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Characterization of perimenopausal bone loss: a prospective study.
1Creighton Osteoporosis Research Center, Department of Medicine, Creighton University, Omaha, Nebraska 68131, USA.
Summary
Menopause causes significant bone loss, particularly in the spine, due to estrogen deprivation. Hip and total body bone loss result from both estrogen loss and aging.
Area of Science:
- Endocrinology
- Bone Biology
- Menopause Research
Background:
- Menopause is associated with changes in bone mass.
- The relative contributions of estrogen deprivation and aging to bone loss are not fully elucidated.
Purpose of the Study:
- To characterize changes in bone mass, hormones, and bone markers during normal menopause.
- To differentiate age-related bone loss from estrogen-deprivation bone loss.
Main Methods:
- Longitudinal study of 75 healthy women over 9.5 years.
- Categorization into postmenopausal (PM) and estrogen-replete (ER) groups.
- Measurement of bone mineral density, hormones (estradiol, gonadotropins), and bone turnover markers (osteocalcin, alkaline phosphatase, hydroxyproline/creatinine).
Main Results:
- Postmenopausal women experienced significant bone loss: 10.50% (spine), 7.73% (total body), 5.30% (femoral neck) due to estrogen deprivation.
- Age-related losses were 0% (spine), 4.88% (total body), 3.40% (femoral neck).
- Bone turnover markers increased significantly in the PM group compared to the ER group.
Conclusions:
- Menopausal bone loss is driven by estrogen deprivation for the spine.
- For the hip and total body, bone loss is a combination of estrogen deprivation and aging.
- Estrogen deprivation significantly impacts bone metabolism and density during menopause.