Experimental Gerontology,Vol. 25, pp. 303-307, 1990
0531-5565/90 $3.00 + .00 Copyright © 1990 Pergamon Press plc
Printed in the USA. All rights reserved.
VERTEBRAL BONE LOSS IN MENOPAUSE
G.C. ISAIA, G. SALAMANO,M. MUSSETTAand G.M. MOLINATTI Istituto di Medicina Interna, Universith di Torino, Corso Polonia, 14 10126, Torino, Italy
Abstract -- A direct correlation between loss of ovarian function and reduction of bone mass is well established. The incidence of fractures sharply increases with age starting from the menopause. Therefore, it is very important to know the rate of bone loss occurring after menopause, at both trabecular and cortical levels. Several factors may contribute to the reduction of bone mass in menopause. Reduced estrogen secretion results in reduced intestinal calcium absorption, increased bone resorption, and probably a deficient production of calcitonin. Furthermore, in vivo and in vitro experimental data confirm that estrogen failure is associated with histologic changes, mirroring the biochemical changes described in postmenopausal osteoporosis. Key Words: osteoporosis, menopause, estrogens, oophorectomy, bone mineral density, caicitonin
INTRODUCTION ALTHOUCHMENOPAUSEis a natural event, certain accompanying complications may need prompt medical treatment and prevention. Of particular importance is the reduction of bone mass, which in a number of cases leadsto the clinical picture of postmenopausal osteoporosis. In 1941, Albright et al. hypothesized for the first time the existence of a direct correlation between loss of ovarian function and reduction of bone mass. This link was later confirmed, and some pathogenetic mechanisms leading to postmenopausal osteoporosis have been delineated (Christiansen et al., 1981; Riggs et al., 1986a). Today, osteoporosis constitutes an important social problem in Western countries. In the United States in particular, this condition accounts for at least 1.2 million fractures per year, and it has been estimated that in older age groups 1 of every 3 women and 1 of every 6 men will develop a hip fracture. Thus, direct and indirect costs related to osteoporosis are consistently elevated in every country (Riggs et al., 1986b). EPIDEMIOLOGY In women, bone mass reaches its peak around age 30-35, remains substantially constant until the menopause, and decreases thereafter (Chesnut, 1987). A recent review by Melton (1988)
Correspondence to: G.C. Isaia. 303
304
o.c.
ISA1A
et al.
n.lO --_ n,18 n~36
r =-0.50
p
0531-5565/90 $3.00 + .00 Copyright © 1990 Pergamon Press plc
Printed in the USA. All rights reserved.
VERTEBRAL BONE LOSS IN MENOPAUSE
G.C. ISAIA, G. SALAMANO,M. MUSSETTAand G.M. MOLINATTI Istituto di Medicina Interna, Universith di Torino, Corso Polonia, 14 10126, Torino, Italy
Abstract -- A direct correlation between loss of ovarian function and reduction of bone mass is well established. The incidence of fractures sharply increases with age starting from the menopause. Therefore, it is very important to know the rate of bone loss occurring after menopause, at both trabecular and cortical levels. Several factors may contribute to the reduction of bone mass in menopause. Reduced estrogen secretion results in reduced intestinal calcium absorption, increased bone resorption, and probably a deficient production of calcitonin. Furthermore, in vivo and in vitro experimental data confirm that estrogen failure is associated with histologic changes, mirroring the biochemical changes described in postmenopausal osteoporosis. Key Words: osteoporosis, menopause, estrogens, oophorectomy, bone mineral density, caicitonin
INTRODUCTION ALTHOUCHMENOPAUSEis a natural event, certain accompanying complications may need prompt medical treatment and prevention. Of particular importance is the reduction of bone mass, which in a number of cases leadsto the clinical picture of postmenopausal osteoporosis. In 1941, Albright et al. hypothesized for the first time the existence of a direct correlation between loss of ovarian function and reduction of bone mass. This link was later confirmed, and some pathogenetic mechanisms leading to postmenopausal osteoporosis have been delineated (Christiansen et al., 1981; Riggs et al., 1986a). Today, osteoporosis constitutes an important social problem in Western countries. In the United States in particular, this condition accounts for at least 1.2 million fractures per year, and it has been estimated that in older age groups 1 of every 3 women and 1 of every 6 men will develop a hip fracture. Thus, direct and indirect costs related to osteoporosis are consistently elevated in every country (Riggs et al., 1986b). EPIDEMIOLOGY In women, bone mass reaches its peak around age 30-35, remains substantially constant until the menopause, and decreases thereafter (Chesnut, 1987). A recent review by Melton (1988)
Correspondence to: G.C. Isaia. 303
304
o.c.
ISA1A
et al.
n.lO --_ n,18 n~36
r =-0.50
p
