Abstract
Dual energy x-ray absorptiometry (DXA) was used to measure bone mineral density (BMD) of the lumbar spine and proximal femur (neck, Ward's triangle, and trochanter) in 417 normal women (aged 20–79) living in São Paulo, Brazil. Bone density decreased with age at all sites. At the spine, the greatest decrease occurred during the sixth decade, with an average 11.4% bone loss compared with the previous decade. Stratifying the subjects according to menopausal status revealed that the fastest bone occurred at the time around the menopause (ages 45–60) when the rate of bone loss (-0.66%/year) was almost twice as rapid as in postmenopausal women (-0.39%/year). Although significant linear rates of bone loss were detected in all proximal femur sites before the menopause, a menopause-dependent pattern was less evident that at the spine. Lifetime rates of bone loss at the appendicular skeleton were-0.43,-0.62, and-0.35%/year at the femoral neck, Ward's triangle, and trochanteric area, respectively. After the menopause, BMD declined with menopausal age at all sites, although the rate of bone loss was faster at the femoral neck (-0.62%/year) and Ward's triangle (-0.84%/year) than at the spine-0.49%/year). The results are consistent with the notion that in women, the fastest bone loss occurs at the time round the menopause, most likely consequent to ovarian failure; and that faster rates of bone loss are detected at the proximal femur than at the lumbar spine in late postmenopausal women.
Similar content being viewed by others
References
Einhorn TA (1992) Bone strength: the bottom line [Editorial]. Calcif Tissue Int 51:333–339
Horsman A, Currey JD (1983) Estimation of mechanical properties of the distal radius from bone mineral content and cortical width. Clin Orthop Rel Res 176:298
Cohn SH, Yasumura AS, Aloia JF, Zanzi I, Ellis KJ (1977) Comparative skeletal mass radial bone mineral content in black and white women. Metabolism 26:171–178
Trotter M, Broman GE, Peterson RR (1960) Densities of bones of white and Negro skeletons. J Bone Joint Surg 42-A:50–58
Liel Y, Edwards J, Shary J, Spicer KM, Gordon L, Bell NH (1988) The effect of race and body habitus on bone mineral density of the radius, hip and spine in premenopausal women. J Clin Endocrinol Metab 66:1247–1250
Luckey MM, Meier DE, Mandeli JP, DaCosta MC, Hubbard ML, Goldsmith SJ (1989) Radial and vertebral bone density in white and black women: evidence for racial differences in premenopausal bone homeostasis. J Clin Endocrinol Metab 69: 762–770
Melton LJ III, Riggs BL (1993) Epidemiology of age-related fractures. In: Avioli LV (ed) The osteoporotic syndrome: detection, prevention and treatment. Wiley-Liss, Inc, New York, pp 17–38
Farmer ME, White LR, Brody JA (1984) Race and sex differences in hip fracture incidence. Am J Public Health 44:1374–1380
Gilsanz V, Roe TF, Mora S, Costin G, Goodman WG (1991) Changes in vertebral bone density in black girls and white girls during childhood and puberty. N Engl J Med 325:1597–1600
Ross PD, Orimo H, Wasnich RD, Vogel JM, McLean CJ, Davis JW, Nomura A (1989) Methodological issues in comparing genetic and environmental influences on bone mass. Bone Miner 7:67–77
Yano K, Wasnich RD, Vogel JM, Heilbrun LK (1984) Bone mineral measurements among middle-aged and elderly Japanes residents in Hawaii. Am J Epidemiol 119:751–764
Del Rio Barquero L, Baures MR, Segura JP, Quinquer JS, Majem LS, Ruiz PG (1992) Bone mineral density in two different socio-economic population groups. Bone Miner 18:159–168
Pocock NA, Eisman JA, Mazess RB, Sambrook PN, Yeates MG, Freund J (1988) Bone mineral density in Australia compared with the United States. J Bone Miner Res 3:601–604
Mautalen C, Rubin Z, Vega E, Ghiringhelli G, Fromm G (1990) Densidad de la coluna lumbar y femur proximal en mujeres de Buenos Aires. Medicina 50:25–29
Morrone MMS, Lewin S, Bianco AC, Correa PHS (1989) Diagnostico de osteoporose atraves da densitometria de dois fotons. Rev Ass Med Brasil 35:57–62
Schulz LO (1986) Obese, overweight, desirable, ideal: where to draw the line in 1986? J Am Diet Assoc 86:1702–1704
Mazess RB, Collick B, Trempe J, Barden H, Hannson J (1989) Performance evaluation of dual-energy x-ray bone densitometer. Calcif Tissue Int 44:228–232
Szejnfeld VL, Aldrighi JM, Ferraz MB, Atra E, Piato S (1990) Age and bone mass in Brazilian premenopausal women (abstract). J Bone Miner Res 5:S115
Favus MJ (1993) Bone density reference data. In: Favus MJ (ed) Primer on the metabolic bone disease and disorders of mineral metabolism. Raven Press, New York, NY, pp 426–430
Mazess RB, Barden HS, Ettinger B, Johnston CC Jr, Dawson-Hughes B, Baran DT, Powell M, Notelovitz M (1987) Spine and femur density using dual-photon absorptiometry in US white women. Bone Miner 2:211–219
Johnston CC Jr, Hui SL, Witt RM, Appledorn CR, Baker RS, Longcope C (1985) Early menopausal changes in bone mass and sex steroids. J Clin Endocrinol Metab 61:905–911
Lindquist O, Bengtsson C, Hansson T, Jonsson R (1983) Changes in bone mineral content of the axial skeleton in relation to aging and the menopause. Scand J Clin Lab Invest 43:333–338
Hui SL, Slemenda CW, Johnston CC Jr, Appledorn CR (1987) Effects of age and menopause on vertebral bone density. Bone Miner 2:141–146
Riggs BL, Wahner HW, Melton LJ III, Richelson LS, Judd HL, Offord KP (1986) Rates of bone loss in the appendicular and axial skeletons of women. J Clin Invest 77:1487–1491
Riggs BL, Wahner HW, Dunn WL, Mazess RB, Offord KP, Melton LJ III (1981) Differential changes in bone mineral density of the appendicular and axial skeleton with aging. J Clin Invest 67:328–335
Richelson LS, Wahner HW, Melton LJ III, Riggs BL (1984) Relative contributions of aging and estrogen deficiency to postmenopausal bone loss. N Engl J Med 311:1273–1275
Nordin BEC, Need AG, Chatterton BE, Horowitz M, Morris HA (1990) The relative contributions of age and years since menopause to postmenopausal bone loss. J Clin Endocrinol Metab 70:83–88
Reid IR, Evans MC, Ames R, Wattie DJ (1991) The influence of osteophytes and aortic calcification on spinal mineral density in postmenopausal women. J Clin Endocrinol Metab 72:1372–1374
Knight SM, Ring EFJ, Bhalla AK (1992) Bone mineral density and osteoarthritis. Ann Rheum Dis 51:1025–1026
Griffin MG, Rupich RC, Avioli LV, Pacifici R (1991) A comparison of dual energy radiography measurements at the lumbar spine and proximal femur for the diagnosis of osteoporosis. J Clin Endocrinol Metab 73:1164–1169
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Szejnfeld, V.L., Atra, E., Baracat, E.C. et al. Bone density in white Brazilian women: Rapid loss at the time around the menopause. Calcif Tissue Int 56, 186–191 (1995). https://doi.org/10.1007/BF00298607
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00298607