Summary
The aim of our study was to compare the results provided by the measurement of vertebral and femoral bone mineral density (BMD) for assessing the individual risk of osteoporosis as defined by either low BMD and/or rapid bone loss. Vertebral and femoral BMD were measured twice at a mean interval of 21 months in 85 normal, early post-menopausal women who had passed a natural menopause 6 months to 3 years previously. According to the measurement site, 36% (spine), 29% (femoral neck), 35% (Ward's triangle), and 25% (trochanter) fall in the “at risk” category, defined by a BMD value of 1 SD or more below the normal values for premenopausal women. Based on vertebral BMD, 39–48% of the women at risk had a normal femoral BMD. On the other hand, 24–37% of the women classified at risk based on femoral BMD maintained a low risk at the vertebral level. The annual rate of bone loss was significantly greater for the Ward's triangle (-2.7±3.8%) and femoral neck (-2.1±2.5%) than for the spine (-1.5±2.1%) and trochanter (-1.5±3.4%). There was a significant relationship between the rate of loss measured at the spine and femoral levels (r=0.34–0.58). Among the 21 women with a rapid vertebral bone loss, 48–67% had a low bone loss at the femoral level and vice versa. The ratio between mean rate of loss and the precision of the measurement sites was greater for the spine (1.6) compared with the femur (1.1–0.71). Our results indicate that vertebral and femoral BMD measurements produce discordant results in assessing the individual risk for osteoporosis.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Slemenda CW, Hui SL, Longcope C, Wellman H, Johnston CC (1990) Predictors of bone mass in perimenopausal women. A prospective study of clinical data using photon absorptiometry. Ann Int Med 112:96–101
Ribot C, Pouillès JM, Bonneu M, Trémollières F (1992) Assessment of the risk of post-menopausal osteoporosis using clinical factors. Clin Endocrinol 36:225–228
Johnston CC, Melton LJ, Lindsay R, Eddy DM (1989) Clinical indications for bone mass measurements. J Bone Miner Res 4(suppl 2):1–28
Melton LJ, Eddy DM, Johnston CC (1990) Screening for osteoporosis. Ann Intern Med 112:516–528
Seeley DG, Browner WS, Nevitt MC, Genant HK, Scott JC, Cummings SR (1991) Which fractures are associated with low appendicular bone mass in elderly women? Ann Int Med 115: 837–842
Melton LJ, Atkinson EJ, O'Fallon WM, Wahner HW, Riggs BL (1991) Long-term fracture risk prediction with bone mineral measurements made at various skeletal sites (abstract) J Bone Miner Res 6(suppl 1):S136
Need AG, Nordin BEC (1990) Which bone to measure? Osteoporosis Int 1:3–6
Wasnich RD, Ross PD, Heilbrun LK, Vogel JM (1987) Selection of the optimal skeletal site for fracture risk prediction. Clin Orthop Rel Res 216:262–269
Ribot C, Trémollières F, Pouillès JM, Louvet JP, Guiraud R (1988) Influence of the menopause and aging on spinal density in French women. Bone Miner 5:89–97
Pouillès JM, Trémollières F, Todorovsky N, Ribot C (1991) Precision and sensitivity of dual-energy X-ray absorptiometry in spinal osteoporosis. J Bone Miner Res 6:997–1001
Christiansen C, Riis BJ, Rodbro P (1990) Screening procedure for women at risk of developing postmenopausal osteoporosis. Osteoporosis Int 1:35–40
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
Mazess RB, Barden HS (1990) Interrelationships among bone densitometry sites in normal young women. Bone Miner 11: 347–356
Jones CD, Laval-Jeantet AM, Laval-Jeantet MH, Genant HK (1987) Importance of measurement of spongious vertebral bone mineral density in the assessment of osteoporosis. Bone 8:201–206
Eastell R, Mosekilde LI, Hodgson SF, Riggs BL (1990) Proportion of human vertebral body that is cancellous. J Bone Miner Res 5:1237–1241
Nottestad SY, Baumel JJ, Kimmel DB, Recker RR, Heaney RP (1987) The proportion of trabecular bone in human vertebrae. J Bone Miner Res 2:221–229
Sandor T, Felsenberg D, Kalender WA, Clain A, Brown E (1992) Compact trabecular components of the spine using quantitative computed tomography. Calcif Tissue Int 50:502–506
Bohr H, Schaadt O (1985) Bone mineral content of the femoral neck and shaft: relation between cortical and trabecular bone. Calcif Tissue Int 37:340–344
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
Duboeuf F, Braillon P, Chapuy MC, Haond P, Hardouin C, Meary MF, Delmas PD, Meunier PJ (1991) Bone mineral density of the hip measured with dual-energy X-ray absorptiometry in normal elderly women and in patients with hip fracture. Osteoporosis Int 1:242–249
Hedlund LR, Gallagher JC (1989) The effect of age and menopause on bone mineral density of the proximal femur. J Bone Miner Res 4:639–642
Mazess RB, Barden HS, Ettinger M, Johnston C, Dawson-Hughes B, Baran D, Powell M, Notelovitz M (1987) Spine and femur density using dual-photon absorptiometry in US white women. Bone Miner 2:211–219
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Pouilles, J.M., Tremollieres, F. & Ribot, C. Spine and femur densitometry at the menopause: Are both sites necessary in the assessment of the risk of osteoporosis?. Calcif Tissue Int 52, 344–347 (1993). https://doi.org/10.1007/BF00310196
Received:
Revised:
Issue Date:
DOI: https://doi.org/10.1007/BF00310196