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Menopausal changes in bone remodeling

R P Heaney, R R Recker, P D Saville

    The Journal of Laboratory and Clinical Medicine
    |December 1, 1978
    PubMed
    Summary
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    Estrogen loss at menopause increases bone resorption and accretion rates, leading to a negative skeletal balance. Hormone therapy can restore premenopausal bone remodeling levels.

    Area of Science:

    • Endocrinology
    • Bone Biology
    • Calcium Metabolism

    Background:

    • Menopause is associated with significant hormonal changes, particularly estrogen deficiency.
    • Estrogen plays a crucial role in regulating bone remodeling and maintaining skeletal balance.

    Purpose of the Study:

    • To investigate the effect of estrogen status on bone remodeling and skeletal balance in perimenopausal and postmenopausal women.
    • To determine the impact of estrogen loss on mineral accretion and resorption rates.

    Main Methods:

    • Utilized a calcium-kinetic method to measure bone remodeling.
    • Studied 151 normal perimenopausal women, comparing premenopausal, postmenopausal, and estrogen-treated postmenopausal groups.
    • Conducted paired studies across menopause in 15 women.

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    Main Results:

    • Premenopausal women had remodeling rates of 0.337 gm/day Ca for accretion and 0.358 gm/day Ca for resorption (skeletal balance: -0.021 gm/day Ca).
    • Untreated postmenopausal women showed significantly higher rates: 0.387 gm/day Ca for accretion and 0.425 gm/day Ca for resorption (skeletal balance: -0.038 gm/day Ca).
    • Estrogen-treated postmenopausal women exhibited rates similar to premenopausal women.

    Conclusions:

    • Estrogen loss at menopause is linked to increased skeletal resorption, contributing to a negative skeletal balance.
    • Estrogen replacement therapy can normalize bone remodeling rates, mitigating the negative skeletal balance observed postmenopause.