Abstract
Introduction: The influence and interactions of various genetic, hormonal, environmental and nutritional factors and risks for decreased bone mineral density in older age are not yet clear. The aim of this study was to examine relationship between reduced exposure to estrogen over a lifetime (early age at menopause, shorter period between menarche and menopause) and bone mineral density in older women.
 Methods: A total of 60 women, aged 60-75 years were included and assigned to osteoporosis group (n=30), or control group with normal bone mineral density or osteopenia (n=30). The values of bone mineral density were obtained by dual energy X-ray absorptiometry (DXA) at the lumbar spine (L2-L4) and proximal femur.
 Results: Women with osteoporosis entered the menopause at a younger age (43.03±3.18 years) compared to women without osteoporosis (51.93± 2.30 years) and the difference was statistically significant, p=0.0001. In addition, women with osteoporosis had shorter timespan between menarche and menopause (28.33±3.31 years), compared to women without osteoporosis (38.43±2.48 years), which was statistically significant, p=0.0001.
 Conclusion: Reduced exposure to estrogen over a lifetime because of early menopause, and shorter timespan between menarche and menopause may be associated with decreased bone mineral density and osteoporosis in postmenopausal women.
Highlights
The influence and interactions of various genetic, hormonal, environmental and nutritional factors, and risks for decreased bone mineral density in older age are not yet clear
Osteoporosis is a skeletal disorder characterized by compromised bone strength, which depends on bone
The women who met following criteria were included in the study: Women aged 60–75 years, women who do not use hormone replacement therapy, women whose finding of bone densitometry was at the level of osteoporosis, and women whose finding of bone densitometry was at the level of osteopenia or normal
Summary
The influence and interactions of various genetic, hormonal, environmental and nutritional factors, and risks for decreased bone mineral density in older age are not yet clear. Consequences of vertebral fracture, even asymptomatic ones, include loss of height, back pain, kyphosis, protuberant abdomen, and decreased lung vital capacity, loss of self-esteem, sleep disorders, and depression, further fractures and increased mortality [6]. The results of the study by Ong et al showed that inpatient and 1-year mortality after vertebral fragility fracture was between 0.9 and 3.5%, and 20 and 27%, respectively, between 34 and 50% were discharged from hospital to a care facility. Older age and increasing comorbidities were associated with longer hospital stay and higher mortality [7]
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