Bone loss at the femoral neck in
premenopausal white women: effects of weight change and sex-hormone
levels.
Hui SL, Perkins AJ, Zhou L, Longcope C, Econs MJ, Peacock M,
McClintock C, Johnston CC Jr.
Department of Medicine, Indiana University School of Medicine,
Indianapolis, Indiana 46202, USA. shui@iupui.edu
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 (L2-L4), femoral neck, and total
hip, as well as the sex hormone levels of 130 healthy premenopausal
white women (age, 31-50 yr) at least three times over 1-9 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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