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Endocrine Care |
Department of Medicine (S.L.H., L.Z., M.J.E., M.P., C.M., C.C.J.), Indiana University School of Medicine, Indianapolis, Indiana 46202; Regenstrief Institute for Health Care, and Indiana University Center on Aging Research (S.L.H., A.J.P.), Indianapolis, Indiana 46202; and Departments of Obstetrics and Gynecology and Medicine (C.L.), University of Massachusetts Medical School, Worcester, Massachusetts 01655
Address all correspondence and requests for reprints to: Siu L. Hui, Ph.D., Regenstrief Institute, Indiana University School of Medicine, 1001 West 10th Street, RG6, Indianapolis, Indiana 46202. E-mail: . shui{at}iupui.edu
Abstract
To investigate whether bone loss occurs in the premenopause, we measured the bone mineral content (BMC), bone mineral density (BMD), and bone area in the spine (L2L4), femoral neck, and total hip, as well as the sex hormone levels of 130 healthy premenopausal white women (age, 3150 yr) at least three times over 19 yr. We found an increase in all three bone measurements at the spine but no change in volumetric density. Neither could we detect any age-related changes in any of the three measurements in the total hip. In contrast, we detected a significant decrease in femoral neck BMD over time, due to a decrease in BMC and increase in bone area. Greater loss in femoral neck BMD was associated independently with weight loss and lower levels of estrone sulfate or E2. Separating the women into those with FSH spikes (>20 IU/liter) and women with consistently low FSH, we found the latter group had smaller decrease in BMD and that the decrease was due less to a decline in BMC and more to an increase in bone area. In summary, femoral neck BMD decreases in premenopausal women, particularly those with lower levels of estrogens resulting from slowing ovarian function despite regular menses. This decrease can be offset by more rapid weight gain.
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