Bone mineral density measurements in post-menopausal women: When and which areas should be measured?

Yıl 2013, Cilt: 30 Sayı: 3, 229 - 231, 05.11.2013

Metin Uzun , Ahmet Bülbül Burak Beksaç Adnan Kara

https://doi.org/10.5835/jecm.omu.30.03.004

Öz

The aim of this study is to evaluate perimenopausal and postmenopausal women with extensive bone pain, who were not undergoing any osteoporosis treatment, were nonsmokers and who had a body mass index (BMI) below 30, to determine which age groups and which areas should have bone mineral density (BMD) measurements taken by Dual Energy X-Ray Absorptiometry (DXA). The study comprised 243 perimenopausal and postmenopausal (age range 42–78 years) women who presented at our clinic with extensive bone pain. All cases had BMD measurements taken by the same DXA machine on the right femoral neck (RT), the left femoral neck (LT) and lumbar vertebrae 1–4 (L1-4T). The patients were assigned to one of three groups; Group 1, under 50 years of age (n=83); Group 2, 50-60 years of age (n=103); Group 3, over 60 years of age (n=57). The difference between the T scores obtained from the BMD measurements of the whole group was found to be significant with the Kruskar-Wallis test. To determine between which age groups the difference in the T-scores was statistically significant, the patients were allocated to 3 age-related groups. The T-scores of these three groups were compared and evaluated with the Mann-Whitney U-test. The T-score differences (RT, LT, L1-4T) between Group 1 and Group 2 were found to be statistically significant, between Group 1 and Group 3, statistically highly significant, and between Group 2 and Group 3 there was no statistical significance. The differences between the T-score measurements of left hip, right hip and lumbar 1–4 vertebrae of the 3 created groups were statistically evaluated with a 95% confidence interval. In each group RT, LT and L1-4T were evaluated with no statistical difference. Our results lead us to believe that postmenopausal women with extensive bone pain should undergo routine BMD measurement after the age of 60 and that these measurements will be sufficient from just one area.

Anahtar Kelimeler

Body areas, Bone mineral density, Osteoporosis, T-score

Kaynakça

• Baran, D.R., Kelly, A.M., Karellos, A., 1988. Ultrasound attenuation of the os calcis in women with osteoporosis and hip fractures. Calcif. Tissue Int. 43,138.
• Bergot, C., Laval, Jeantet, A.M., Prêteux, F., Meunier, A., 1988. Measurement of anisotropic vertebral trabecular bone loss during aging by quantitative image analysis. Calcif. Tissue Int. 43,143.
• Bonnick, S.L., 2005. Bone mass measurement techniques in clinical practise. Methods, Applications and Interpretation. Top. Geriatr. Rehabil. 21, 30-41.
• Brown, J.P., Kendler, D.L., Mc Clung, M.R., 2002. The efficacy and tolerability of risedronate once a week fort he treatment of postmenauposal osteoporosis. Calcif. Tissue Int. 71, 103-111.
• Comsan, F., Schnitzer, M.B., Mc Cann, P.D., 1992. Relationships between quantitative histological measuremens and noninvasive assesments of bone mass. Bone. 13, 237.
• Concensus conference, 1984. Osteoporosis. JAMA. 252,799.
• Gonelli, S., Cepallaro, C., Agnusdei, D., 1995. Diagnostic value of ultrasound analysis and bone densitometry as predictors of vertebral deformity in postmenauposal women. Osteoporos. Int. 5,413-418.
• Hall, F.M., David, M.A., Baran, D.T., 1987. Bone mineral screening for osteoporosis. N. Eng. J. Med. 316, 322.
• Johnston, C.C., Melton, L.J., Lindsay, R., Eddy, D.M., 1989. Clinical Indications for bone mass measurements. A report from the scientific advisory board of the national osteoporosis foundation. J. Bone Miner. Res. 4, 2.
• Lenchik, L., Kiebzak, G., Blunt, B., 2002. What is role of serial bone mineral density measurements in patient management? J. Clin. Densitometry. 5, 29-38.
• Lewiecki, E.M., 2008. Prevention and treatment of postmenauposal osteoporosis. Obstet. Gynecol. Clin. N. Am. 35, 301-315.
• Libanoti, C.R., Schulz, E.E., Shook, J.E., 1992. Hip mineral density in females with a recent hip fracture. J. Clin. Endocrinol. Metab. 74, 351. Poss, P.D., Davis, J.W., Vogel, J.M., 1990. A Critical review of bone mass and the risk of fractures in osteoporosis. Calcif. Tissue. Int. 46, 49-61. Riggs, B.L., Melton, L.J., 1986. Involutional Osteoporosis. N. Eng. J. Med. 314, 1676.
• Sartoris, D.J., Andre, M., Resnick, C., 1986. Trabecular bone density in the proximal femur: Quantitative CT assesment. Radiology. 182, 849. Simon, L.S., 2007. Osteoporosis. Rheum. Dis. N. Am. 3, 149-176.
• Slemenda, C.W., Hill, S.L., Longscope, C., Wellman, H., Johnston, C.C.Jr., 1990. Predictors of bone mass in perimenauposal women. Ann. Intern. Med.112, 96.
• World Health Organization, 1994. Assesment of fracture risk and its application to screening for postmenauposal osteoporosis. Geneva, Switzerland.