Bone Loss and Bone Size After Menopause

Ahlborg, Henrik; Johnell, Olof; Turner, Charles H.; Rannevik, Gunnar; Karlsson, Magnus K.

doi:10.1097/01.ogx.0000109262.37864.99

Cited by 113 publications

(172 citation statements)

References 2 publications

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“…Thus, the results of our current study provide the motivation to incorporate these structural features into clinical studies and to refocus the question from whether women show a lower periosteal expansion with aging on an absolute basis compared with men [29] to whether there are factors impairing periosteal expansion in women beyond that expected for having more slender bones combined with lower than expected cortical area. The linear regressions for the human data showed r 2 values ranging from 0.03 to 0.6, which is entirely consistent with those reported in the literature for interactions among traits or for associations between similar traits and age [1,20,25]. The human data are certainly more variable than the mouse data, and this should be expected.…”

Section: Discussionsupporting

confidence: 88%

Women Build Long Bones With Less Cortical Mass Relative to Body Size and Bone Size Compared With Men

Jepsen

Bigelow

Schlecht

2015

Clinical Orthopaedics &Amp; Related Research

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Background The twofold greater lifetime risk of fracturing a bone for white women compared with white men and black women has been attributed in part to differences in how the skeletal system accumulates bone mass during growth. On average, women build more slender long bones with less cortical area compared with men. Although slender bones are known to have a naturally lower cortical area compared with wider bones, it remains unclear whether the relatively lower cortical area of women is consistent with their increased slenderness or is reduced beyond that expected for the sex-specific differences in bone size and body size. Whether this sexual dimorphism is consistent with ethnic background and is recapitulated in the widely used mouse model also remains unclear. Questions/purposes We asked (1) do black women build bones with reduced cortical area compared with black men; (2) do white women build bones with reduced cortical area compared with white men; and (3) do female mice build bones with reduced cortical area compared with male mice? Methods Bone strength and cross-sectional morphology of adult human and mouse bone were calculated from quantitative CT images of the femoral midshaft. The data were tested for normality and regression analyses were used to test for differences in cortical area between men and women after adjusting for body size and bone size by general linear model (GLM). Results Linear regression analysis showed that the femurs of black women had 11% lower cortical area compared with those of black men after adjusting for body size and bone size (women: mean = 357.7 mm 2 ; 95% confidence interval [CI], 347.9-367.5 mm 2 ; men: mean = 400.1 mm 2 ; 95% CI, 391.5-408.7 mm 2 ; effect size = 1.2; p \ 0.001, GLM). Likewise, the femurs of white women had 12% less cortical area compared with those of white men after adjusting for body size and bone size (women: mean = 350.1 mm 2 ; 95% CI, 340.4-359.8 mm 2 ; men: mean = 394.3 mm 2 ; 95% CI, 386.5-402.1 mm 2 ; effect size = 1.3; p \ 0.001, GLM). In contrast, female and male femora from recombinant inbred mouse strains showed the opposite trend; femurs from female mice had a 4% larger cortical area compared with those of male mice after adjusting for body size and bone size (female: mean = 0.73 mm 2 ; 95% CI, 0.71-0.74 mm 2 ; male: mean = 0.70 mm 2 ; 95% CI, 0.68-0.71 mm 2 ; effect size = 0.74; p = 0.04, GLM).

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Section: Discussionsupporting

confidence: 88%

Women Build Long Bones With Less Cortical Mass Relative to Body Size and Bone Size Compared With Men

Jepsen

Bigelow

Schlecht

2015

Clinical Orthopaedics &Amp; Related Research

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“…The scanning technique has previously been described in detail 2,16 . We scanned both arms and used the mean value except for in individuals with a history of upper extremity fracture (11 on the right side and 17 on the left side), where we used only the result from the non-fractured arm.…”

Section: Methodsmentioning

confidence: 99%

“…This has led to speculations inferring that a reduction of age-related bone loss 2 or optimizing of peak bone mass 1,4 could possibly reduce the prevalence of osteoporosis. For intervention strategies in adulthood it thus seem feasible to target not only the population at large 6 , but also high-risk individuals.…”

Section: Introductionmentioning

confidence: 99%

A Pediatric Bone Mass Scan Has Poor Ability to Predict Adult Bone Mass: A 28-Year Prospective Study in 214 Children

et al. 2013

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We conducted a prospective study following bone traits from childhood to adulthood.Our aim was to study if a bone mass scan in childhood can be used to predict bone mass in adulthood. We found that a pediatric bone mass scan has poor ability to predict adult bone mass. AbstractPurpose: As the correlation of bone mass from childhood to adulthood is unclear, we conducted a long-term prospective observational study to determine if a pediatric bone mass scan could predict adult bone mass. Methods:We measured cortical bone mineral content (BMC; g), bone mineral density (BMD; g/cm 2 ) and bone width (cm) in the distal forearm by single photon absorptiometry in 120 boys and 94 girls with a mean age of 10 years (range 3-17) and mean 28 years (range 25-29) later. We calculated individual and age specific bone mass Z-scores, using the control cohort included at baseline as reference and evaluated correlations between the two measurements with Pearson's correlation coefficient. Individual Z-scores were also stratified in quartiles to register movements between quartiles from growth to adulthood.Results: BMD Z-scores in childhood and adulthood correlated in both boys (r=0.35; p<0.0001) and girls (r=0.50, p<0.0001) and in both children ≥10 years at baseline (boys r=0.43 and girls r=0.58, both p<0.0001) and in children <10 years at baseline (boys r=0.26 and girls r=0.40, both p<0.05).Of the children in the lowest quartile of BMD, 58% had left the lowest quartile in adulthood. A pediatric bone scan with a value in the lowest quartile had a sensitivity of 48% (95% CI 27%, 69%) and a specificity of 76% (95% CI 66%, 84%) to identify individuals who would remain in the lowest quartile also in adulthood Conclusions: Childhood forearm BMD explained 12% of the variance in adult BMD in men and 25% in women.A pediatric distal forearm BMD scan has poor ability to predict adult bone mass.3

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“…When discussing physical activity in prepubertal girls as a possible prevention strategy for future fractures, the results are of great importance as both BMC, aBMD and bone width contribute to the final bone strength (28).…”

Section: Discussionmentioning

confidence: 99%

“…Less is known if similar intervention program increase aBMD and at what age the program should be initiated (25,27). In addition, it must also be clarified if moderate intense exercise in children could influence bone width, another trait that contribute to the bone strength (28).…”

Section: Introductionmentioning

confidence: 99%

Daily Physical Education in the School Curriculum in Prepubertal Girls during 1 Year is Followed by an Increase in Bone Mineral Accrual and Bone Width—Data from the Prospective Controlled Malmö Pediatric Osteoporosis Prevention Study

et al. 2006

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The aim of this study was to evaluate a general school-based one-year exercise intervention program in a population-based cohort of girl at Tanner stage I. Fifty-three girls aged 7 to 9 years were included. The school curriculum based exercise intervention program included 40 minutes per school day. Fifty healthy age-matched girls assigned to the general school curriculum of 60 minutes physical activity per week served as controls. Bone mineral content (BMC; g) and areal bone mineral density (aBMD; g/cm 2 ) were measured with dual X-ray absorptiometry (DXA) of the total body (TB), lumbar spine (L2-L4 vertebra), the third lumbar vertebra (L3), the femoral neck (FN) and the leg. Volumetric bone mineral density (vBMD; g/cm 3 ) and bone width were calculated at L3 and FN. Total lean body mass and total fat mass were estimated from the total body scan. No differences were at baseline found in age, anthropometrics or bone parameters when the groups were compared. The annual gain in BMC was in the cases 4.7 percentage points higher in lumbar spine and 9.5 percentage points higher in L3 than in the controls (both p<0.001). The annual gain in aBMD was in the cases 2.8 percentage points higher in lumbar spine and 3.1 percentage points higher in L3 than in the controls (both p<0.001). The annual gain in bone width was in the cases 2.9 percentage points higher in L3 than in the controls (p<0.001).A general school-based exercise program in 7 -9-year-old girls enhances the accrual of BMC and aBMD and increases bone width.

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Bone Loss and Bone Size After Menopause

Cited by 113 publications

References 2 publications

Women Build Long Bones With Less Cortical Mass Relative to Body Size and Bone Size Compared With Men

Women Build Long Bones With Less Cortical Mass Relative to Body Size and Bone Size Compared With Men

A Pediatric Bone Mass Scan Has Poor Ability to Predict Adult Bone Mass: A 28-Year Prospective Study in 214 Children

Daily Physical Education in the School Curriculum in Prepubertal Girls during 1 Year is Followed by an Increase in Bone Mineral Accrual and Bone Width—Data from the Prospective Controlled Malmö Pediatric Osteoporosis Prevention Study

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