Osteoporosis International

, Volume 13, Issue 5, pp 400–406

A Clinical Prediction Rule to Identify Premenopausal Women with Low Bone Mass

  • G. A. Hawker
  • G. A. Hawker
  • S. A. Jamal
  • S. A. Jamal
  • R. Ridout
  • R. Ridout
  • C. Chase
Original Article

DOI: 10.1007/s001980200046

Cite this article as:
Hawker, G., Hawker, G., Jamal, S. et al. Osteoporos Int (2002) 13: 400. doi:10.1007/s001980200046

Abstract:

Identifying premenopausal women at risk for osteoporosis and related fractures is a potentially important way to reduce the burden of illness from this disease as low peak bone mass is a risk factor for postmenopausal osteoporosis. We examined predictors of ‘low’ peak bone mass in 668 healthy, pre-menopausal, Caucasian women ages 18–35 years. Predictors of bone mass were assessed using a detailed, standardized interview. Bone mass was assessed using two measures: dual-energy X-ray absorptiometry (DXA) at the femoral neck and lumbar spine, and quantitative ultrasound (QUS) of the heel, which evaluates stiffness, speed of sound (SOS) and broadband ultrasound attenuation (BUA). Bone mass was considered ‘low’ if the corresponding Z-score was <–1.00 (DXA values, stiffness) or if values were in the lowest quintile (BUA, SOS). Using multivariate logistic regression modeling, predictors of low bone mass based on QUS, DXA or both were determined. The mean age of the cohort was 27.3 years. Independent predictors of low bone mass by both DXA and QUS were: low body weight, menarche at age 15 years or later and physical inactivity as an adolescent. Individuals with all three risk factors had a 92% chance of having low bone mass using both techniques. This suggests that a simple risk factor assessment can identify most young women with low peak bone mass. Early intervention in this group of women may reduce the risk for osteoporosis in later life.

Key words:Bone mineral density – Calcaneal ultrasound – Clinical prediction rule – Peak bone mass – Premenopausal women 

Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2002

Authors and Affiliations

  • G. A. Hawker
    • 1
  • G. A. Hawker
    • 2
  • S. A. Jamal
    • 2
  • S. A. Jamal
    • 3
  • R. Ridout
    • 2
  • R. Ridout
    • 3
  • C. Chase
    • 2
  1. 1.Division of RheumatologyCA
  2. 2.Osteoporosis Research ProgramCA
  3. 3.Division of Endocrinology, Women’s College Ambulatory Care Centre, Sunnybrook and Women’s College Health Sciences Centre, The University of Toronto, Toronto, Ontario, CanadaCA

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