Bone Mineral Density Across the Menopausal Transition: A Multi-Ethnic DXA Study from the Northern Emirates, UAE

Background Population-specific data on bone mineral density (BMD) among women in the Northern Emirates of the United Arab Emirates (UAE) remain limited, constraining evidence-based screening strategies in a multi-ethnic setting. This study quantified the prevalence of osteopenia and osteoporosis across menopausal status and examined the relative contributions of body mass index (BMI), ethnicity, and medical history to low BMD. Methodology A cross-sectional analysis of 161 women aged 29–64 years was conducted, who underwent dual-energy X-ray absorptiometry (DXA) of the lumbar spine and femoral neck between January and December 2023. BMD was classified according to World Health Organization criteria. Associations with menopausal status, BMI, self-reported region of origin, and past medical history were evaluated using chi-square tests, one-way ANOVA, Pearson correlations, bootstrap resampling (1,000 iterations), and multivariable logistic regression. Results Postmenopausal women exhibited a markedly higher prevalence of low BMD (osteopenia or osteoporosis) than premenopausal women (84.6% vs. 50.9%; p < 0.001). Mean BMI was significantly higher among women with normal BMD compared with those at risk (34.98 vs. 30.02 kg·m −2 ), with non-overlapping bootstrap 95% confidence intervals. BMI correlated positively with lumbar-spine T-scores (r = 0.31) and femoral-neck T-scores (r = 0.16). Substantial regional disparities were observed: women from the Middle East and North Africa (MENA) and Asia demonstrated the highest burden of low BMD (83% and 79%, respectively), whereas African women had the greatest proportion of normal BMD (54%). Conclusion In this multi-ethnic cohort from the Northern Emirates, menopausal status, BMI, and region of origin emerged as the dominant determinants of BMD, while isolated comorbidities contributed little additional predictive value. These findings support simplified, targeted DXA referral strategies based on readily available demographic and anthropometric factors and highlight the importance of maintaining BMI within an upper-normal range to mitigate postmenopausal bone loss. Clinical Trial Status: Not Applicable.