Evaluation of Bone Mineral Density Indications and Outcomes in Female Adolescents: Implications for Early Detection of Osteopenia/Osteoporosis and Gynecologic Practice

Retrospective Evaluation of Bone Mineral Density Measurements, Clinical Indications, and Risk Factors for Osteopenia/Osteoporosis in Female Adolescents Attending at a Tertiary Care Center

This retrospective study evaluates bone mineral density (BMD) measurements obtained by dual-energy X-ray absorptiometry (DEXA) in adolescent girls aged 12 to 21 years at a tertiary care center. The study focuses on patients referred from the adolescent gynecology clinic as well as from other medical specialties.

Key objectives are:

Comparing the BMD indications and results requested from the gynecology department with the indications and BMD results requested from other departments. Thus, the BMD scores of patients with hypogonadism can be compared with other groups at risk for bone health.

To assess BMD Z-scores across specific gynecologic diagnoses, including premature ovarian insufficiency, functional hypothalamic amenorrhea (FHA), and hypogonadotropic hypogonadism.

To analyze the relationship between gynecologic clinical features-such as age at menarche and duration of amenorrhea-and BMD Z-scores.

By combining clinical, hormonal, and densitometric data, this study aims to identify risk factors for low bone density in adolescents, support earlier recognition of osteopenia/osteoporosis, and provide guidance for appropriate interventions in adolescent gynecology practice.

Adolescence is a critical period for bone mass acquisition, and disturbances during this stage may predispose to osteopenia or osteoporosis in later life. Various clinical conditions encountered in gynecology, endocrinology, and other specialties may require evaluation of bone mineral density (BMD). However, data on referral indications and bone health outcomes in adolescents remain scarce.

This retrospective study focuses on female adolescents aged 12-21 years who underwent dual-energy X-ray absorptiometry (DEXA) scans at a tertiary care center. The cohort includes patients referred from the adolescent gynecology clinic as well as those referred from other medical departments.

The study objectives are:

To compare referral indications for BMD testing between gynecology and other specialties.

To evaluate differences in BMD Z-scores across specific gynecologic diagnoses, including premature ovarian insufficiency (POI), functional hypothalamic amenorrhea (FHA), and hypogonadotropic hypogonadism.

To examine the relationship between clinical features (such as age at menarche and duration of amenorrhea) and BMD outcomes within the gynecology group.

The analysis will provide insight into how referral patterns, gynecologic and endocrine conditions, and clinical characteristics influence bone health in adolescent girls. By highlighting risk factors for low BMD, the study aims to support earlier recognition and management of bone health problems in this population.

Inclusion Criteria:

• Female adolescents aged 12-21 years
• Underwent bone mineral density (BMD) measurement with DEXA at the study center between 2020 and 2025
• Available clinical and biochemical records, including referral indication

Exclusion Criteria:

• Incomplete or missing BMD scan data
• Insufficient clinical information in medical records
• Patients with underlying conditions unrelated to bone health that preclude accurate evaluation (e.g., major skeletal deformities interfering with DEXA interpretation)