Holloway-Kew Kara L, Morse Amelia G, Anderson Kara B, Kotowicz Mark A, Pasco Julie A
Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, Australia.
Department of Medicine - Western Health, The University of Melbourne, St Albans, Australia.
Calcif Tissue Int. 2025 Jun 4;116(1):80. doi: 10.1007/s00223-025-01392-8.
Post-menopausal bone loss has been well described, however fewer studies have focussed on changes around the time of menopause. This study describes bone mineral density (BMD) loss following recent menopause, stratified by hormone replacement therapy (HT) use. Women (n = 287) who self-reported recent menopause (≥ 12 months to < 5 yr since last menstrual period) for at least one assessment phase of the Geelong Osteoporosis Study were included. BMD was measured using Lunar DPX-L and GE-Prodigy machines. Time since menopause was calculated for each participant at each assessment phase and divided into three categories: < 5 yr, 5-10 yr and ≥ 10 yr. BMD loss was expressed as: (i) cumulative loss over time, (ii) absolute value per year and (iii) percentage loss per year. Proportions of women with normal BMD, osteopenia and osteoporosis were also calculated. Cumulative BMD loss was lower among HT users than non-users at all sites and time categories, except the femoral neck. Compared to the other time categories, HT non-users had a greater rate of BMD loss (expressed as an absolute value or percentage per year) during the first five years postmenopause at the ultra-distal forearm and lumbar spine. No differences were observed between the time categories for HT users. The proportions of women with osteopenia and osteoporosis increased across each of the time categories, but patterns differed by skeletal site, being more pronounced for the femoral neck and mid-forearm sites. Rates of bone loss were greater at the lumbar spine and ultra-distal forearm during the first five years following menopause.
绝经后骨质流失已有充分描述，但较少有研究关注绝经前后的变化。本研究描述了近期绝经后按激素替代疗法（HT）使用情况分层的骨矿物质密度（BMD）流失情况。纳入了在吉朗骨质疏松症研究的至少一个评估阶段自我报告近期绝经（自末次月经以来≥12个月至＜5年）的女性（n = 287）。使用Lunar DPX-L和GE-Prodigy机器测量BMD。在每个评估阶段为每位参与者计算绝经后的时间，并分为三类：＜5年、5 - 10年和≥10年。BMD流失表示为：（i）随时间的累积流失，（ii）每年的绝对值，以及（iii）每年的百分比流失。还计算了BMD正常、骨量减少和骨质疏松女性的比例。除股骨颈外，在所有部位和时间类别中，HT使用者的累积BMD流失均低于非使用者。与其他时间类别相比，HT非使用者在绝经后的前五年中，在前臂超远端和腰椎处的BMD流失率更高（以绝对值或每年的百分比表示）。HT使用者在不同时间类别之间未观察到差异。骨量减少和骨质疏松女性的比例在每个时间类别中均有所增加，但不同骨骼部位的模式不同，在股骨颈和前臂中部更为明显。绝经后的前五年中，腰椎和前臂超远端的骨质流失率更高。
