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KMID : 0438420070140020125
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Korean Journal of Bone Metabolism
2007 Volume.14 No. 2 p.125 ~ p.132
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Clinical Characteristics of Postmenopausal Women Whose Total Hip BMD is Lower than Lumbar Spine BMD
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Kim Mee-Kyoung
Baek Ki-Hyun
Lim Dong-Jun
Le Seong-Su
Han Je-Ho
Song Ki-Ho
Cha Bong-Yun
Son Ho-Young
Lee Kwang-Woo
Kang Sung-Koo
Kang Moo-Il
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Abstract
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Objectives: Generally, T-score of the lumbar spine is lower than that of the total hip in postmenopausal women because of an accelerated loss of trabecular bone after menopause. However, some women had the reversed T-score which meant that the T-score of the total hip was lower than that of the lumbar spine. Thus, we aimed to investigate the characteristics of postmenopausal women with T-score of the total hip that is lower than that of lumbar spine. Bone mineral density is not uniform throughout the skeleton. The postmenopausal women were classified at the total hip and spine as in the upper, middle, or lower bone mass tertile. We aimed to investigate the characteristics of postmenopausal women with discordance of bone mineral density between total hip and lumbar spine.
Methods: We enrolled 304 postmenopausal women (mean age: 55.87±6.99 years) in our study. The bone mineral density of the lumbar spine and femur were measured by dual energy X-ray absorptiometry. Serum levels of TSH, free T4, PTH, FSH, Estradiol, Calcium, Phosphorus were measured by the standard methods.
Results: Among 304 postmenopausal women, there were 30 cases (9.8%) in which the T-score of the total hip were lower than that of the lumbar spine (low hip T-score group). The levels of free T4 and TSH in the low hip T-score group were not significantly different from those in the high hip T-score group (1.341±0.189, 1.274±0.2930, P=0.22, 2.84±2.120, 3.33±9.685, P=0.48). Five percent of the postmenopausal women had marked heterogeneity in bone mass between total hip and lumbar spine. These women were classified in the lower tertile at one site, but in the upper tertile at another site. When the group having upper tertile at spine BMD and lower tertile at hip BMD is compared to the group having upper tertile at hip BMD and lower tertile at spine BMD, there are marked body weight (55.5±6.8, 70.0±4.0, P=0.00) and BMI (22.6±2.0, 27.7±2.6, P=0.00) differences.
Conclusions: There were no differences in the levels of thyroid hormones and PTH when low hip T-score group is compared with the high hip T-score group. Additional studies are required to find the characteristics of postmenopausal women having the lower T-score of the total hip than that of the lumbar spine. Our data show a regional effect of body weight on hip BMD. The discordance of bone mineral density between total hip and lumbar spine may be attributed to Body weight and BMI. [Korean Journal of Bone Metabolism, 14(2): 125-132, 2007]
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KEYWORD
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Bone mineral density, Hip, Lumbar, Postmenopause, Discordance
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