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Cited by 643

The DOI matches its Crossref record; 5 of the 5 references it cites were found in a registry or an index.

Bone Loss and Bone Size after Menopause

Open access
Ahlborg, Henrik G., Johnell, Olof, Turner, Charles H., Rannevik, Gunnar, Karlsson, Magnus K.·2003·New England Journal of Medicine
DOI 10.1056/nejmoa022464
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Abstract

BACKGROUND: Bone loss increases after menopause. However, bone strength also depends on structural characteristics such as bone size. Whether bone size increases as a result of periosteal apposition and whether a strength index accounting for both bone density and bone size might predict the risk of fracture better than bone density alone are unclear. METHODS: Bone mass and the skeletal structure of the distal radius were evaluated by single-photon absorptiometry every other year in 108 women, all of whom were followed from the time of menopause for a mean period of 15 years. Postmenopausal serum estradiol levels and fractures of the distal radius were noted. RESULTS: The mean (+/-SD) annual decrease in bone mineral density was 1.9+/-0.7 percent. The medullary bone diameter increased annually by 1.1+/-0.9 percent, and the periosteal diameter by 0.7+/-0.3 percent; the strength index decreased by 0.7+/-0.7 percent. The expansion of the medullary diameter and the expansion of the periosteal diameter were correlated with one another (r = 0.54, P<0.001), and women in the highest quartile of medullary expansion had more loss of bone mineral density and greater periosteal apposition than women in the lowest quartile (P<0.001 for both comparisons). The postmenopausal serum estradiol level was correlated with changes in the periosteal diameter (r = -0.25, P=0.009) and with changes in bone mineral density (r = 0.34, P<0.001). A 1-SD decrement in the strength index at base line was associated with a risk ratio for fracture of the distal radius of 3.8 (95 percent confidence interval, 1.8 to 8.0). CONCLUSIONS: Increased bone loss after menopause is associated with increased periosteal apposition, which partially preserves bone strength. A strength index may be a helpful predictor of the risk of fracture.

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Metadata

Authors
Ahlborg, H. G., Johnell, O., Turner, C. H., Rannevik, G., & Karlsson, M. K.
Venue
New England Journal of Medicine
Publisher
Massachusetts Medical Society
Published
2003-07-24
Volume
349
Issue
4
Pages
327-334
ISSN
  • 0028-4793 (ISSN-L)
  • 1533-4406
DOI
10.1056/nejmoa022464
OpenAlex
W2045805069
Cited by
643
References
5
FWCI
36.94
Type
journal article
Language
en
Open access
bronze

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