Heterogeneity of trabecular and cortical postmenopausal bone loss: a longitudinal study with pQCT

Eighty-one women were studied longitudinally to measure trabecular bone mineral density (BMDTrab) and cortical bone mineral density (BMDCorti) in the distal radius by peripheral quantitative computed tomography (pQCT) at intervals of about 1 year and to calculate the rate of percent change/year. Fifty-three women were naturally postmenopausal [mean age 63.3 +/- 5.3 years, age at menopause 50.7 +/- 3.8 years, 13 years since menopause (YSM)] and 28 had been ovariectomized (mean age 52.7 +/- 5.8 years, age at menopause 39.5 +/- 5.0 years, 13 YSM). There was no difference between groups (ANOVA) in the rate of percent change/years in BMDTrab (p = 0.692), but there was in BMDCorti (p = 0.020). When the women who had either gained or lost bone mass were compared (chi-square test), only BMDCorti differed significantly (p = 0.018). Considering > -2.5% change/years as the limit for rapid bone mass loss, BMDTrab values showed that 43% of the naturally postmenopausal women and 42.7% of the ovariectomized women had rapid bone loss (p ns). On the basis of BMDCorti values, 45% of the naturally postmenopausal women and 28.4% of the ovariectomized women had rapid bone loss (p = 0.018). Height, weight, body mass index (BMI), age, YSM, and years of reproductive life did not differ (ANOVA) between the women who gained or lost either BMDTrab or BMDCorti. Using Fisher's r to z and partial correlation adjusted for age and YSM of the percent change/year in BMDTrab and BMDCorti in the overall group and in each menopausal group, only BMDCorti differed.