Vertebral bone mineral density, content and area in 8789 normal women aged33-73 years who have never had hormone replacement therapy

The vertebral bone mineral density (BMD), bone mineral content (BMC) and bo ne area of the lumbar spine were measured using a bone densitometer in 8789 women aged 33-73 years who had had no previous hormone replacement therapy (HRT). The overall relationship between BMD and age was analyzed on a year -by-year basis, and comprised three separate regions that could each be des cribed by a straight line: 33-46 years (gradient = 0.00166 g cm(-2)/year), 47-63 years (gradient = 0.0121 g cm(-2)/year) and 64-73 years (gradient = 0 .0045 g cm(-2)/year). Above the age of 50 years our results were higher tha n the BMD in most previous reports. In those 3198 women who knew the time o f their last menstrual period (mean age 49.25 years, SD 4.83) bone loss was most rapid in the first 10 menopausal years. In the whole group, the relat ionship between BMC and age was found to be similar to that of BMD, with th ree distinct regions, including a rapid drop between the ages of 47 and 63 years (gradient 0.781 g/year). Bone area showed a much more gradual (though significant) decrease with age. Based on WHO definitions and using BMD as an indicator, the percentage of women with osteoporosis varied from zero in the younger age group to about 30% of women aged over 70 years; in contras t, where BMC was used, although the trend with age had a similar shape, the percentages at each year were about half those derived from the correspond ing BMD values. Osteopenia derived in the same way occurred in about 50% of women over 70 years using either BMD or BMC. The results presented here pr ovide a reliable local reference range for lumbar spine bone densitometry m easurements. They also show that for this site BMD and BMC cannot be used i nterchangeably to define osteoporosis.