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PubMed2003

Transvaginal sonography combined with saline contrast sonohysterography to evaluate the uterine cavity in patients with abnormal uterine bleeding and postmenopausal endometrium more than 5 mm.

OBJECTIVES: To determine whether saline contrast sonohysterography (SCSH) gives additional information to that obtained by transvaginal sonography (TVS) for predicting endometrial abnormality in premenopausal, menopausal and postmenopausal patients with abnormal uterine bleeding and postmenopausal patients with endometrial thickness > 5 mm. METHODS: This was a prospective study at the Ege University Obstetrics and Gynecology Clinic in Izmir, Turkey. Patients presenting with abnormal bleeding related to uterine pathologies, postmenopausal patients with endometrial thickness more than 5 mm and scheduled for surgical treatment were prospectively included in our study conducted between 1 July, 2000 and 31 January, 2002. The uterine cavity was first evaluated with TVS in 53 premenopausal, menopausal, postmenopausal patients with abnormal uterine bleeding and postmenopausal patients whose endometrial thickness was > 5 mm measured by conventional ultrasound examination. SCSH was carried out later with the intention of establishing further surgical management (hysterectomy). Twenty of the patients had operative hysterectomy within the 1.5 year period of time. The presence of focally growing lesions and the type of lesion (endometrial polyp, submucous myoma, malignancy or unclear focal lesion) were noted at ultrasound examination and at hysteroscopy, and then hysterectomy material was examined by Ege University's Pathology Department which provided a detailed evaluation of the uterine cavity. RESULTS: Based on normal endometrial morphology alone, the results for detection of an abnormal uterine cavity were as follows: sensitivity of TVS 0.94, SCSH 0.97; specificity of TVS 0.56, SCSH 0.62; positive predictive value of TVS 0.79, SCSH 0.81; negative predictive value of TVS 0.83, SCSH 0.93. Transvaginal sonography combined with SCSH was superior to TVS for detection of intracavitary abnormalities. When normal endometrial morphology was combined with an endometrial thickness of < 12 mm for evaluation of all abnormalities including hyperplasia, the diagnostic potential of TVS or SCSH was almost unchanged. Transvaginal sonography missed 24% of the polyps. CONCLUSIONS: Sonohysterography was a sensitive tool and was superior to TVS used alone for evaluation of the uterine cavity in patients who underwent operative surgery for abnormal uterine bleeding.

Adult↗

PubMed2004

AGUS and ASCUS: different incidence in pre- and postmenopausal women.

PURPOSE OF INVESTIGATION: The aim of this study was to determine the incidence of AGUS (atypical glandular cells of undetermined significance), ASCUS (atypical squamous cells of undetermined significance) and SIL (squamous intraepithelial lesion) in the cytologic diagnosis in pre- and postmenopausal women. METHODS: We did a retrospective study selecting 183 patients who were screened for cervical pathology. Ninety-six patients were in postmenopausal age. We determined the incidence of cytologic abnormalities defined as ASCUS, SIL, and AGUS in pre- and postmenopausal women. RESULTS: We expected a marked incidence of low-grade SILs in the fertile population, while the postmenopausal group was thought to be affected more by AGUS and ASCUS. We obtained different results. In our population study, premenopausal women presented more AGUS and ASCUS; the two subgroups presented the same incidence of low-grade SILs; postmenopausal women were more affected by high-grade SILs. CONCLUSIONS: The significance of the new categories introduced by the Bethesda System is still uncertain for different authors. As we look to the future new markers that more specifically identify individuals at-risk can be expected.

Adolescent↗

PubMed1992

A comparison of nutrition knowledge and attitudes, dietary practices, and bone densities of postmenopausal women, female college athletes, and nonathletic college women.

This study evaluated the nutrition knowledge and attitudes, dietary practices, and bone densities of four groups of women: 18 postmenopausal women, 14 college-aged dancers, 13 members of a college track team, and 14 nonathletic college women. Subjects completed a personal information questionnaire, a 24-hour food recall, a food frequency questionnaire, a nutrition knowledge test, and an attitude survey; measurements of the subjects' spinal bone density were also taken. The mean (+/- 0.5 standard error [SEM]) nutrition knowledge score of the dancers (22.5) was significantly lower than the mean scores of the postmenopausal women (28.5), the nonathletes (29.7), and the track team members (26.5). Dancers also reported eating fewer mean (+/- 4.0 SEM) servings of high-calcium foods per month (43) than did postmenopausal women (77), nonathletes (66), or track team members (73). Track team members had a significantly higher mean (+/- 0.2 SEM) anorexia/bulimia score (3.7) than did postmenopausal women (2.5), nonathletes (2.1), or dancers (2.2). There were no significant differences in bone mineral density among the four groups. The number of servings of high-calcium foods eaten was significantly correlated with nutrition knowledge scores (r = .38) and attitude scores (R = .32), but nutrition knowledge and attitude scores were not significantly correlated with each other. The track team members exercised significantly more than women in all other groups--mean (+/- 40 SEM) minutes exercise time was 700 minutes/week for track team members, 79 minutes/week for postmenopausal women, 92 minutes/week for nonathletes, and 500 minutes/week for dancers--and also experienced the most amenorrhea.

Adolescent↗

PubMed2004

Circadian rhythm of androstendione and free testosterone in asthmatic women with postmenopausal hormone therapy.

OBJECTIVE: of this study was to assess daily rhythm of androstendione (delta4alpha) and free testosterone (FT) levels in postmenopausal asthmatic women before and after hormonal replacement therapy and the influence of inhaled glucocorticosteroids (GC). METHODS: 54 asthmatic and 20 healthy postmenopausal women (aged 48-59) before and after 6 months of estrogen plus progestin therapy (EPT) were studied. Hormone concentrations in serum (delta4alpha and FT) were assessed with the use of RIA method. Statistical analysis of the circadian rhythm was performed with the use of cosinor test according to Halberg et al RESULTS: Cosinor analysis of delta4alpha and FT secretion during the day showed existence of daily rhythm in three studied groups before as well as after postmenopausal hormone therapy (HT). A statistically significant decrease of circadian concentrations of delta4alpha and FT in groups of patients treated with GC was observed. Changes in amplitude of delta4alpha and FT rhythm between studied groups were not observed. However, displacement of rhythm acrophase of studied hormones in asthmatic women in comparison to control group before and after HT was shown. No significant differences in circadian values of delta4alpha and FT concentrations before HT use compared to values after HT were shown. CONCLUSIONS: Postmenopausal asthmatic women show diminished circadian concentrations of androstendione and free testosterone in serum caused among other things by inhalative GC. Postmenopausal hormone therapy did not influence any changes in function of studied endocrine organs.

Administration, Inhalation↗

PubMed1977

Estrogen treatment of postmenopausal women. Benefits and risks.

Estrogen treatment of postmenopausal women is effective in relieving the symptoms of vasomotor instability and urogenital atrophy; estrogen treatment is effective in preventing accelerated bone loss and osteoporosis in young women following castration, but in postmenopausal women aging is a more important determinant of accelerated bone loss than is decreased estrogen secretion. Low-dose estrogen treatment of postmenopausal women neither prevents nor increases the risk of arteriosclerotic cardiovascular disease or cerebral vascular disease. It cannot be definitively established that estrogen treatment of postmenopausal women causes an increased incidence of breast tumors, but it is clear that such treatment does not prevent these tumors. It is established that estrogen treatment of postmenopausal women increases the risk ratio of endometrial carcinoma.

Age Factors↗

PubMed1984

Bone loss in premenopausal and postmenopausal women. A cross-sectional and longitudinal study using quantitative computed tomography.

Trabecular and total bone densities were determined by quantitative computed tomography in patients with untreated postmenopausal osteoporosis and in normal premenopausal and postmenopausal women. A special procedure was used for precise low-dose examinations of the distal end of the radius and the distal end of the tibia. The results indicate that the trabecular bone density of the peripheral skeleton is a reliable index of postmenopausal osteoporosis. In general, osteoporotic patients could be distinguished from patients with age-related bone loss based on differences in the magnitude of the decrease in trabecular bone density. Serial determinations of trabecular bone density in individual patients indicated that trabecular bone loss in postmenopausal osteoporotic patients shows a step-wise pattern in which phases of relative stability are followed by brief phases of bone loss. Quantitative computed-tomography measurements of bone density should provide a better understanding of the pathogenesis of postmenopausal osteoporosis and be useful in the assessment of different methods of treatment.

Adult↗

PubMed1984

Diagnostic hysteroscopy after postmenopausal uterine bleeding.

Hysteroscopy was done immediately before diagnostic fractional curettage in 93 patients with postmenopausal uterine bleeding, as well as in 84 control patients with premenopausal abnormal uterine bleeding. About 13% of patients in both groups were receiving hormonal therapy, while patients with intra-uterine devices were excluded from the study. Bleeding within the uterine cavity obscured the view at hysteroscopy in 3,6% of premenopausal patients, but in none of the postmenopausal patients. Comparison of the final diagnoses in the two groups revealed more endometrial polyps and carcinoma in the postmenopausal patients. However, no tissue for histological examination was obtained at fractional curettage in 28% of the postmenopausal patients, compared with only 4,8% of premenopausal patients (P less than 0,0001). Thus the combined use of hysteroscopy and fractional curettage significantly improves diagnostic accuracy in postmenopausal patients.

Adult↗

PubMed1981

Objective techniques for the assessment of postmenopausal hot flashes.

The present study was undertaken to evaluate objective methods of monitoring postmenopausal hot flashes. Continuous recordings of finger and core temperature and sternal skin conductance were carried out in 8 postmenopausal and 4 premenopausal women. Four postmenopausal patients were studied a second time following 30 days of daily oral administration of ethinyl estradiol 0.05 mg. One hundred twenty flashes were subjectively noted and recorded during 104 hours of study in the postmenopausal women. Eighty-two, 98, and 81% of subjective flashes were associated with changes in finger temperature, skin conductance, and core temperature, respectively. The rate of occurrence and magnitude of changes of physiologic markers were significantly greater (P less than .01) in postmenopausal than premenopausal women. Estrogen replacement therapy not only eliminated the subjective sensations but also significantly reduced (P less than .02) the frequency and magnitude of the changes in physiologic function measured by finger temperature. Measurement of skin conductance changes was the single most sensitive and specific indicator of hot flashes. The simultaneous change of both skin conductance and finger temperature, although less sensitive, was a very specific indicator of a hot flash. These results support the concept that the measurement of physiologic changes can be used to assess objectively the occurrence of this symptom complex.

Adult↗

PubMed1996

The relation of fibrous degeneration to menopausal status in small uterine leiomyomas with evidence for postmenopausal origin of seedling myomas.

It is well known that uterine leiomyomas shrink after the menopause. Fibrosis is the most common type of myomatous degeneration, but its relationship to menopause has not been studied. We evaluated fibrosis in 237 small myomas (< 1 cm) in relation to menopause, tumor size, intrauterine location, and patient age. Substantial fibrosis was seen in 33 (21%) of 159 small premenopausal myomas versus 39 (50%) of 78 small postmenopausal myomas (P < 0.001). This relationship was even stronger for women between 40 and 60 years of age: 27 (21%) of 126 premenopausal women versus 12 (71%) of 17 postmenopausal women (P < 0.001). Only 23 (23%) of 101 2- to 4-mm myomas had substantial fibrosis versus 45 (40%) of 112 5- to 9-mm myomas (P < 0.01). Small postmenopausal myomas that were inframucosal had less frequent fibrosis (3 [27%] of 11) than their intramural and subserosal counterparts (36 [54%] of 67) (P = 0.05). There was a significant increase in seedling myomas (fully cellular myomas < 1 cm) from postmenopausal women aged 60 to 70 years (13 [35%] of 37) compared with younger postmenopausal women (1 [6%] of 17) (P < 0.01). We conclude that fibrosis is strongly associated with menopausal status in small uterine myomas, that size and location are also related to fibrosis in small myomas, and that seedling myomas may arise after the menopause. Our interpretation of these findings is that the most likely cause of fibrosis in small myomas is senescence and that there may be heterogeneity in the molecular basis of senescence.

Adolescent↗

PubMed1997

Vitamin D and HRT: no benefit additional to that of HRT alone in prevention of bone loss in early postmenopausal women. A 2.5-year randomized placebo-controlled study.

The study was designed to examine the effect of hormone replacement therapy (HRT) and low-dose bone loss in non-osteoporotic early postmenopausal women and to determine whether Vit D supplementation can give additional benefit to an already optimized estrogen regimen. The effects of HRT and Vit D on bone mineral density (BMD) were studied in postmenopausal women in a 2.5-year randomized placebo-controlled study. The study population was a subgroup of the Kuopio Osteoporosis Risk Factor and Prevention Study (OSTPRE) (n = 13100). A total of 464 early postmenopausal women were randomized to four groups: (1) HRT (a sequential combination of 2 mg estradiol valerate and 1 mg cyproterone acetate (E2Val/CPA); (2) vitamin D3 (cholecalciferol, 300 IU/day); (3) HRT + Vit D; and (4) placebo (calcium lactate; 93 mg Ca2+/day). Lumbar (L1-4) and femoral neck BMD were determined by dual-energy X-ray absorptiometry before and after 2.5 years of treatment. After 2.5 years, lumbar BMD had increased by 1.8% in the HRT group (p > 0.001) and by 1.4% in the HRT + Vit D group (p = 0.002), whereas lumbar BMD had decreased by 3.5% (p < 0.001) in the Vit D group and by 3.7% (p < 0.001) in the placebo group. The loss of femoral neck BMD was lower in the HRT (-0.3%) and the HRT + Vit D (0.9%) groups compared with the Vit D (-2.4%) and the placebo groups (-3.7%). This study confirms the beneficial effect of HRT on BMD. It also shows that low-dose vitamin D supplementation has only a minor effect in the prevention of osteoporosis in non-osteoporotic early postmenopausal women and does not give any benefit additional to that of HRT alone.

Anthropometry↗

PubMed1997

Evaluation of bone turnover in postmenopause, vertebral fracture, and hip fracture using biochemical markers for bone formation and resorption.

The purpose of this study is to evaluate bone turnover in postmenopausal status and established osteoporosis with vertebral fracture and hip fracture by assessing bone biochemical markers. Subjects were 50 healthy premenopausal subjects, 44 healthy postmenopausal subjects, 30 osteoporotic patients with vertebral fracture, and 31 osteoporotic patients with hip fracture. Alkaline phosphatase, osteocalcin, PICP, ICTP, NTx, free deoxypyridinoline, total pyridinoline and deoxypyridinoline were measured. In postmenopause, both Z-scores of bone formation markers and resorption markers were around 1-2. In osteoporosis, although Z-scores of bone formation markers were 0.4-2.8, resorption markers were 2.3-9.5. Moreover, Z-scores of resorption markers were higher in hip fracture than in vertebral fracture. These results indicate that bone formation and resorption increased and balanced in postmenopausal status. However, bone resorption increased more than bone formation and did not balance at all in osteoporosis. This imbalance is greater in hip fractures than in vertebral fractures.

Adult↗

PubMed2005

Consumption of a high calcium mineral water lowers biochemical indices of bone remodeling in postmenopausal women with low calcium intake.

Many postmenopausal women have a calcium intake far below the recommended amount and, in addition to attempting to improve their diet, need a calcium supplement. The aim of the study was to assess the effects of the consumption of a high calcium mineral water (HCaMW) on biochemical indices of bone remodeling in postmenopausal women with low Ca intake. A 6-month randomized double-blind placebo-controlled trial was designed to assess the effects of a daily consumption of 1 liter of a HCaMW (596 mg Ca/l) on serum parathyroid hormone (PTH) and biochemical markers of bone remodeling in postmenopausal women with a dietary Ca intake lower than 700 mg/day. The placebo group drank 1 liter of a mineral water with a low calcium content (10 mg/l). One hundred eighty healthy women were recruited (mean age: 70.1+/-4.0 years); 152 completed the 6-month trial. The changes from baseline of biochemical indices after 6 months consisted of a significant 14.1% decrease of serum PTH, osteocalcin (-8.6%), bone alkaline phosphatase (-11.5%), serum (-16.3%) and urine (-13.0%) type-1 collagen C-telopeptide in the HCaMW group compared to the placebo group, where all biochemical indices increased after 6 months. The additive effect of a small vitamin D supplement (400 iu/day) was also evaluated. In women receiving vitamin D in addition to HCaMW, the decrease in bone indices was not found to be greater than in women drinking only the HCaMW. A daily supplement of 596 mg of Ca through the consumption of 1 l of HCaMW was able to lower serum PTH and the indices of bone turnover in postmenopausal women with a low Ca intake. This could contribute to the repair of calcium deficiency and to the reduction of age-related bone loss in this population.

Aged↗

PubMed2006

The effect of treatment with a thiazide diuretic for 4 years on bone density in normal postmenopausal women.

SUMMARY: We performed a 2-year extension of our previous 2-year randomized controlled trial of the effects of hydrochlorothiazide on bone mineral density. The improvements in bone density seen in the first 2 years were sustained throughout the extension study. Thiazides provide a further option in the prevention of postmenopausal bone loss. INTRODUCTION: Thiazide diuretics reduce urinary calcium excretion and therefore might prevent osteoporosis. Previously we reported a 2-year randomized controlled trial of hydrochlorothiazide treatment in 185 postmenopausal women that showed positive benefits of hydrochlorothiazide on bone density. Here, we report the results of a 2-year extension to that study. METHODS: Of 185 healthy postmenopausal women, 122 agreed to continue in a double-blinded 2-year extension taking 50 mg hydrochlorothiazide or placebo daily. Measurements of bone density occurred every 6 months and of calcium metabolism at 2 and 4 years. RESULTS: The improvements in bone density seen in the first 2 years of the trial were sustained throughout the extension. There were significant between-groups differences in the change in bone density over 4 years at the total body (0.9%, P<0.001), legs (1.0%, P=0.002), mid-forearm (1.1%, P=0.03), and ultradistal forearm (1.4%, P=0.04). At the lumbar spine (0.9%, P=0.76) and femoral neck (0.4%, P=0.53) the between-groups differences did not reach statistical significance. CONCLUSIONS: Hydrochlorothiazide produces small positive benefits on cortical bone density that are sustained for at least the first 4 years of treatment. They provide a further option in the prevention of postmenopausal bone loss, especially for women with hypertension or a history of kidney stones.

Blood Chemical Analysis↗

PubMed2002

Is it necessary to screen for celiac disease in postmenopausal osteoporotic women?

Decreased bone mass is a frequent finding in celiac patients, and subclinical celiac disease (CD) appears to be unusually overrepresented among patients with idiopathic osteoporosis. Since silent CD may be more common than previously believed, it has been suggested that all osteoporotic patients should be checked for occult CD. The aim of this study was to explore the prevalence of CD in a well-defined population of postmenopausal osteoporotic women. We evaluated 127 consecutive postmenopausal patients (mean age: 68 years; range: 50-82 years) with verified osteoporosis. The observed prevalence of CD in this group was compared to that observed in a group of 747 women recruited for a population-based study. The screening algorithm used to diagnose CD was based on a 3-level screening using type IgA and IgG antigliadin antibodies (AGA) in all the patients (1st level) followed by antiendomysial antibodies (EmA) and total IgA (2nd level) of samples testing positive, and intestinal biopsy of positive cases (3rd level). At the end of the serological screening, only 1 of 127 osteoporotic women was eligible for jejunal biopsy showing a characteristic celiac flat mucosa (prevalence 7.9 x 1,000; 95% CI 0.2-43.1). In addition, CD was diagnosed in 6 of 747 women of the population-based study (prevalence: 8.0 x 1,000; 95% CI 3.3-18.3). There was no significant difference between the two groups. Therefore, our study showed that the prevalence of CD in postmenopausal osteoporotic women was lower than that reported in previous studies and similar to that of the general population. In conclusion, although the relatively small size of the group tested does not allow us to be conclusive, the results suggest that a case finding policy in postmenopausal osteoporosis would have a high cost/benefit ratio except for patients not responding to conventional therapies, or presenting borderline laboratory results.

Absorptiometry, Photon↗

PubMed2001

Forearm bone mineral density in postmenopausal women with rheumatoid arthritis.

Osteoporosis in cases of rheumatoid arthritis (RA) is multifactorial, and the pathogenesis of bone loss induced by RA in postmenopausal women is not fully understood. The purpose of the present study was to determine the factors that affect forearm bone mineral density (BMD) in postmenopausal women with RA. In total, 839 postmenopausal women aged 46-90 years, were enrolled in the study; 470 patients with RA and 369 healthy controls (CON). Forearm (distal radius) BMD, measured by DXA using a DTX-200 (Osteometer, MediTech, CA, USA), was significantly lower in the RA group than in the CON group (P < 0.0001), even when adjusted for age, height, body weight, body mass index, and years since menopause (YSM) (P < 0.01). On multiple regression analysis, in the CON group, age and YSM were significantly correlated with BMD (P < 0.01 and P < 0.05, respectively). On the other hand, in the RA group, in addition to YSM, anatomic grade in the wrist, modified health assessment questionnaire (HAQ) score for the upper extremities, and erythrocyte sedimentation rate were each significantly correlated with BMD (P < 0.0001, P < 0.001, P < 0.0001, and P < 0.001, respectively), whereas functional class, duration of disease, dose of prednisolone used, modified HAQ score for the lower extremities, and the levels of c-reactive protein and rheumatoid factor were not. The present study with a large number of subjects shows that in addition to YSM, disuse (anatomic grade) of the wrist, arm function, and disease activity appear to be significant determinants of forearm BMD in postmenopausal women with RA.

Absorptiometry, Photon↗

PubMed2000

Comparison of serum insulin-like growth factor-1 and growth hormone levels in osteoporotic and non-osteoporotic postmenopausal women.

The purpose of this study was to compare the insulin-like growth factor-1 (IGF-1) levels and the growth hormone (GH) levels in osteoporotic and non-osteoporotic postmenopausal women. Eleven non-osteoporotic postmenopausal women and 9 women with untreated postmenopausal osteoporosis were included in the study. Bone mineral density (BMD) was assessed by dual energy X-ray absorbtiometry. Serum was assayed for calcium, phosphorus, alkaline phosphatase, bone-specific alkaline phosphatase, parathyroid hormone, IGF-1 and GH levels. IGF-1 levels were 98.8 +/- 43.5 ng/ml for osteoporotic women and 169.8 +/- 50.3 ng/ml for the women with normal BMD (p < 0.05). GH levels were 1.3 +/- 1.1 ng/ml and 1.3 +/- 1.0 ng/ml, respectively. When compared with normal postmenopausal women, IGF-1 levels were found to be lower in women with osteoporosis. IGF-1 seems to play an important role in the development of low bone mass and the present results suggest that IGF-1 is a useful predictor of the presence of osteoporosis.

Aged↗

PubMed2001

A polymorphic variant at the Werner helicase (WRN) gene is associated with bone density, but not spondylosis, in postmenopausal women.

Werner syndrome (WS) is a rare autosomal recessive progeroid syndrome characterized by the premature onset of multiple age-related disorders. The gene responsible for WS has been identified as WRN, a member of the RecQ family of helicase genes. Based on the fact that patients with WS exhibit osteoporosis and osteoarthritis, the present study was undertaken to clarify the contribution of the WRN gene to the etiology of these two common age-related disorders in normal postmenopausal women. We investigated the association of a WRN gene polymorphism, namely c.4330 T --> C leading to an amino acid substitution from Cys to Arg, with bone density and lumbar spondylosis score in unrelated Japanese postmenopausal women (n = 377). Genotypic frequencies of T/T, T/C, and C/C were 87.5%, 12.2%, and 0.3%, respectively. Bone density of the lumbar spine (L2-4) was significantly lower in women carrying the minor C allele than in non-carriers (P = 0.037). When bone density was expressed by the Z score after being adjusted by age and weight, carriers of the C allele showed lower values not only in the lumbar spine, but also in the total body (P = 0.015 and 0.042, respectively). The association study with spondylosis in postmenopausal women (n = 221) revealed that this polymorphism was not related to the severity of spondylosis expressed by the Kellgren-Lawrence score at any disk level of the lumbar spine (L2/3-L5/S1). These findings indicate that the WRN gene may be a candidate for the genetic regulation of osteoporosis, but not spondylosis, in normal Japanese postmenopausal women.

Aged↗

PubMed2002

Forearm bone mineral density in postmenopausal women with osteoarthritis of the knee.

The aims of the present study were to clarify whether postmenopausal women with osteoarthritis (OA) of the knee show higher bone mineral density (BMD) than healthy controls, and to investigate the relationship between BMD and the Kellgren and Lawrence radiological grade in postmenopausal women with OA of the knee. A total of 674 postmenopausal women, 46-90 years of age, were enrolled in the study: 305 patients with OA of the knee and 369 healthy controls. Forearm (distal radius) BMD, measured by dual-energy X-ray absorptionetry (DXA), using a DTX-200 (Osteometer), was significantly higher in the OA group than in the control group (P < 0.001), even when adjusted for age, height, body weight, body mass index, years since menopause, and grip strength (P < 0.01). Analysis of variance (ANOVA) with Fisher's protected least significant difference (PLSD) test showed that BMD in radiological grades 2, 3, and 4 was significantly higher than that in grade 1 (P < 0.05, P < 0.001, and P < 0.05, respectively), and BMD in grade 3 was significantly higher than that in grade 2 (P < 0.01), but BMD in grade 4 was significantly lower than that in grade 3 (P < 0.05). These findings suggest that forearm BMD appears to be significantly higher in postmenopausal women with OA of the knee than in healthy controls. Although BMD may be increased in low to moderate radiological grades of OA, severe grade OA may not always develop from moderate grade OA. Some cases of severe grade OA may be associated with low BMD.

Aged↗