Ninety-three healthy women who had experienced a natural menopause 6 to 60 months earlier were followed prospectively for two consecutive 22-month periods (38). BMD was measured in the spine and proximal femur using DXA (Lunar DPX). The average decline in BMD in the spine was 1.46% per year (+2.6% to -6.9%) in the first period and 1.28% per year (+2.8% to -5.3%) in the second period. In the proximal femur, the average decline in the first period was 1.41% per year (+4.8% to -6.8%) and 1.35% per year (+1.8% to -7.0%) in the second. Individual rates of bone loss were not stable over time. Only 20-30% of women retained their initial classification as fast, intermediate, or slow losers during both observation periods. Of 24 women classified as fast losers during the first observation period, 5 remained fast, 12 became intermediate, and 5 became slow losers during the second period. The mean rate of loss in the fast loser group initially was -3.9%. Women who were originally classified as slow losers at the spine during the initial observation period were reclassified as intermediate or fast losers during the second observation period. Similar patterns were seen at the femoral neck.
BMD measurements were made at the PA spine, lateral spine, and distal forearm using DXA (Hologic QDR-2000) in a cross-sectional study of 363 women who were 6 months to 10 years postmenopausal (39). The most rapid decline in bone density was initially seen in the lateral spine, followed by the PA spine, and then the forearm. Ten years after menopause, however, the overall percent decrease at all three sites was approximately the same at 12% at the PA spine and 13% at the lateral spine and forearm.
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