关键词: 早绝经, 骨密度, 骨质疏松, 脂肪含量, 体质量指数, 性激素

Abstract: Objective  To analyze the current status of bone mineral density (BMD) in women with early menopause and explore the correlations between BMD with age, body mass index (BMI), total body fat mass, spinal fat mass, femoral fat mass, follicle-stimulating hormone (FSH), estradiol (E2), and testosterone (T). Methods  A total of 106 women with early menopause, who first visited the Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University from January 2023 to May 2025, were recruited after meeting the inclusion and exclusion criteria. The spinal BMD, femoral BMD, total body fat mass, femoral fat mass, and spinal fat mass were measured with dual-energy X-ray absorptiometry (DXA). The age, height, and weight of the patients were recorded, and serum levels of FSH, E2, and T were measured. Spearman correlation analysis was used to explore the correlations between spinal and femoral BMD and age, FSH, E2, T, BMI, total body fat content, femoral fat content, and spinal fat content. The patients were divided into three groups based on BMD: normal bone mass, osteopenia, and osteoporosis. Non-parametric Kruskal-Wallis H test was used to compare BMI, fat content, age, FSH, E2, and T levels among the three groups. Bonferroni-corrected Mann-Whitney U test was used for pairwise comparisons of significant differences. Multiple linear regression analysis was conducted to explore the influencing factors for femoral BMD T-score. Results  Among the 106 patients with early menopause, 30 (28.3%) had normal bone mass, 64 (60.4%) had osteopenia, and 12 (11.3%) had osteoporosis, with an average age of (43.99±0.16) years. Femoral BMD was positively correlated with BMI，total body fat mass，and spinal fat mass (all P<0.05). No significant differences were found in femoral fat mass, age, FSH, and T levels among the different bone mass groups, but, BMI, total body fat mass, spinal fat mass, and E2 were significantly different (P<0.05). BMI, total body fat mass, spinal fat mass and E2 were significantly higher in the normal bone mass group compared to the osteopenia group (P<0.05). The BMI of the normal bone mass group was significantly higher than that of the osteoporosis group (P<0.05).  Multiple linear regression analysis showed that FSH were influencing factors for femoral BMD T-scores (P<0.05).Conclusion  The osteoporosis is more prevalent in women with early menopause. Femoral BMD is positively correlated with BMI ,total body fat mass and spinal fat content. Elevated FSH is a risk factor for reduced femoral BMD T-score. Attention should be paid to the risk of osteoporosis in women with early menopause, and individualized treatment plans should be developed to reduce the prevalence of osteoporosis.

Key words: early menopause, bone mineral density, osteoporosis, fat content, body mass index, sex hormone