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The role of bone loss

B J Riis1

  • 1Center for Clinical and Basic Research, Ballerup, Denmark.

The American Journal of Medicine
|February 27, 1995
PubMed
Summary

Postmenopausal women are categorized as fast or normal bone losers. Both low bone mass and rapid bone loss equally increase fracture risk, with combined factors significantly raising odds.

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Area of Science:

  • Osteoporosis Research
  • Postmenopausal Health
  • Biochemical Markers of Bone Metabolism

Background:

  • Postmenopausal women exhibit distinct bone mineral loss patterns, with ~35% identified as 'fast losers' and ~65% as 'normal losers'.
  • Assessing the rate of bone loss is crucial for understanding fracture risk.
  • Advancements in biochemical markers offer improved methods for indirect assessment of bone resorption and formation.

Purpose of the Study:

  • To evaluate the role of baseline bone mass and the rate of bone loss in predicting fracture risk.
  • To investigate the correlation between biochemical markers and the rate of bone loss.
  • To determine the combined effect of low bone mass and fast bone loss on fracture incidence.

Main Methods:

  • Longitudinal studies tracking bone mineral density in early postmenopausal women.
  • Utilized novel biochemical markers, including urinary type I collagen degradation products and serum osteocalcin, to assess bone turnover.
  • A prospective 12-year study analyzed bone turnover rates and correlated them with baseline bone mass and fracture events.

Main Results:

  • Biochemical markers demonstrated a significant correlation with the rate of bone loss.
  • Fast bone losers exhibited persistently higher bone turnover rates compared to normal bone losers over 12 years.
  • Both low baseline bone mass (<-1 SD) and a fast rate of bone loss independently increased fracture risk (OR ≈ 2).
  • A combination of low baseline bone mass and fast bone loss significantly elevated the odds of experiencing a fracture.

Conclusions:

  • Low bone mass and a rapid rate of bone loss are equally significant predictors of future fracture risk in postmenopausal women.
  • Biochemical markers provide a reliable method for indirectly assessing the rate of bone loss.
  • Identifying women with fast bone loss or low baseline bone mass is critical for targeted fracture prevention strategies.

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