Does the presence of postmenopausal symptoms influence susceptibility to vertebral deformity?

Background: Previous reports suggest a possible increased risk of osteoporo sis in those with postmenopausal symptoms. There are, however, no data from population samples, exploring the relationship between postmenopausal symp toms and vertebral osteoporosis. Aim: To determine if there is an associati on between self-reported postmenopausal symptoms and radiographic vertebral deformity. Methods: Women aged 50 years and over were recruited from popul ation registers in 30 European centres and invited to attend for an intervi ewer administered questionnaire and lateral thoracic and lumbar spine radio graphs. The questionnaire sought information about aspects of lifestyle, pe rsonal, medical and gynaecological history, including postmenopausal sympto ms: flushing, sleep disturbance and 'other' symptoms. Radiographs were take n according to a standard protocol and evaluated morphometrically. Vertebra l deformity was defined according to the McCloskey-Kanis method. Bone miner al density data were obtained in a subsample of women at both the spine and femoral neck. Results: A total of 4023 postmenopausal women, aged 50-64 ye ars, were studied: 73% reported a history of hushing, 45% sleep disturbance and 23% 'other' symptoms, at or around their menopause. The prevalence of vertebral deformity was 8.2%. Those with postmenopausal symptoms were sligh tly younger and more likely to have ever taken hormone replacement therapy (HRT) than those without symptoms. After adjusting for potential confounder s (age, centre, body mass index, cigarette smoking and HRT) there was no as sociation between deformity and any of the postmenopausal symptoms: flushin g (odds ratio (OR) 1.0; 95% confidence intervals (CI) 0.8, 1.3), sleep dist urbance (OR 1.0; 95% CI 0.8, 1.2),'other' symptoms (OR 0.9; 95% CI 0.7, 1.3 ). Amongst women who had ever taken HRT, however, these with vertebral defo rmity were more likely to report a history of flushing (OR 2.1; 95% CI 0.9, 4.8). Conclusion: A history of postmenopausal symptoms per se does not appe ar to be associated with increased susceptibility to vertebral osteoporosis . However, women with more severe symptoms (as suggested by their use of HR T) may be at increased risk. (C) 1999 Elsevier Science Ireland Ltd. All rig hts reserved.