Osteoporos Int (2006) 17: 834–840 DOI 10.1007/s00198-005-0046-1 ORIGINAL ARTICLE Bone mineral density and estimated height loss based on patients’ recalls A. Moayyeri . S. Ahmadi-Abhari . A. Hossein-nezhad . B. Larijani . A. Soltani Received: 17 August 2005 / Accepted: 2 December 2005 / Published online: 31 March 2006 # International Osteoporosis Foundation and National Osteoporosis Foundation 2006 Abstract Introduction: Height loss has been shown to be an indicator of incident vertebral fractures. However, the relationship between height loss and bone mineral density (BMD) in different skeletal regions, as well as the power of human memory in estimation of height loss across the life span, has not yet been established. Given that the variation in BMD between populations is substantially less than the variation in fracture risk, we studied the relationship between height loss based on patient’ s recalls and BMD in Iranian men and women of all ages. Methods: Randomized clustered sampling from all re- gions of Tehran was performed to recruit the study population. Participants were asked about their maximum recalled previously measured height, if they were confident. In the 457 participants included, the difference between the participants’ maximum recalled and current measured height was calculated. Result: L1–L4 lumbar BMD, femoral neck BMD, and young adjusted T-scores were significantly lower in the group of participants with estimated height reduction of greater than 5 cm. In simple linear regression analysis, height loss was a significant predictor of femoral neck T-score (standardized beta coefficient =-0.15; p0.003) and L1–L4 lumbar T-score (beta =-0.08; p0.048). After adjustment for age, gender, and weight, height loss remained a significant predictor for femoral neck T-score (beta =-0.078; p0 .043). In multi- variate models for lumbar T-score, height loss was an independent predictor only in participants equal to or younger than 50 years of age (beta =-0.144; p0.033). Conclusion: Higher estimated height loss according to patients’ recalls was an indicator of lower BMD in our sample. Especially in the femoral neck region, this factor might be considered as a substitute case-finding tool for low BMD. Considering relatively young nature of our study group and biological differences between popula- tions, our findings need to be validated in future prospective studies. Keywords Bone mineral density . Height loss . Iran . Osteoporosis Introduction Osteoporosis is a major public health concern and is characterized by reduction in bone mineral density (BMD) and a subsequent increase in fracture risk [1]. The effects of preventive strategies, as well as the results of drug intervention studies, stimulate the idea that early diagnosis of osteoporosis is beneficial to the patients [2]. BMD is proven to be one of the best predictors of osteoporosis-related fractures in a number of prospective studies [3–5], and preventive therapy is offered to those at a specified risk level of BMD [6, 7]. But the cost-to-benefit ratio of proposing a BMD assessment to all people of a given age has been challenged and demonstrated to be rather poor [8]. Therefore, selection of cases who mostly benefit from these preventive strategies, based on addi- tional clinical risk factors, is justified. These clinical risk factors have to be identified and validated [9]. As variations in BMD between populations appear to be substantially less than variations in fracture risk [8], various risk factors highly related to low bone densities are commonly used as predictors of osteoporosis, and these relationships are more generalizable among different populations. It has been shown that subjects with lower bone densities lose height substantially faster than those with higher BMD [10–12]. However, previous studies on this issue were mostly restricted to postmenopausal women. Although osteoporosis is more common in women, men are, with a time lag, also affected, and morbidity and mortality after osteoporotic fractures appears to be more serious in men than in women [13]. A. Moayyeri (*) . S. Ahmadi-Abhari . A. Hossein-nezhad . B. Larijani . A. Soltani Endocrinology & Metabolism Research Centre, Shariati Hospital, Tehran University of Medical Sciences, Northern Kargar Ave, Tehran, 14114, Iran e-mail: moayyeri@doctor.com Tel.: +98-21-88026902 Fax: +98-21-88029399