Osteoporosis of the Slender Smoker

Abstract
A group of thirty-eight women under age 70 who sustained vertebral compression fractures during minor trauma included more postmenopausal smokers than a group of 34 similar women with fractures resulting from major trauma and more than a group of 572 other women. Advanced idiopathic osteoporosis occurring before age 65 was found rarely among nonsmokers. The percent cortical area at the second metacarpal midpoint was measured in 103 white women aged 40 to 49 years, and 208 white women aged 60 to 69 years. In the younger group, no quantitative differences were demonstrated between bones of the obese and the nonobese or between smokers and nonsmokers. In contrast, among the older group, post-menopausal smokers exhibited much more bone loss than did nonsmokers (P<.001), and nonobese women demonstrated much more bone loss than did obese women, this difference being most striking among smokers. (Arch Intern Med136:298-304, 1976)