One-year spinal bone change in pre- and perimenopausal Japanese women. A prospective observational study.
BACKGROUND
This prospective observational study was designed to determine whether the bone mineral density (BMD) of the lumbar spine decreases before menopause.


METHODS
The change in BMD of the second through fourth lumbar vertebrae (delta%L2-4BMD) over the course of 12 months was measured in 197 pre- and perimenopausal Japanese women aged 48.2 +/- 2.3 (mean +/- SD) years.


RESULTS
Overall, delta%L2-4BMD decreased significantly, with a greater decrease seen in perimenopausal women. This group also had a significantly higher level of FSH (p < 0.05, t = 7.356), a significantly lower level of estradiol (p < 0.05, t = 4.245), and significantly higher levels of the bone metabolic markers, alkaline phosphatase (p < 0.05, t = 3.841), calcium (p < 0.05, t = 3.939), and osteocalcin (p < 0.05, t = -3.295). Overall, there was a significant positive correlation between osteocalcin and delta%L2-4BMD (r = -0.194, p = 0.0479).


CONCLUSIONS
A subset of perimenopausal women with transient decreases in ovarian function that do not respond to increased FSH may be at increased risk for abnormally low BMD, and may benefit from early management of bone mass.
Komukai
Shigeyuki
S
Department of Obstetrics and Gynecology, School of Medicine, Keio University, Tokyo, Japan.
Ohta
Hiroaki
H
Makita
Kazuya
K
Yanamoto
Shigehisa
S
Takamatsu
Kiyoshi
K
Okano
Hiroya
H
Yajima
Masazumi
M
Nozawa
Shiro
S
D000328:Adult; D000469:Alkaline Phosphatase / Q000378:metabolism; D015415:Biomarkers; D015519:Bone Density; D002118:Calcium / Q000097:blood; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D007564:Japan; D008593:Menopause / Q000378:metabolism*; D008875:Middle Aged; D015675:Osteocalcin / Q000097:blood; D017697:Premenopause / Q000378:metabolism*; D011446:Prospective Studies; D013131:Spine / Q000033:anatomy & histology*
D015415:Biomarkers; D015675:Osteocalcin; D005640:Follicle Stimulating Hormone; D000469:Alkaline Phosphatase; D002118:Calcium