Correlation Analysis Between The Loss Of Bone Mass Density And The Severity Of Menopausal Symptoms In Chinese Women

Objectives:This study investigates the relationship between loss of bone mass density and the severity of menopausal symptoms in Chinese women.The aim is to help target women at risk for osteoporosis at the time of menopause.Osteoporosis,often referred to as a?silent?disease,is a public health issue and how to prevent bone loss represents a major challenge for the coming years.Methods:A cross-sectional study was carried out at the Department of Gynecology of the Sixth Affiliated People's Hospital of Shanghai Jiaotong University.A total of three hundred ninety Chinese women were enrolled.The severity of menopausal symptoms was assessed through the modified Kupperman Menopausal Index(modified KI),and Bone Mineral Density(BMD)was measured at the spine and at the hip.The correlation was studied with respect to age and Body Mass Index,that are common risk factors for osteoporosis and menopausal symptoms.An artificial neural network was also performed,with T-scores at L1-L4 lumbar spine as the output and the following inputs:the modified KI,menopausal status,age,Body Mass Index,height,and severity of muscle and joint pain.Results:There is an association between the severity of menopausal symptoms,age,BMI and BMD,but there is no strong cause-and-effect relationship between menopausal symptoms and bone loss.Bone loss as well as the modified KI increase with age.Menopausal symptoms all become more frequent with age,but heart palpitation(p=0.88),sexual complaints(p=0.88)and muscle and joint pain(p=0.84)especially become more severe as women get older.The symptoms,particularly hot flushes and sweating,are more prevalent in women of smaller stature,very overweight women and women with diabetes.Whereas muscle and joint pain severity significantly increases with Body Mass Index,osteoporosis,however,is more prevalent in women with a low BMI.The correlation coefficient obtained from the training of the neural network(r=0.62)is bigger than 0.5 but smaller than 0.9,stressing the complexity of the correlation.This is mainly due to the great number of risk factors related to osteoporosis and menopausal symptoms,as well as the existence of conflicting interrelationships among them.Overall,old age and low BMI were found to be more significantly related to bone loss than menopausal symptoms.Conclusions:The results suggest that the importance of menopausal symptoms linked with the development of osteoporosis has been overemphasized and that other factors are quantitatively more important.The unbalanced ratio between patients suffering from osteoporosis or osteopenia(23.2%)and patients experiencing moderate to severe menopausal symptoms(73%)shows that women with frequent menopausal symptoms benefit more from the preventive actions to reduce the risk of osteoporosis.Actually detailed observations of routine exams revealed that habits at the hospital made women with frequent menopausal symptoms learn about osteoporosis and care more about bone loss.This study suggests to involve more women in this virtuous circle and particularly fosters the empowerment of postmenopausal women with low BMI in the prevention of osteoporosis.