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Site of bone density measurement may affect therapy decision
Authors:Khai Lai  Monica Rencken  Barbara L. Drinkwater  Charles H. Chesnut III
Affiliation:(1) Osteoporosis Research Center, University of Washington Medical Center, Division of Nuclear Medicine, 98195 Seattle, Washington, USA;(2) Department of Medicine, Pacific Medical Center, 98144 Seattle, Washington, USA
Abstract:Summary The purpose of this study was to determine whether bone mineral density (BMD) measurements at the lumbar spine and femoral neck provided comparable information to women planning to use that knowledge to help them make a decision about hormone replacement therapy. Eighty-eight healthy Caucasian women, aged 44–59 and within 0 to 5 years of menopause, participated in the study. BMD measurements were performed at the lumbar spine (L1-L4) and the femoral neck by dual energy X-ray absorptiometry (DXA). Criteria suggested by the National Osteoporosis Foundation were used to categorize women as ldquoat riskrdquo for osteoporosis, bone density more than one standard deviation (SD) below the young adult mean, or as ldquolow riskrdquo, bone density at or above this level. The re that 46 women would be classified into the low risk category on the basis of spinal BMD alone. However, 28 of these 46 women would fall into the at risk category when the femoral neck BMD was measured. Sixty-one percent of women informed they were at low risk on the basis of spinal BMD would be considered at risk based on femoral neck BMD. When femoral neck BMD was used as the primary risk indicator, 14% of the women classified as low risk would be at risk if spinal BMD were added. These results suggest that both lumbar spine and proximal femur measurements should be made when women are using bone density measurements as an aid in deciding whether or not to use hormone therapy in their postmenopausal years.
Keywords:Osteoporosis  Hormone replacement therapy  Menopause  Bone density
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