Osteoporosis International

, Volume 14, Issue 1, pp 27–33

Risk factors associated with peri- and postmenopausal bone loss: does HRT prevent weight loss-related bone loss?

  • J. Sirola
  • H. Kröger
  • R. Honkanen
  • L. Sandini
  • M. Tuppurainen
  • J.S. Jurvelin
  • S. Saarikoski
ORIGINAL ARTICLE

DOI: 10.1007/s00198-002-1318-7

Cite this article as:
Sirola, J., Kröger, H., Honkanen, R. et al. Osteoporos Int (2003) 14: 27. doi:10.1007/s00198-002-1318-7

Abstract

 In the present study we evaluated the risk factors associated with peri- and postmenopausal bone loss and the effect of hormone replacement therapy (HRT) on weight-loss-related bone loss. The study population, 940 peri- and postmenopausal women, was selected from a random sample (n = 2025) of the OSTPRE study cohort (n = 13 100) in Kuopio, Finland. Bone mineral density (BMD; g/cm2) at the lumbar spine and femoral neck, and body weight, were measured at baseline in 1989–91 and at 5-year follow-up in 1994–97 by trained personnel. Five hundred and forty-seven women had never used HRT and 393 women used part-time or continuous HRT during follow-up of 3.8–7.9 years (mean 5.8 years). Similarly, of the 172 weight losers, 97 had never used HRT while 75 used it during follow-up. According to multiple regression analysis on the total study population (n = 940), HRT use, years since menopause and weight increase significantly predicted lower annual bone loss at both the lumbar spine and femoral neck (p < 0.005). Low baseline weight and higher age predicted higher bone loss only at the lumbar spine (p < 0.001) and high grip strength predicted lower bone loss only at the femoral neck (p = 0.021). In a sub-analysis on weight losers, weight loss predicted greater bone loss in HRT non-users (p < 0.05), whereas this was not observed in HRT users. These results remained similar after adjustment for age, weight, height, calcium intake, duration of menopause, baseline BMD and bone-affecting diseases/medication. In conclusion, the transition to menopause, HRT and weight change are the most important determinants of bone loss at both the lumbar spine and femoral neck. Furthermore, HRT seems to be effective in prevention of weight loss related bone loss.

Keywords HRT Osteoporosis Postmenopausal bone loss Risk factors Weight change 

Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2003

Authors and Affiliations

  • J. Sirola
    • 1
  • H. Kröger
    • 2
  • R. Honkanen
    • 1
  • L. Sandini
    • 2
  • M. Tuppurainen
    • 3
  • J.S. Jurvelin
    • 4
  • S. Saarikoski
    • 3
  1. 1.Research Institute of Public Health, University of Kuopio Finland FI
  2. 2.Department of Surgery, Kuopio University Hospital, FinlandFI
  3. 3.Department of Obstetrics and Gynaecology, Kuopio University Hospital, FinlandFI
  4. 4.Department of Clinical Physiology & Nuclear Medicine, Kuopio University Hospital, FinlandFI
  5. 5.Clinical Research Centre, Bone and Cartilage Research Unit, University of Kuopio, FinlandFI
  6. 6.OSTPRE study, Teknia Building, University of Kuopio, PO Box 1627, 70211, Kuopio, Finland Tel.: +358 50 3555938. Fax: +358 17 162978 e-mail: jsirola@hytti.uku.fiFI

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