A cross-sectional study of postmenopausal women found an association between osteoporosis and past gastric surgery or oral corticosteroids.

OBJECTIVE: To determine the relationship between osteoporosis and the presence of specific and nonspecific medical conditions in postmenopausal women. To what extent is this relationship useful in detecting osteoporosis in daily general practice. STUDY DESIGN AND SETTING: Subjects were 1,684 postmenopausal women registered with 23 general practitioners. Multivariate logistic regression analysis was done with 52 disease variables and 24 biometrical and lifestyle variables, using BMD as the dependent variable. Bivariate analysis was performed to calculate their contribution to the risk of having osteoporosis. RESULTS: Having more than one disease was associated with a lower prevalence of osteoporosis. A positive association with the presence of osteoporosis was only found for the use of corticosteroids, gastric surgery, and cervical complaints. The risk for osteoporosis in the high risk category increased from 39 to 71% in women using oral corticosteroids, from 39 to 56% in women with a history of gastric surgery, and from 39 to 63% in women with cervical complaints. CONCLUSION: The clinical relevance of medical conditions for detecting osteoporosis is limited. However, all patients using oral corticosteroids and patients with a history of gastric surgery should be checked for the presence of osteoporosis. Cervical compaints in the high risk category was associated with osteoporosis.

Early menopause: increased fracture risk at older age.

The aim of this study was primarily to determine the relationship between early menopause and the presence of fractures later in life, and secondly, to check for the significance of confounding factors (such as smoking habits, body mass index (BMI), weight and use of hormones). In this cross-sectional population based study, the subjects were 4725 postmenopausal women, 50-80 years of age, registered with 23 general practitioners (GPs). For the purpose of the present study, the total population was analyzed as well as the subgroup of 2757 women (the study population) with a natural menopause. Medical history questionnaire, weight, height and bone mineral density measurements were taken. Bivariate and multivariate analyses were carried out with documented fractures in three categories: during lifetime; after menopause and after age 50 years) as dependent variable and age, BMI, bone mineral density, weight, smoking habits, use of hormones and early menopause as independent variables. The total study population as well as the subgroups "early" and "normal menopause", stratified in three 10-year and in six 5-year categories, were analyzed. Results are expressed as odds ratio and 95% confidence intervals (CI). Multivariate logistic regression analysis revealed that over 70 years of age, BMD< or =0.800 ( t-score<2.5) and early menopause were the only systemic independent predictors of all three fracture categories. Comparing the subgroups normal menopause and early menopause, the early menopause group showed a statistically significant higher overall fracture rate (OR=1.5; CI 1.2-1.8). Over age 70, the difference in the prevalence of fractures reached statistical significance in each age category (OR: 1.8 and 2.1, respectively). Smoking was found to be associated with early menopause (OR=1.5; CI 1.2-1.8) but not with the presence of fractures. Height above 165 cm was found to be associated with a higher prevalence of fractures during lifetime. The present study shows that early menopause is statistically significant associated with the presence of fractures during lifetime, after age 50 years and after menopause. Especially at older age, early menopause is an important predictor of fractures.