Demir B, Haberal A, Geyik P, Baskan B, Ozturkoglu E, Karacay O, Deveci S
Department of Obstetrics and Gynecology, Ministry of Health Ankara Etlik Maternity and Women's Health Teaching Research Hospital, Turkey.
Maturitas. 2008 Jul-Aug;60(3-4):253-6. doi: 10.1016/j.maturitas.2008.07.011. Epub 2008 Sep 7.
The aim of this study was to determine the effect of different durations of menopause at the time of bone mineral density (BMD) measurement and of different age at menopause intervals on the prevalence of osteopenia and osteoporosis among untreated postmenopausal women. We also assessed related factors leading to low BMD.
A total of 2769 postmenopausal women who had not taken any anti-osteoporosis treatment and/or hormone replacement therapy were divided into three groups according to duration of menopause at the time of BMD measurement. The women were also evaluated in four different age groups according to their age at menopause onset. Multinomial logistic regression analysis was used to determine related factors leading to low BMD. Investigated parameters include demographic characteristics, plasma glucose, lipids, and lipoproteins.
According to World Health Organization (WHO) criteria, among 2769 patients, 449 (16.2%) were identified as having osteoporosis, 1085 (39.2%) as having osteopenia, and 1235 (44.6%) as having normal BMD. Osteoporosis was determined in 10.6% and 16.2% of women with menopause duration of 0-3 years and 4-7 years, respectively, whereas this rate was 31.9% in women with menopause duration of over 7 years (p = 0.001). The percentages for osteopenia remained constant among the three different menopause durations (0-3 years: 37.2%, 4-7 years: 42.1%, and >7 years: 40.9%). Thirty percent of women with age at onset of <40 years were osteoporotic. However, the percentages of women with osteoporosis among the other age groups were similar (40-46 years: 18.3%, 47-52 years: 14.1%, and >52 years: 15.4%). The percentages for osteopenia remained relatively constant among the four age groups (36.7, 40, 39.1 and 39%). According to the multinomial logistic regression analysis, duration of menopause at the time of BMD test and parity were positively correlated with both osteoporosis and osteopenia, while glucose level was negatively correlated with both osteoporosis and osteopenia. Age at menopause was negatively correlated only for osteoporosis. Low-density lipoprotein cholesterol (LDL-c) level may be accepted as a clinically significant factor for osteopenia (OR: 1.01; CI(95%): 1.00-1.02). No differences were determined in the prevalence of osteopenia and osteoporosis in women with menopause duration of >7 years when evaluated according to the four menopause age groups as described before (p = 0.74). Contribution to the regression model was 0.8% by age at menopause, 5.6% by menopause duration at time of BMD measurement, 5.8% by both factors.
According to our results, osteoporosis is related more to the duration of menopause at the time of BMD measurement rather than the age at menopause among untreated postmenopausal women. High parity was determined as another risk factor for low BMD.
本研究旨在确定骨密度（BMD）测量时不同绝经持续时间以及绝经间隔的不同年龄对未接受治疗的绝经后女性骨质疏松症和骨质减少症患病率的影响。我们还评估了导致低骨密度的相关因素。
共有2769名未接受任何抗骨质疏松治疗和/或激素替代疗法的绝经后女性，根据BMD测量时的绝经持续时间分为三组。这些女性还根据绝经起始年龄分为四个不同年龄组进行评估。采用多项逻辑回归分析来确定导致低骨密度的相关因素。研究参数包括人口统计学特征、血糖、血脂和脂蛋白。
根据世界卫生组织（WHO）标准，在2769例患者中，449例（16.2%）被确定为患有骨质疏松症，1085例（39.2%）患有骨质减少症，1235例（44.6%）骨密度正常。绝经持续时间为0 - 3年和4 - 7年的女性中，骨质疏松症的发生率分别为10.6%和16.2%，而绝经持续时间超过7年的女性中这一比例为31.9%（p = 0.001）。骨质减少症在三个不同绝经持续时间组中的百分比保持不变（0 - 3年：37.2%，4 - 7年：42.1%，>7年：40.9%）。绝经起始年龄<40岁的女性中有30%患有骨质疏松症。然而，其他年龄组中患有骨质疏松症的女性百分比相似（40 - 46岁：18.3%，47 - 52岁：14.1%，>52岁：15.4%）。骨质减少症在四个年龄组中的百分比相对保持不变（36.7%、40%、39.1%和39%）。根据多项逻辑回归分析，BMD检测时的绝经持续时间和产次与骨质疏松症和骨质减少症均呈正相关，而血糖水平与骨质疏松症和骨质减少症均呈负相关。绝经年龄仅与骨质疏松症呈负相关。低密度脂蛋白胆固醇（LDL - c）水平可被视为骨质减少症的一个具有临床意义的因素（OR：1.01；CI(95%)：1.00 - 1.02）。按照之前描述的四个绝经年龄组评估时，绝经持续时间>7年的女性中骨质减少症和骨质疏松症的患病率无差异（p = 0.74）。绝经年龄对回归模型的贡献为0.8%，BMD测量时的绝经持续时间为5.6%，两者共同作用为5.8%。
根据我们的研究结果，在未接受治疗的绝经后女性中，骨质疏松症与BMD测量时的绝经持续时间而非绝经年龄的关系更为密切。高生育次数被确定为低骨密度的另一个危险因素。
