Meer osteoporose na vroege overgang*
Uit een Zweedse studie onder 390 vrouwen blijkt dat vrouwen die vroeg in de overgang komen, voor hun 47ste levensjaar, blijken duidelijk meer kans te hebben op
osteoporose en een vroegere dood. Tot de leeftijd van 82 werden de vrouwen gevolgd. Tijdens de studie werden botbreuken en overlijdens geregistreerd en op 77 jarige leeftijd werd de botdichtheid vastgesteld. Na afloop bleek dat een vroege overgang de kans op osteoporose met 83% deed stijgen,
de kans op een botbreuk met 68% en de kans op overlijden met 59%. Waarom vrouwen die vroeger in de overgang komen ook vroeger overlijden verdient nader onderzoek volgens de wetenschappers want mogelijk spelen hierbij allerlei andere factoren een rol.
Early menopause and risk of osteoporosis, fracture and mortality: a 34-year prospective observational study in 390 women
1. O Svejme, 2. HG Ahlborg, 3. J-Å Nilsson, 4. MK Karlsson
DOI: 10.1111/j.1471-0528.2012.03324.x
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. (Mei 2012)
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