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Young, estrogen-deficient, minority women at increased risk for low bone mineral density later in life

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Minority women with primary ovarian insufficiency are more likely to have osteoporosis and fractures later in life when compared with healthy controls, according to a study appearing online in the Journal of Clinical Endocrinology & Metabolism.

“For years, primary ovarian insufficiency has been known to put women at risk for low bone mineral density (BMD),” Duane Alexander, MD, director of the U.S. National Institute of Health’s Eunice Kennedy Shriver National Institute of Child Health and Human Development, said in a press release. “This new study helps explain why some women with the condition are more likely to develop low BMD.”

Researchers at the National Institute of Health assessed BMD (measured by DEXA) and associated risk factors in 442 young women with estrogen deficiency and compared data with 70 concurrent controls and 353 matched controls included in the NHANES III study.

On average, women had a 2% to 3% decreased BMD in the first to fourth lumbar vertebrae in the lower back, femoral neck and total hip (P<.01), according to the abstract.

Significant BMD-modifiable risk factors below the expected age range were: a greater than 1-year delay in diagnosis of estrogen deficiency, low vitamin D levels, estrogen replacement non-adherence, lack of exercise and low calcium intake.

Black and Asian women with primary ovarian insufficiency were 3.18 times more and 4.34 times more likely to have a z-score less than -2, respectively. Although race was an overall risk factor, it was not an independent predictor for low BMD. Racial disparity “appears to be related to a combined effect of several modifiable risk factors,” the researchers wrote.

The data provide “strong evidence that by diagnosing the condition early, replacing deficient estrogen and getting adequate calcium and vitamin D, these women can protect their bones from weakness and fractures,” Alexander said in the press release.

Reference:

• Popat VB, Calis KA, Vanderhoof VH, et al. Bone mineral density in estrogen-deficient young women. J Clin Endocrinol Metab. 2009;doi:10.1210/jc.2008-1878.