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Bone mass and risk factors for bone loss in perimenopausal Danish women
C Brot1, L B Jensen, O H Sørensen
1Department of Rheumatology, Copenhagen Municipal Hospital, Denmark.
Objectives:
To determine risk factors for low bone mass at menopause and risk factors for subsequent bone loss in the following period.
Design:
A cross-sectional study and a 2-year prospective follow-up.
Setting:
The catchment area of Sundby Hospital in Copenhagen.
Subjects:
Four hundred and thirty-three women aged 45-58 years, with amenorrhea for 3-24 months, of whom 87 were followed for a 2-year period.
Measurements:
Registration of life-style and anthropometric variables, reproductive history, and family history of fractures. Total body bone mineral content (BMC) was measured with dual energy X-ray absorptiometry.
Results:
By means of multiple regression analysis height, body weight, and length of reproductive period were found to be positively related to whole body BMC (P < 0.001), whilst a negative relationship was found to age (P < 0.001), smoking (P < 0.001), and family history of fractures (P < 0.005). In the longitudinal study, only body weight at the inclusion (P = 0.005) and subsequent changes in body weight and fat mass (P < 0.001) were related to the changes in bone mass.
Conclusion:
The most significant predictors for bone loss were changes in body weight and fat mass. Hence, weight loss is a risk factor for bone loss in the early postmenopausal period, whereas weight gain seems to preserve bone.