Postmenopausal women lose about 10% of femoral neck BMD over 25 years
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A cohort of postmenopausal women from Finland had a bone mineral density decrease of about 10% during a follow-up period of 25 years, according to findings published in the Journal of Bone and Mineral Research.
“Long-term bone loss in postmenopausal women was much lower than in previous studies,” Anna Moilanen, MD, a doctor in training and specializing physician at the University of Eastern Finland, told Healio. “Higher baseline BMD was associated with higher bone loss rate, and protective factors against postmenopausal bone loss were greater increase in BMI, lower baseline BMI and use of hormone-replacement therapy.”
Researchers analyzed data from all women living in the Kuopio region of Finland born between 1932 and 1941. A baseline questionnaire was mailed in 1989 and asked participants for information on health status, physical activity, nutrition, alcohol consumption, smoking history, medications, use of hormone therapy and fracture history. Follow-up questionnaires were submitted at 5-year intervals in 1994, 1999, 2004, 2009 and 2014. A random population-based subgroup of 686 women also completed DXA scans at 5-year intervals for 25 years.
Compared with observed femoral neck BMD for 2,695 women with baseline data available, the 686 women who completed all follow-up scans had a 10.1% lower BMD at 25 years. Of 105 women who had no self-reported diseases or medications, the decline in BMD was 9.7%. BMD was estimated to decline about 4.7% between baseline and 15 years. A BMD decrease of 6% was estimated between 15 and 25 years.
The study population was divided into quartiles based on baseline BMD. Women with a higher baseline BMD had a higher 25-year bone loss, but those in the highest quartiles still maintained a BMD at 25 years greater than the baseline mean of the total population (0.973 g/cm2 vs. 0.938 g/cm2).
HT use was 26.3% in the highest baseline BMD quartile and 41.5% in the lowest baseline BMD quartile (P = .002). There was no difference in the number of diseases between quartiles. No associations were observed between corticosteroid use and bone lose rate, the prevalence of bone-affecting disease or menopausal status at baseline. Significant predictors of BMD change included BMI change (P < .001), BMI (P < .001) HT use (P = .01) and calcium or vitamin D use (P = .029).
“Further research is needed concerning long-term bone loss, because there is a lack of studies describing postmenopausal bone loss over several decades,” Moilanen said. “Our study presents the longest BMD follow-up in postmenopausal women so far. Also, the effect of long-term bone loss on fractures was not investigated.”
For more information:
Anna Moilanen, MD, can be reached at annamoi@uef.fi.
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