BJOG：更年期提前会增加骨质疏松及骨折风险

据一项发表在BJOG: An International Journal of Obstetrics and Gynaecology杂志上的新研究指出：更年期妇女早期患上骨质疏松症的可能提高了近两倍。

来自瑞典的一项研究探讨了，绝经期提前对妇女死亡率、脆弱性骨折和骨质疏松症风险的长期影响。

在1977年，390名欧洲北部48岁的白色人种妇女被招募参与这项研究，研究人员一直对这些参试人员进行随访研究。

这些妇女被分为两类妇女：更年期在47岁之前就出现的妇女，47岁或以后才出现更年期的妇女。

研究人员测量了妇女骨密度（BMD）。所有符合条件的妇女在77岁时被重新测量骨密度。此时，298名妇女仍然活着，而92名妇女已死亡。

研究发现在77岁以下的妇女，相比于30％绝经晚出现较晚的妇女而言，56％经期提前的妇女患有绝骨质疏松症。

更年期提早的妇女被发现有较高的脆弱性骨折和死亡率风险。更年期提早的妇女组死亡率为52.4％，而绝经晚出现较晚的妇女组这一数值只有35.2％。更年期提早的妇女组骨折发生率为44.3％，而绝经晚出现较晚的妇女组为30.7％。

瑞典马尔默斯科讷大学医院Ola Svejme外科医生说：这项研究的结果表明，从长远角度来看，绝经期提前是骨质疏松、脆性断裂和死亡率显著升高的危险因素。

doi:10.1111/j.1471-0528.2012.03324.x
PMC:
PMID:

Early menopause and risk of osteoporosis, fracture and mortality: a 34-year prospective observational study in 390 women

O Svejme, HG Ahlborg, J-Nilsson, MK Karlsson

Keywords:Bone mass; fractures; menopause; mortality; osteoporosis

Please cite this paper as: Svejme O, Ahlborg H, Nilsson J, Karlsson M. Early menopause and risk of osteoporosis, fracture and mortality: a 34-year prospective observational study in 390 women. BJOG 2012; DOI: 10.1111/j.1471-0528.2012.03324.x.

Objective  A prospective evaluation of the long-term effects of early menopause on mortality, risk of fragility fracture and osteoporosis.

Design  Prospective population-based observational study.

Setting  Malmö, Sweden.

Population  A total of 390 white north European women aged 48 years at the start of the study.

Methods  At baseline, bone mineral density (BMD) was measured by single-photon absorptiometry (SPA) in the distal forearm and menopausal status was noted. Menopause was determined according to the World Health Organization criterion of a minimum of 12 months of continuous amenorrhoea. Women were divided into early menopause (occurring before age 47 years) and late menopause (occurring at age 47 years or later). At age 77, forearm BMD was re-measured by SPA and proximal femur and lumbar spine BMD were measured by dual-energy X-ray absorptiometry (DXA). The prevalence of osteoporosis was determined using the DXA data. Mortality rate and the incidence of fractures were registered up until age 82. Data are presented as means with 95% confidence intervals (95% CI).

Main outcome measures  Incidence of fragility fractures, mortality, prevalence of osteoporosis at age 77.

Results  Women with early menopause had a risk ratio of 1.83 (95% CI 1.22–2.74) for osteoporosis at age 77, a risk ratio of 1.68 (95% CI 1.05–2.57) for fragility fracture and a mortality risk of 1.59 (95% CI 1.04–2.36).

Conclusions  Menopause before age 47 is associated with increased mortality risk and increased risk of sustaining fragility fractures and of osteoporosis at age 77.