Low body weight is a major risk factor for low bone mass in healthy 40 to 60 year old women

Bone mineral density (BMD) testing of perimenopausal women is increasing, but may be unnecessary as fracture risk is low. Appropriate assessment among younger women requires identification of risk factors for low BMD specific to this population. The authors of a recent study [1] conducted a systematic literature review of risk factors for low BMD in healthy women aged 40 to 60 years. Articles were retrieved from six databases and reviewed for eligibility and methodological quality. A grade for overall strength of evidence for each risk factor was assigned.

There was good evidence that low body weight and post-menopausal status are risk factors for low BMD. There was good or fair evidence that alcohol and caffeine intake, and reproductive history are not risk factors. There was inconsistent or insufficient evidence for the effect of calcium intake, physical activity, smoking, age at menarche, history of amenorrhea, family history of osteoporosis, race, and current age on BMD.

In conclusion, based on current evidence in Caucasians, it is suggested that, in healthy women aged 40 to 60 years, only those with a low body weight (< 70 kg) be selected for BMD testing. Further research is necessary to determine optimal race-specific discriminatory weight cut-offs and to evaluate the risk factors for which there was inconclusive evidence.

1. Waugh EJ et al. Osteoporos Int. 2009;20:1–21.