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Femoral neck size predicts changes in bone structure, mass among menopausal women
Femoral neck size was predictive of changes in bone structure and mass in women undergoing menopause, whereas areal bone mineral density was not associated, according to findings published in the Journal of Bone and Mineral Research.
“The increased risk of fragility fractures in the elderly arises in part from variation in adult [BMD], and changes in BMD, bone structure and material properties,” Karl J. Jepsen, PhD, of the department of orthopedic surgery at the University of Michigan, Ann Arbor, and colleagues wrote. “However, little is understood about how variation in adult bone traits affects subsequent changes in bone structure and mass during aging, particularly during the menopausal transition among women, a life stage characterized by declines in BMD, strength indices and periosteal expansion. … Thus, a major gap in knowledge is that we know very little about how changes in BMD and bone structure vary among individuals and whether the interindividual variation in bone aging is influenced by peak bone traits.”
The researchers evaluated hip DXA images during a 14-year period among 198 menopausal women. All participants had been enrolled in the Pittsburgh site of the Study of Women’s Health Across the Nation (SWAN) trial in 1996. The mean age of the patients was 45.7 years.
Jepsen and colleagues reported that 14-year changes in bone mineral content (R2 = 0.03; P = .015) and bone area (R2 = 0.13; P = .001) were negatively correlated with baseline femoral neck external size, but areal BMD was not related (R2 = 0; P = .931). The relationship between bone mineral content and bone area was significant even after researchers adjusted for postmenopausal hormone use, race and ethnicity, weight changes, areal BMD, height and age. Women with narrower femoral necks experienced less drastic changes in areal BMD, but had greater increases in bone area, than women with wider femoral necks, Jepsen and colleagues reported.
“The interactions among traits found for the proximal femur contribute to a growing literature showing that people build bones differently and, thus, women begin the aging process at different starting points,” the researchers wrote. “Finally, we reported that women with wide femoral necks showed the greatest loss in [bone mineral content] without a large compensatory increase in periosteal expansion; this structural change may contribute to the greater risk of fracturing later in life for a subset of women that is readily apparent during the [menopausal transition] using existing technologies. Thus, studying interindividual differences provides an opportunity to give a voice to a silent disease and to open the possibility of identifying women that are losing bone mass early without compensatory changes in periosteal expansion and that may benefit from early intervention.” – by Andy Polhamus
Disclosure: The researchers report no relevant financial disclosures.