HARROGATE, ENGLAND — A single bone mineral density measurement early in menopause is a strong predictor of future bone status in women not considered at risk for osteoporosis, a study has shown.
Despite various rates of bone mineral loss among individuals and measurement sites, baseline bone mineral density (BMD) measures of 766 women in the Danish Osteoporosis Prevention Study predicted 75% of the variation in lumbar spine BMD and 74% of femoral neck BMD variation over 10 years, Bo Abrahamsen, M.D., reported at the annual conference of the National Osteoporosis Society.
None of the women were taking hormone therapy or antiresorptive drugs. The baseline scans were acquired within 2 years of menopause.
Baseline lumbar spine T-scores greater than −1.2 were associated with a 90% negative predictive value for developing osteoporosis over 10 years, whereas a lumbar spine T-score greater than 0.5 had a negative predictive value of 100%.
A baseline femoral neck T-score greater than −1.7 had a 90% negative predictive value for femoral neck osteoporosis.
“No women developed femoral neck osteoporosis in the absence of baseline femoral neck osteopenia,” said Dr. Abrahamsen of Odense (Denmark) University Hospital.
At baseline, having a lumbar spine T-score greater than −1.0 or a femoral neck T-score greater than −0.5 was associated with a 90% negative predictive value for osteoporosis of the lumbar spine and/or the femoral neck.
“Women with lumbar spine osteopenia at baseline had a 46% risk for developing osteoporosis of the femoral neck or lumbar spine,” Dr. Abrahamsen explained.
At the same time, fewer than 10% of women whose T-scores of the spine or femoral neck dipped below −2.5 within 10 years had spinal osteopenia at their initial visit, he said.
The findings support the role of bone density measurements in the first years after menopause.
“There is an increasing demand for [bone density measurement] with the onset of menopause due to concerns about the safety of hormone replacement therapy and a possible need for considering other treatment,” he said. “We know that, despite the fact that the average rate of bone mineral loss is only a few percent per year, there is much individual variation in those rates. These results tell us that much of the variation in future bone mineral density can be predicted by baseline BMD.”
As such, baseline measures should be considered for long-term treatment planning, he concluded.