Implications of premature ovarian failure on bone turnover markers and bone mineral density

Premature ovarian failure (POF) is the cessation of ovarian function before the age of 40. The loss of ovarian function, whether premature or not, has an overwhelming impact on female skeletal health, leading to an increased risk of developing osteoporosis because of the lengthened time of exposure to reduced estrogen. The objective of this study was to compare the implications of premature ovarian failure on bone turnover markers and bone mineral density in patients under the age of 40.

Sixty-one patients with a diagnosis of POF were selected for this prospective study. Patients were divided into two groups according to age, patients < 30 years old (n = 30), and patients > or = 30 years old (n = 31).

Between the two age sub-groups (< 30 and > or = 30 years old), there was a significant difference in menopause rating scale (MRS), lumbar spine t-score, N-telopeptides crosslinks (NTx), and serum bone specific alkaline phosphatase (bALP) between the two age groups (10.93 +/- 7.79 vs 17.38 +/- 8.62; -1.84 +/- 1.47 vs -1.06 +/- 0.93; 58.80 +/- 21.32 vs 41.1 +/- 11.37; 48.99 +/- 42.16 vs 23.76 +/- 10.08, respectively).

It is apparent that bone mineral density (BMD) is commonly less in women with POF than normal healthy women. Therefore, measurement of BMD is warranted. At this time, it is not clear how often the tests should be carried out to evaluate BMD. Further prospective studies are required to establish guidelines. However, it seems reasonable to monitor women with POF yearly for the presence of any endocrine dysfunction and to assess BMD at periodic intervals.