New methods for identifying "at risk" patients for osteoporosis.

Bone loss was determined in 178 women in the early postmenopausal period by photon absorptiometry measurement of forearm bone mineral content (BMC) every three months for two years. With a sequential cut-off technique, the results of a single determination of body fat mass, urinary calcium and hydroxyproline, and serum alkaline phosphatase, carried out at the first examination, correctly identified 79% of "fast bone losers" (bone loss greater than 3% annually) and 78% of "slow bone losers". The simple biochemical screening procedure was hereafter tested in a new group of 70 early postmenopausal women, who were followed for two years with measurement of local and total BMC. With this simple approach the majority of women at highest risk of osteoporotic fractures in later life can be identified in the early postmenopausal period and can be started on prophylactic hormone replacement therapy.