Osteoporosis and low bone mass in premenopausal and perimenopausal women.
OBJECTIVE
To characterize the historical, clinical, and biochemical features of 111 young women (age, <55 years) referred for evaluation of osteoporosis or low bone mass.


METHODS
Women with a bone mineral density T score < or = -2.0 (N = 111) at one or more anatomic sites (by dual-energy x-ray absorptiometry) were assessed relative to anthropomorphic and biochemical characteristics and risk factors for osteoporosis.


RESULTS
Of 111 women with low bone mass or osteoporosis, 73 (66%) had identifiable causes of bone loss, of which estrogen deficiency (menopause, premenopausal estrogen deficiency) and conditions associated with estrogen deficiency (anorexia nervosa, cancer chemotherapy) were the most common. Prolonged use of glucocorticoids was the most common secondary cause of osteoporosis. Of 38 women with no identifiable cause of bone loss, 21 were premenopausal (mean age, 38 +/- 10 years [standard deviation]) and 17 were perimenopausal (mean age, 50 +/- 3 years). The mean lumbar spine T score was -2.18 +/- 1.0 in the premenopausal and -2.51 +/- 0.6 in the perimenopausal women. Nontraumatic fractures were reported by 42% of the premenopausal women and 18% of the perimenopausal women. A family history of osteoporosis was reported by 71% of the premenopausal and 47% of the perimenopausal women.


CONCLUSIONS
Most young women with osteoporosis or low bone mass had estrogen deficiency or another secondary cause of premature bone loss (or both). A subset of premenopausal and perimenopausal women, however, had no identifiable cause of bone loss. The strong family history of osteoporosis, especially in the premenopausal women, provides further support for current theories of a genetic predisposition to osteoporosis.
Departments of Medicine and Pharmacology, College of Physicians & Surgeons, Columbia University, New York, New York 10032, USA.
C A
CA
Moreira Kulak
D H
DH
Schussheim
D J
DJ
McMahon
E
E
Kurland
S J
SJ
Silverberg
E S
ES
Siris
J P
JP
Bilezikian
E
E
Shane
D000328:Adult; D017677:Age Distribution; D015519:Bone Density; D015331:Cohort Studies; D004967:Estrogens / Q000172:deficiency; D005260:Female; D050723:Fractures, Bone / Q000453:epidemiology; D020022:Genetic Predisposition to Disease; D005938:Glucocorticoids / Q000009:adverse effects; D006801:Humans; D015994:Incidence; D008159:Lumbar Vertebrae / Q000378:metabolism; D008593:Menopause / Q000502:physiology*; D008875:Middle Aged; D010024:Osteoporosis / Q000139:chemically induced / Q000235:genetics / Q000503:physiopathology*; D015663:Osteoporosis, Postmenopausal / Q000503:physiopathology*; D017698:Postmenopause / Q000502:physiology*; D017697:Premenopause / Q000502:physiology*; D012189:Retrospective Studies; D012307:Risk Factors
D004967:Estrogens; D005938:Glucocorticoids