Objectives: Early menopause is a well-known risk factor for osteoporos
is. It could be an aggravating factor when induced ovariectomy. This s
tudy was conducted to compare vertebral bone density and biochemical m
arkers of bone remodelling in patients with spontaneous and induced ea
rly and ''normal'' menopause. Methods: The main biochemical markers of
bone remodelling (serum calcium, albumin, alkaline phosphatase, osteo
calcin and urinary calcium/creatinine) together with bone density (L2
- IA) were measured in 55 women (age 46-77 at inclusion) with spontane
ous (n = 16) or surgically induced (n = 39) early menopause (before ag
e 40) and in 227 women (age at inclusion 47-67 years) with normal meno
pause (after 40 years) either spontaneous (n = 136) or surgically indu
ced (n = 91). Results: At equivalent ages, vertebral bone density was
7 to 12% lower (p < 0.05) in women with early menopause than in women
menopaused after 40. However, the serum levels of alkaline phosphatase
and osteocalcin as well as the Nordin index were similar in the two g
roups. After adjusting for the duration of menopause, women with early
menopause did not have a higher bone density than their ''normal'' me
nopause conterparts despite their younger age (9 years younger). No di
fferences were observed between spontaneous and surgically induced men
opause. Conclusion: These results suggest that bone loss is more rapid
or more long lasting after precocious menopause. Surgically induced m
enopause does not appear to aggravate bone loss independently of age.
Effective prevention of this hormone dependent bone loss is required.