Kajita E, Iki M, Nishino H, Dohi Y, Moriyama T, Tobita Y, Deguchi Y, Kusaka Y, Ogata A
Department of Community Nursing, Fukui Prefectural University College of Nursing, Japan.
Nihon Eiseigaku Zasshi. 1994 Aug;49(3):674-83. doi: 10.1265/jjh.49.674.
Bone mineral density (BMD) of the lumbar spine in 198 community-dwelling Japanese women aged 35 years and over was measured by dual-energy X-ray absorptiometry to investigate the effects of aging and menopause on BMD. A highly significant negative correlation between age and BMD was observed in postmenopausal women as widely accepted. We found a weak but statistically significant negative correlation between age and BMD in even premenopausal women, suggesting that their bone loss had commenced before menopause. Marked decrement in BMD was seen during the first ten years after menopause. Menopause clearly accelerated bone loss in the lumbar spine. Two-way analysis of variance of BMD on age and menopausal status showed that these explanatory variables had a significantly decreasing effect on BMD independently of each other. Menopausal status had a greater sum of squares than age, which suggested that menopause played a greater role in bone loss than did aging. Early menopause has been implied as one of the risk factors for bone loss. The women aged 50 to 59 having encountered menopause before 49 years old exhibited significantly lower BMD than those of similar age who experienced menopause at age 49 and older. This difference in BMD was not observed in the women aged 60 and over. Early menopause was no more likely to be a risk factor for bone loss in the elderly women. We conclude that bone loss in the lumbar spine begins before menopause and is accelerated markedly by menopause for about ten years, and that menopause has a greater decreasing effect on the bone mass than does chronological age while each of them has an independent effect on the bone mass decrement.
采用双能X线吸收法测量了198名年龄在35岁及以上的社区居住日本女性的腰椎骨密度,以研究衰老和绝经对骨密度的影响。正如广泛认可的那样,绝经后女性的年龄与骨密度之间存在高度显著的负相关。我们发现,即使在绝经前女性中,年龄与骨密度之间也存在微弱但具有统计学意义的负相关,这表明她们的骨质流失在绝经前就已经开始。绝经后的头十年里,骨密度出现了显著下降。绝经明显加速了腰椎的骨质流失。对骨密度关于年龄和绝经状态的双向方差分析表明,这些解释变量彼此独立地对骨密度有显著的降低作用。绝经状态的平方和比年龄的平方和更大,这表明绝经在骨质流失中所起的作用比衰老更大。早绝经被认为是骨质流失的风险因素之一。在49岁之前绝经的50至59岁女性的骨密度显著低于在49岁及以后绝经的同龄女性。在60岁及以上的女性中未观察到这种骨密度差异。早绝经在老年女性中不再可能是骨质流失的风险因素。我们得出结论,腰椎的骨质流失在绝经前就开始了,并在绝经后大约十年内显著加速,而且绝经对骨量的降低作用比实际年龄更大,同时它们各自对骨量减少都有独立的影响。