Bone loss in relation to menopause: a prospective study during 16 years

Ahlborg, Henrik; Johnell, Olof; Nilsson, Bo; Jeppsson, Sten; Rannevik, Gunnar; Karlsson, Magnus K.

doi:10.1016/s8756-3282(00)00451-8

Cited by 123 publications

(77 citation statements)

References 20 publications

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“…A registration of pubertal maturity to stratify the children by true pubertal status would have been preferred as well as individual registration of menopause which would have given reasonable estimates of individuals at risk of postmenopausal bone loss. As the oldest women in our cohort was 44 years, the mean age of menopause in Scandinavia is 51 (95% CI 45-55) years 29 , and bone loss in the cortical region of the distal forearm is initiated after age 40 years 30 , there is a low risk of any significant age-related bone loss in our data Finally it would have been advantageous to have serial measurements to pinpoint the exact time for peak bone mass.…”

Section: Discussionmentioning

confidence: 86%

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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Section: Discussionmentioning

confidence: 86%

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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“…3). Given the likelihood of postreproductive status, they may have experienced a decrease in bone strength similar to that observed in ovariectomized mice (Peng et al, 1994;Mosekilde et al, 1998) and in postmenopausal women (e.g., Riggs et al, 1986;Garnero et al, 1996;Ahlborg et al, 2001Ahlborg et al, , 2003.…”

Section: Combined Effects Of Genetic Background and Of Exercise On Skmentioning

confidence: 80%

The relative importance of genetics and phenotypic plasticity in dictating bone morphology and mechanics in aged mice: Evidence from an artificial selection experiment

Middleton

Shubin

Moore

et al. 2008

Zoology

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Both genetic and environmental factors are known to influence the structure of bone, contributing to its mechanical behavior during, and adaptive response to, loading. We introduce a novel approach to simultaneously address the genetically mediated, exercise-related effects on bone morphometrics and strength, using mice that had been selectively bred for high levels of voluntary wheel running (16 generations). Female mice from high-running and control lines were either allowed (n = 12, 12; respectively) or denied (n = 11, 12; respectively) access to wheels for 20 months. Femoral shaft, neck, and head were measured with calipers and via micro-computed tomography. Fracture characteristics of the femoral head were assessed in cantilever bending. After adjusting for variation in body mass by two-way analysis of covariance, distal width of the femur increased as a result of selective breeding, and mediolateral femoral diameter was reduced by wheel access. Cross-sectional area of the femoral mid-shaft showed a significant linetype × activity effect, increasing with wheel access in high-running lines but decreasing in control lines. Body mass was significantly positively correlated with many of the morphometric traits studied. Fracture load of the femoral neck was strongly positively predicted by morphometric traits of the femoral neck (r 2 > 0.30), but no significant effects of selective breeding or wheel access were found. The significant correlations of body mass with femoral morphometric traits underscore the importance of controlling for body size when analyzing the response of bone size and shape to experimental treatments. After controlling for body mass, measures of the femoral neck remain significant predictors of femoral neck strength.

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“…This report includes 112 women (81%) who participated throughout the entire 23 years. Prospective 16-year data as regards bone loss and bone strength have been reported elsewhere (Ahlborg et al 2001(Ahlborg et al , 2003.…”

Section: Methodsmentioning

confidence: 99%

“…An age-related medullary expansion can have implications for the long-term fixation of hip prostheses  Estrogen deficiency, after the menopause, accelerates the age-related bone loss (Riggs et al 1986, Ahlborg et al 2001. Since the bone loss of the diaphyseal bones occurs mainly at the endosteal surface of the cortex (the inner surface of the cortex) and partly in the Haversian canals (Frost 1999), the medullary cavity should, hypothetically, increase in size after the menopause.…”

mentioning

confidence: 99%

An age-related medullary expansion can have implications for the long-term fixation of hip prostheses

Ahlborg

Johnell

Karlsson

2004

Acta Orthopaedica Scandinavica

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Background Diaphyseal bone loss occurs mainly at the endosteal surface in the medullary cavity. Since the menopause is followed by an increase in bone loss, the size of the medullary cavity should theoretically increase during the postmenopausal period. If so, this might affect the long-term fixation of hip prostheses.Patients and methods This 19-year prospective study evaluated bone loss and geometrical changes in 112 women, all premenopausal at baseline. Bone mineral density (BMD) and skeletal geometry, with special reference to the size of the medullary cavity, were estimated every other year by single-photon absorptiometry at the cortical site of the distal radius.Results After menopause, a decrease of 1.7 (95% Cl 1.6-1.8)% occurred in the BMD every year, while an increase of 0.9 (0.8-1.0)% in the medullary width (endosteal width) too place every year. The annual change in BMD was inversely correlated with the annual change in the medullary width (r = -0.5, p < 0.001). The quartile of women with the largest BMD loss had a greater medullary expansion than the quartile of women with the least BMD loss (p < 0.001).Interpretation If the age-related expansion of the radial medullary cavity is a general phenomenon, this may have implications for the long-term fixation of hip prostheses.

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Bone loss in relation to menopause: a prospective study during 16 years

Cited by 123 publications

References 20 publications

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

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

The relative importance of genetics and phenotypic plasticity in dictating bone morphology and mechanics in aged mice: Evidence from an artificial selection experiment

An age-related medullary expansion can have implications for the long-term fixation of hip prostheses

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