesh, in particular, lacks large comparative studies evaluating bone health across gender and residential settings. <i>Aim: </i>The present study aimed to determine the prevalence of osteopenia and osteoporosis among adults in Bangladesh and to examine the influence of gender, age, and residential setting (urban versus rural) on bone mineral density. <i>Methods: </i>A cross-sectional analytical study was conducted among 380 adults equally sampled from urban Dhaka and rural Sylhet. Bone mineral density was evaluated using WHO-defined T-score and Z-score criteria. Statistical analyses included descriptive statistics, chi-square tests, independent t-tests, Pearson correlation analysis, and multivariable logistic regression to identify independent predictors of abnormal bone health. <i>Results: </i>Abnormal bone mineral density was detected in 80.5% of participants, with osteopenia constituting the majority (72.6%). Females exhibited significantly lower mean T-scores and higher prevalence of osteoporosis compared to males. Age showed a strong inverse correlation with both T-score and Z-score. Gender and age emerged as independent predictors, while residential region showed no significant association. <i>Conclusion: </i>The study highlights a substantial burden of subclinical and clinical bone disease in Bangladesh, particularly among women and older adults. These findings emphasize the need for early screening, preventive interventions, and national osteoporosis control strategies.