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Temporal relationship between bone loss and increased bone turnover: a longitudinal study following natural menopause
R Rosso1, S Minisola, A Scarda
1Istituto di II Clinica Medica, Università degli Studi di Roma La Sapienza, Italy.
Journal of Endocrinological Investigation
|October 1, 1995
Summary
Following natural menopause, bone resorption markers increase immediately, while bone formation markers rise later, leading to bone loss. Initial bone mineral density predicts future bone mass.
Area of Science:
- Endocrinology
- Bone Metabolism
- Menopause Research
Background:
- Natural menopause triggers significant hormonal shifts affecting bone health.
- Bone remodeling involves a delicate balance between resorption and formation, crucial for maintaining skeletal integrity.
Purpose of the Study:
- To investigate the temporal relationship between bone mineral density (BMD) and bone turnover markers after natural menopause.
- To identify early indicators of bone loss in the postmenopausal period.
Main Methods:
- Longitudinal study tracking BMD and four bone turnover markers (serum osteocalcin, alkaline phosphatase, urinary hydroxyproline/creatinine, calcium/creatinine).
- Analysis of changes over time following cessation of gonadal function.
Main Results:
- Bone resorption markers (urinary hydroxyproline/creatinine) increased immediately post-menopause.
- Bone formation markers (serum osteocalcin, alkaline phosphatase) showed a delayed but sustained increase.
- Significant yearly bone loss (-2.83 +/- 2.6%) was observed, correlated with initial BMD.
- An inverse correlation was found between initial serum alkaline phosphatase and yearly bone loss.
Conclusions:
- Postmenopausal bone loss results from a delayed increase in bone formation relative to resorption.
- Initial bone mineral density is a strong predictor of future bone mass.
- Increased bone turnover, indicated by serum alkaline phosphatase, may predict accelerated bone loss.