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Osteogenesis imperfecta after the menopause.

C R Paterson, S McAllion, J L Stellman

The New England Journal of Medicine

|June 28, 1984

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Osteogenesis imperfecta fracture rates increase after menopause in women due to age-related bone loss, unlike men. Hormone therapy may benefit these women.

Area of Science:

Bone Biology and Genetics
Metabolic Bone Disease
Rheumatology

Background:

Osteogenesis imperfecta (OI) is a genetic disorder characterized by brittle bones and increased fracture risk.
Fracture patterns in OI can vary with age and sex, but postmenopausal changes are not well understood.

Purpose of the Study:

To investigate the age- and sex-specific fracture rates in individuals with osteogenesis imperfecta.
To explore the impact of menopause on fracture risk in women with OI.
To identify potential therapeutic interventions for postmenopausal women with OI.

Main Methods:

Retrospective analysis of fracture incidence in a cohort of 45 women and 20 men with osteogenesis imperfecta.
Age-stratified analysis of fracture rates, with specific attention to pre- and post-menopausal periods in women.

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Main Results:

In women with OI, fracture rates peaked in childhood, decreased in adolescence, and increased again after menopause.
Men with OI showed consistently lower fracture rates after adolescence.
Postmenopausal women with OI experienced an increased risk of spinal crush fractures and long bone fractures.

Conclusions:

The postmenopausal increase in fracture rate in women with OI results from the combined effects of age-related bone loss and the underlying collagen defect.
Hormone replacement therapy (HRT) may be specifically indicated for women with OI from the time of menopause.
Osteogenesis imperfecta should be considered in the differential diagnosis for women presenting with spinal crush fractures.