Summary
Bone mineral content (BMC) and bone mineral density (BMD) of lumbar spine have been measured in 695 healthy postmenopausal and 64 type I osteoporotic Belgian, Caucasian females. Bone loss is strongly correlated to time elapse from menopause (Tm) with a maximum rate of bone loss during the first five years of menopause. BMC (gHA)=41.6+0.662 ln Tm −0.481 (ln Tm)2 and BMD (gHA/cm2)=0.91+0.00711 in Tm −0.00846 (ln Tm)2 (in both cases p<0.001 and Tm expressed in months of menopause). After 20 years of menopause, 50 to 60% of normal women have vertebral BMC and BMD values below the 90th percentile of women with vertebral fractures and, thus, might be considered to have asymptomatic osteoporosis. We conclude that prevention of postmenopausal osteoporosis should be initiated as soon as possible after the onset of menopause and that bone density screening should be extended in elderly in order to detect and allow treatment of asymptomatic “densitometric” osteoporosis.
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Riggs, L.B., Melton, L.J. Involutional osteoporosis. New Engl J Med 1986, 314, 1676–1685.
Krolner, B., Pors Nielsen, S. Bone mineral content of the lumbar spine in normal and osteoporotic women: cross-sectional and longitudinal studies. Clin Sci 1982, 62, 329–336.
Riggs, B.L., Wahner, H.W., Dunn, W.C., Mazess, R.B., Offord, K.P., Meltin, III. L.J. Differential changes in bone mineral density of the appendicular and axial skeleton with aging; relationship to spinal osteoporosis. J Clin Invest 1981, 67, 328–335.
Nilas, L., Borg, J., Gotfredsen, A., Christiansen, C. Comparison of single and dual photon absorptiometry in postmenopausal bone mineral loss. J Nucl Med 1985, 26, 1257–1262.
Geusens, P., Dequeker, J., Verstraeten, A., Nijs, J. Age, sex, and menopause-related changes of vertebral and peripheral bone: Population study using dual and single photon absorptiometry and radiogrammetry. J Nucl Med 1986, 27, 1540–1549.
Pocock, N.A., Eisman, J.A., Yeates, M.G., Sambrook, P.N., Eberl, S., Wren, B.G. Limitations of forearm bone densitometry as an index of vertebral or femoral neck osteopenia. J Bone Min Res 1986, 1, 369–375.
Krolner, B., Pors Nielsen, S. Measurements of bone mineral content (BMC) of the lumbar spine I. Theory and application of a new two-dimensional dualphoton attenuation method. Scand J Clin Lab Invest 1980, 40, 653–663.
Chalmers, J., Weaver, J.K. Cancellous bone: its strength and changes with aging and an evaluation of some methods for measuring its mineral content. J Bone Joint Surg 1966, 48A, 299–308.
Arnold, J.S. Amount and quality of trabecular bone in osteoporotic vertebral fractures. Clin Endocrinol Metab 1973, 2, 221–238.
Nordin, B.E.C., Wishart, J.M., Horowitz, N., Need, A.G., Bridges, A., Bellon, M. The relation between forearm and vertebral mineral density and fractures in postmenopausal women. Bone 1988, 5, 21–34.
Nagant de Deuxchaisnes, C., Devogelaer, J.P. Increase in the incidence of hip fractures and of the ratio of trochanteric to cervical hip fractures in Belgium. Calcif Tissue Intern 1988, 42, 201–203.
Barret-Connor, E.. The RDA for calcium in the elderly: too little, loo late. Calcif Tissue Intern 1989, 44, 303–307.
O'Hanlow, P., Kohrs, M.B. Dietary studies of older Americans. Am J Clin Nutr 1978, 31, 1257–1269.
Nagant de Deuxchaisnes, C. The pathogenesis and treatment of involutional osteoporosis. Eds: Dixon, A. St. J., Russel, R.G.G., Stamp, T.B.C. In: Osteoporosis. A Multi-Disciplinary Problem. Grune and Stratton, New-York, 1983, pp. 291–333.
Kellgren, J.H. Atlas of standard radiographs of arthritis. In: The Epidemiology of Chronic Rheumatism. Vol II, Blackwell, Oxford, 1963.
Dequeker, J., Goris, P., Uytterhoeven, R. Osteoporosis and osteoarthritis: anthropometric distinctions. J Am Med Assoc 192, 249, 1448–1451.
Reginster, J.Y., Geusens, P., Nijs, J., Denis, D., Franchimont, P., Dequeker, J. In vivo long-term precision of spinal bone mass measurement by dual photon absorptiometry. Bone Mineral 1989, 2, 225–229.
Heaney, R.P., Recker, R.R., Saville, P.D. Menopausal changes in bone remodeling. J Lab Clin Med 1978, 92, 964–970.
Newton-John, H.F., Morgan, D.B. Osteoporosis: disease or senescence. Lancet 1968, 1, 232–233.
Riggs, B.L., Wahner, H.W., Melton, L.J. III. Richelson, L.S., Judd, H.L., Offord, K.P. Rates of bone loss in the axial and appendicular skeletons of women, evidence of substantial vertebral bone loss prior to menopause. J Clin Invest 1986, 77, 1487–1491.
Lindsay, R., Hart, D.M., Forrest, C., Baird, C. Prevention of spinal osteoporosis in oophorectomized women. Lancet 1980, 2, 1151–1153.
Parfitt, A.M., Mathews, C.H.E., Villaneuve, A.R., Kleerekoper, M., Frame, B., Rao, D.S. Relationship between surface volume and thickness of trabecular bone in aging and osteoporosis. J Clin Invest 1983, 72, 1396–1409.
Gryfes, C.L., Amies, A., Ashley, M.J. A longitudinal study of falls in an elderly population I: Incidence and morbidity. Age Ageing 1977, 6, 201–210.
Carter, D.R., Hayes, W.C. Bone compressive strength. The influence of density and strain rate. Science 1976, 194, 1174–1176.
Rochoff, S.D., Sweet, E., Bleustein, J. The relative contribution of trabecular and cortical bone to the strength of human lumbar vertebrae. Calcif Tissue Res 1969, 3, 163–175.
Khairi, M.R.A., Cronin, J.H., Robb, J.A., Smith, D.M., Yu, P.L., Johnston, C.C. Femoral trabecular pattern index and bone mineral measurement by photon absorptiometry in senile osteoporosis. J Bone Joint Surg 1976, 58A, 221–226.
Wasnich, R.D., Ross, P.D., Heilburn, L.K., Vogel, J.M. Prediction of postmenopausal fracture risk with bone mineral measurements. Am J Obstet Gynecol 1985, 153, 745–751.
Jensen, G.F., Christiansen, C., Boesen, J., Hegedus, V., Transbol, I. Relationship between bone mineral content and frequency of postmenopausal fractures. Acta Med Scand 1983, 213, 61–63.
Melton, L.J., Riggs, B.L. Risk factors for injury after a fall. Clin Geriatr Med 1985, 1, 525–537.
Elders, P.J.M., Netelenbos, J.C., Lips, P., von Ginkel, F.C., von der Stelt, P.F. Accelerated vertebral bone loss in relation to the menopause: a cross-sectional study on lumbar bone density in 286 women of 46 to 55 years of age. Bone Mineral 1988, 5, 11–20.
Aloia, J.F., Vaswani, A., Ellis, K., Yven, K., Cohns, S.H. A model for involutional bone loss. J Lab Clin Med 1985, 106, 630–637.
Hui, S.L., Slemenda, C.W., Jonhston, C.C., Appeldorn, C.R. Effects of age and menopause on vertebral bone density. Bone Mineral 1987, 2, 141–146.
Nilas, L., Christiansen, C. Bone mass and its relationship to age and the menopause. J Clin Endocrinol Metab 1987, 65, 697–702.
Pouilles, J.M., Ribot, C. Que peut-on attendre d'une mesure de la masse osseuse? Rev Rhum Mal Osteoarthritis 1989, 6, 479–486.
Ribot, C., Tremollieres, F., Pouilles, J.M., Louvet, J.P., Guiraud, R. Influence of the menopause and aging on spinal bone density in French women. Bone Mineral 1988, 5, 89–97.
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Reginster, J.Y., Denis, D., Deroisy, R. et al. Dual photon absorptiometry of lumbar spine in West European (Belgian) postmenopausal females: normal range and fracture threshold. Clin Rheumatol 9, 220–224 (1990). https://doi.org/10.1007/BF02031972
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DOI: https://doi.org/10.1007/BF02031972