Smeets-Goevaers C G, Lesusink G L, Papapoulos S E, Maartens L W, Keyzer J J, Weerdenburg J P, Beijers L M, Zwinderman A H, Knottnerus J A, Pols H A, Pop V J
Diagnostic Centre Eindhoven, The Netherlands.
Osteoporos Int. 1998;8(5):404-9. doi: 10.1007/s001980050083.
The aim of this study was to estimate the prevalence of osteopenia and osteoporosis in perimenopausal women, and to assess determinants of low bone mineral density (BMD). All women born between 1941 and 1947 (aged between 46 and 54 years) living in the city of Eindhoven were invited to participate in the study: 5896 white Dutch women, representing 73% of the total number of Dutch women in this age group, were studied. Of these, 24% were using estrogen preparations and 19% had undergone hysterectomy, with or without oophorectomy. All women were interviewed and bone mineral density (BMD) of the lumbar spine was measured by dual-energy X-ray absorptiometry (DXA). Osteopenia and osteoporosis were defined according to the criteria proposed by a WHO working group. In the population studied the prevalence of osteopenia and osteoporosis was 27.3% and 4.1%, respectively. With progression from premenopause to menopause, the prevalence of osteoporosis increased from 0.4% to 12.7%, and that of osteopenia from 14.5% to 42.8%. An increased risk for low BMD (osteopenia and osteoporosis) was associated with age, menopausal status and smoking, while alcohol consumption, high body mass index (BMI) and use of estrogens had a protective effect. This study of a large population-based cohort of perimenopausal women revealed a high prevalence of low bone mass and, therefore, a higher risk for osteoporotic fractures. The data further suggest that, when issues on the long-term efficacy and safety of preventive treatments are resolved, it may be possible to identify women at higher risk who are most likely to benefit from screening strategies.
本研究的目的是估计围绝经期女性骨质疏松症和骨质减少的患病率，并评估低骨密度（BMD）的决定因素。邀请了所有居住在埃因霍温市、出生于1941年至1947年（年龄在46至54岁之间）的女性参与研究：对5896名荷兰白人女性进行了研究，她们占该年龄组荷兰女性总数的73%。其中，24%的女性正在使用雌激素制剂，19%的女性已接受子宫切除术，无论是否同时进行了卵巢切除术。所有女性均接受了访谈，并通过双能X线吸收法（DXA）测量了腰椎的骨密度（BMD）。骨质疏松症和骨质减少是根据世界卫生组织一个工作组提出的标准定义的。在所研究的人群中，骨质疏松症和骨质减少的患病率分别为27.3%和4.1%。随着从绝经前到绝经的进展，骨质疏松症的患病率从0.4%增加到12.7%，骨质减少的患病率从14.5%增加到42.8%。低BMD（骨质疏松症和骨质减少）风险增加与年龄、绝经状态和吸烟有关，而饮酒、高体重指数（BMI）和使用雌激素具有保护作用。这项对大量基于人群的围绝经期女性队列的研究显示，低骨量患病率很高，因此骨质疏松性骨折的风险也更高。数据进一步表明，当预防性治疗的长期疗效和安全性问题得到解决时，有可能识别出最有可能从筛查策略中受益的高风险女性。
