Osteoporosis International

, Volume 14, Issue 4, pp 289–294 | Cite as

Differential effects of hormone replacement therapy on bone mineral density and axial transmission ultrasound measurements in cortical bone

  • K. M. Knapp
  • G. M. Blake
  • T. D. Spector
  • I. Fogelman
Original Article


The menopause has a large effect on bone density, and hormone replacement therapy (HRT) has been shown to be an effective treatment for preventing postmenopausal bone loss. The aim of this study was to compare the effects of HRT use on speed of sound (SOS) measurements at the radius, tibia, phalanx, and metatarsal with bone mineral density (BMD) measurements of the lumbar spine and proximal femur. The study population consisted of 278 healthy premenopausal women, 194 healthy postmenopausal women, and 126 healthy postmenopausal women currently receiving HRT for one or more years. SOS measurements were taken at the radius, tibia, phalanx, and metatarsal using the Sunlight Omnisense, and BMD measurements at the lumbar spine and proximal femur using Hologic QDR-4500 densitometers. Z-scores were calculated using the postmenopausal control group. Z-score differences between the postmenopausal controls and HRT group, for the entire group and with the HRT group subdivided into three groups based on duration of HRT usage, were calculated. Significant postmenopausal bone loss was found for all SOS and BMD measurements. A positive effect of HRT usage was found for all SOS measurement sites and lumbar spine BMD, although only the radius and tibia SOS and lumbar spine BMD reached statistical significance. The Z-score differences between the two groups were 0.44, 0.37, 0.15, and 0.26 for the radius, tibia, phalanx, and metatarsal SOS respectively, and 0.28, 0.00, and −0.03 for the lumbar spine, femoral neck, and total hip BMD respectively. A clear effect of the duration of HRT use was seen for the radius measurements, the differences being less marked elsewhere. In conclusion, these results demonstrate a positive effect of HRT on SOS measurements at the radius and tibia and BMD measurements of the lumbar spine.


Axial transmission ultrasound Hormone replacement therapy Postmenopausal age-related change Precision 



The authors would like to thank Lisa Carter (research nurse); Fiona Crane, Anita Jefferies, and Christine O'Gara (DXA radiographers); Ursula Perks, Edel Strong, Lucy Campbell, Naomi Welsh, Lucy Wormald, Jane Urwin, Jane Williams, Tracy Harris, and Janine Kelleher (Twin Research nurses); the volunteers, patients, and twins; and, finally, the National Osteoporosis Society, UK, for funding from a Research Fellowship.


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Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2003

Authors and Affiliations

  • K. M. Knapp
    • 1
    • 3
  • G. M. Blake
    • 2
  • T. D. Spector
    • 3
  • I. Fogelman
    • 2
  1. 1.Osteoporosis Screening and Research Unit, 16th Floor, Guy's TowerGuy's HospitalLondonUK
  2. 2.Imaging SciencesGuy's Kings and St Thomas' School of MedicineLondonUK
  3. 3.The Twin Research and Genetic Epidemiology UnitSt Thomas' HospitalLondonUK

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