Marked recovery from axial osteopenia in children with liver transplantation

Abstract

locations of cancellous bones than in those of cortical bones. This explains why the ratio of cortical bone mineral content to cancellous bone mineral content may indicate that estrogen deficiency has taken place in the past. In this study, we sought to establish normal Im values in Mexican women. For this purpose, 465 healthy Mexican women with no conditions known to affect bone metabolism were studied by bone densitometry (DXA) in multiple centers using Lunar DPX equipment. In all cases, bone mineral density (BMD) assessment of the spine and femoral neck was carried out. The Im was calculated using Lunar reference values from the normal Hispanic population with the following formula: Im 5 Z value of Lmin 2 Z value from femoral neck, where Lmin is the Z value of the vertebrae with the lowest value. Three groups of patients were investigated: (1) 148 premenopausal women; (2) 233 postmenopausal women without hormone replacement therapy (HRT); and (3) 84 postmenopausal women with HRT from the first year of menopause. Significant differences were found between the average of Im in postmenopausal women (21.137) vs. premonopausal women (20.286) (p , 0.0001) and vs. postmenopausal women with HRT (20.213) (p , 0.0001). With the increase in the number of years since onset of menopause, Im of postmenopausal women has been shown to decrease linearly. Calculation of Im in other locations, such as the trochanter or the femoral neck, is not a good indicator of postmenopausal bone loss. Onset and degree of postmenopausal bone loss may be determined by the difference between Z of Lmin and the femoral neck during the first densitometric assessment. In healthy perimenopausal women, an Im of ,20.3 indicates onset of menopausal bone loss. The degree of bone loss caused by estrogen deficit in the past may be determined for each woman by comparing her index to the average Im of postmenopausal women up to 65 years of age. This new index provides a dynamic evaluation of BMD and is an aid in the differential diagnosis. It also represents an advancement in the treatment of osteoporosis and estrogen deficiency.