Seeman E, Cooper M E, Hopper J L, Parkinson E, McKay J, Jerums G
Department of Medicine, Austin Hospital, Heidelberg, Melbourne, Victoria, Australia.
Am J Med. 1988 Aug;85(2):213-6. doi: 10.1016/s0002-9343(88)80345-0.
Early menopause is widely regarded as a risk factor for osteoporosis. The aim of this study was to determine whether this risk is conferred by a lower bone mass.
Two hundred thirteen normal postmenopausal women and 55 women with postmenopausal osteoporosis (vertebral fractures) underwent bone mass measurements at the lumbar spine, femoral neck, and midshaft using dual-photon absorptiometry. To examine the effect of early menopause, postmenopausal normal women were stratified according to whether menopause occurred before or after the age of 50 years. Patients with osteoporosis were stratified in the same way.
Patients with osteoporosis had menopause at an earlier age than control subjects, but the difference in bone mass between the patients with osteoporosis and the control subjects could not be attributed to this earlier age at menopause. Furthermore, within the osteoporotic patient group, those with early menopause did not have lower bone mass than those with normal age at menopause. Similarly, within the normal subject group, those with early menopause did not have lower bone mass than those with normal age at menopause.
Patients with osteoporosis have lower bone mass, which is independent of the age at menopause. Although a small effect (less than or equal to 5 percent) of early menopause on bone mass cannot be entirely excluded, these data suggest that the amount of bone lost following menopause is the same irrespective of the age at which menopause occurs. If early menopause is a risk factor for osteoporosis, the risk is not conferred by a bone mass substantially lower than predicted had menopause occurred later, but may be related to the duration of exposure to minimal trauma at low bone mass.
早发性绝经被广泛认为是骨质疏松症的一个危险因素。本研究的目的是确定这种风险是否由较低的骨量所致。
213名绝经后正常女性和55名绝经后骨质疏松症（椎体骨折）女性接受了双光子吸收法测量腰椎、股骨颈和骨干的骨量。为了研究早发性绝经的影响，绝经后正常女性根据绝经是否发生在50岁之前或之后进行分层。骨质疏松症患者也以同样的方式分层。
骨质疏松症患者的绝经年龄比对照组早，但骨质疏松症患者与对照组之间的骨量差异不能归因于绝经年龄较早。此外，在骨质疏松症患者组中，早发性绝经患者的骨量并不低于绝经年龄正常的患者。同样，在正常受试者组中，早发性绝经患者的骨量也不低于绝经年龄正常的患者。
骨质疏松症患者的骨量较低，这与绝经年龄无关。虽然不能完全排除早发性绝经对骨量有小的影响（小于或等于5%），但这些数据表明，绝经后骨质流失的量与绝经发生的年龄无关。如果早发性绝经是骨质疏松症的一个危险因素，那么这种风险不是由骨量显著低于绝经较晚时预测的骨量所致，而可能与低骨量时暴露于微小创伤的持续时间有关。
