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[The profile of low bone mass in amenorrhea with elevated follicle stimulating hormone]
1Chinese Academy of Medical Science, Peking Union Medical College, Peking Union Medical College Hospital, Beijing 100730.
Objective:
To observe the characteristics of low bone mass in amenorrhea with elevated follicle stimulating hormone(FSH).
Methods:
Amenorrhea patients with elevated FSH: primary amenorrhea (PA) 18 cases, secondary amenorrhea (SA), 171 cases and age matched control with normal menstruation (Nor) 180 cases. The descriptive parameters were: estradiol (E2), alkaline phosphatase (ALP), urinary excretion of calcium to creatinine ratio (Ca/Cr), the cortical bone mineral density (CBMD) at right radius measured by single photon absorptimetry (SPA) and the trabecular bone mineral density (TBMD) at lumbar vertebra body measured by quantitative computerized tomography (QCT).
Results:
The experiment had shown the average E2 level in amenorrhea patients to be < 150 pmol/L. Significantly higher ALP and Ca/Cr values than the Nor group. In the SA group, the CBMD value was (655 +/- 69) mg/cm2, which was significantly lower than the Nor group's value of (677 +/- 56) mg/cm2 (3.2% lower, P < 0.01). The TBMD value is (145 +/- 26) mg/cm3, which is significantly lower than the Nor group's value of (192 +/- 28) mg/cm3 (24.5%, P < 0.001). The disparity with the Nor group was even greater in the PA group (11.1% and 35.7% lower, respectively). The BMD of the amenorrhea patients were negatively linearly correlated with their amenorrhea age.
Conclusions:
The serum estradiol level in amenorrhea patients with high FSH was so low that their bone turnover was increased which led to the insufficient bone accumulation and dramatically dropping of TBMD. Its extent was related to the initial age and the duration of ovarian failure.
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