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Abnormal Bone Microarchitecture And Evidence Of Osteoblast Dysfunction In Premenopausal Women With Idiopathic Osteoporosis.

A. Cohen, D. Dempster, R. Recker, E. Stein, J. Lappe, H. Zhou, A. J. Wirth, G. H. van Lenthe, T. Kohler, A. Zwahlen, R. Mueller, C. Rosen, S. Cremers, T. Nickolas, D. McMahon, Halley F Rogers, R. B. Staron, J. Lemaster, E. Shane
Published 2011 · Medicine

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CONTEXT Idiopathic osteoporosis (IOP) in premenopausal women is an uncommon disorder of uncertain pathogenesis in which fragility fractures occur in otherwise healthy women with intact gonadal function. It is unclear whether women with idiopathic low bone mineral density and no history of fragility fractures have osteoporosis. OBJECTIVE The objective of the study was to elucidate the microarchitectural and remodeling features of premenopausal women with IOP. DESIGN We performed transiliac biopsies after tetracycline labeling in 104 women: 45 with fragility fractures (IOP), 19 with idiopathic low bone mineral density (Z score ≤-2.0) and 40 controls. Biopsies were analyzed by two-dimensional quantitative histomorphometry and three-dimensional microcomputed tomography. Bone stiffness was estimated using finite element analysis. RESULTS Compared with controls, affected women had thinner cortices; fewer, thinner, more widely separated, and heterogeneously distributed trabeculae; reduced stiffness; and lower osteoid width and mean wall width. All parameters were indistinguishable between women with IOP and idiopathic low bone mineral density. Although there were no group differences in dynamic histomorphometric remodeling parameters, serum calciotropic hormones, bone turnover markers, or IGF-I, subjects in the lowest tertile of bone formation rate had significantly lower osteoid and wall width, more severely disrupted microarchitecture, lower stiffness, and higher serum IGF-I than those in the upper two tertiles, suggesting that women with low turnover IOP have osteoblast dysfunction with resistance to IGF-I. Subjects with high bone turnover had significantly higher serum 1,25 dihydroxyvitamin D levels and a nonsignificant trend toward higher serum PTH and urinary calcium excretion. CONCLUSIONS These results suggest that the diagnosis of IOP should not require a history of fracture. Women with IOP may have high, normal or low bone turnover; those with low bone turnover have the most marked deficits in microarchitecture and stiffness. These results also suggest that the pathogenesis of idiopathic osteoporosis is heterogeneous and may differ according to remodeling activity.
This paper references
10.1007/S11914-005-0022-X
Treatment of low bone mass in premenopausal women: When may it be appropriate?
E. Leib (2005)
10.1007/s00198-004-1716-0
Idiopathic osteoporosis in premenopausal women
M. Rubin (2004)
10.1016/J.BONE.2004.12.008
Bone histomorphometry in 22 male patients with normocalciuric idiopathic osteoporosis.
M. Ciria-Recasens (2005)
10.1073/PNAS.84.13.4616
Spontaneous release of interleukin 1 from human blood monocytes reflects bone formation in idiopathic osteoporosis.
R. Pacifici (1987)
10.1002/JOR.1100160516
Finite‐element modeling of trabecular bone: Comparison with mechanical testing and determination of tissue modulus
A. J. Ladd (1998)
10.1007/s00198-009-0945-7
Assessment of trabecular and cortical architecture and mechanical competence of bone by high-resolution peripheral computed tomography: comparison with transiliac bone biopsy
A. Cohen (2009)
10.1016/J.BONE.2003.12.013
Risedronate preserves bone architecture in postmenopausal women with osteoporosis as measured by three-dimensional microcomputed tomography.
B. Borah (2004)
10.1210/JCEM.82.9.4264
Idiopathic osteoporosis--is the osteoblast to blame?
S. Khosla (1997)
Does she or doesn't she...have osteoporosis?" The use and abuse of bone densitometry.
Licata Aa (2000)
10.1007/BF02509542
A microtomographic system for the nondestructive evaluation of bone architecture
P. Rüegsegger (2006)
Idiopathic osteoporosis: a heterogeneous entity.
H. Heshmati (1998)
10.1359/jbmr.2000.15.1.13
Trabecular Bone Microarchitecture, Bone Mineral Density, and Vertebral Fractures in Male Osteoporosis
E. Legrand (2000)
10.1002/JBMR.5650100812
Serum IGF 1 is low and correlated with osteoblastic surface in idiopathic osteoporosis
B. Reed (1995)
10.1007/S11914-008-0007-7
Treatment of premenopausal women with low bone mineral density
A. Cohen (2008)
10.1385/JCD:7:1:1
Official positions of the International Society for Clinical Densitometry.
E. Lewiecki (2006)
10.1359/jbmr.1999.14.7.1167
Direct Three‐Dimensional Morphometric Analysis of Human Cancellous Bone: Microstructural Data from Spine, Femur, Iliac Crest, and Calcaneus
T. Hildebrand (1999)
10.1080/01495739708936692
Quantification of Bone Microarchitecture with the Structure Model Index.
T. Hildebrand (1997)
10.1002/jbmr.50
Individual Trabeculae Segmentation (ITS)–Based Morphological Analysis of High-Resolution Peripheral Quantitative Computed Tomography Images Detects Abnormal Trabecular Plate and Rod Microarchitecture in Premenopausal Women With Idiopathic Osteoporosis
X. Liu (2010)
10.1210/JC.2004-2042
Low bone formation in premenopausal women with idiopathic osteoporosis.
Marcella A Donovan (2005)
10.1007/s00198-011-1560-y
Premenopausal women with idiopathic low-trauma fractures and/or low bone mineral density
A. Cohen (2011)
10.1136/bmj.289.6444.517
Impaired osteoblast function in osteoporosis: comparison between calcium balance and dynamic histomorphometry.
M. Arlot (1984)
10.4158/EP.6.4.296
Osteoporosis and low bone mass in premenopausal and perimenopausal women.
C. A. Moreira Kulak (2000)
10.1007/s00198-003-1562-5
Risk factors for low bone mineral density and the 6-year rate of bone loss among premenopausal and perimenopausal women
K. E. Bainbridge (2003)
10.1385/JCD:7:1:85
Bone densitometry in premenopausal women: synthesis and review.
A. Khan (2004)
10.1016/j.bone.2008.11.004
Vertebral fractures are associated with increased cortical porosity in iliac crest bone biopsy of men with idiopathic osteoporosis.
A. Ostertag (2009)
10.1016/J.BONE.2007.03.019
Transmenopausal changes in the trabecular bone structure.
M. Akhter (2007)
10.1016/8756-3282(94)90280-1
Epidemiology and clinical features of osteoporosis in young individuals.
S. Khosla (1994)
10.1172/JCI111096
Relationships between surface, volume, and thickness of iliac trabecular bone in aging and in osteoporosis. Implications for the microanatomic and cellular mechanisms of bone loss.
A. Parfitt (1983)
10.1210/JCEM.82.9.4148
Reduced serum levels of the growth hormone-dependent insulin-like growth factor binding protein and a negative bone balance at the level of individual remodeling units in idiopathic osteoporosis in men.
A. Johansson (1997)
10.1210/jc.2009-0996
Bone microarchitecture and stiffness in premenopausal women with idiopathic osteoporosis.
A. Cohen (2009)
10.1007/s00223-009-9239-5
Bone Histomorphometry in Male Idiopathic Osteoporosis
Y. Pernow (2009)
10.1172/JCI115418
Decreased DNA synthesis by cultured osteoblastic cells in eugonadal osteoporotic men with defective bone formation.
P. Marie (1991)
10.1001/ARCHINTE.1982.00340200053014
Osteoporosis in young men: a syndrome of hypercalciuria and accelerated bone turnover.
H. Perry (1982)
10.1007/BF01623819
Impaired bone formation in male idiopathic osteoporosis: Further reduction in the presence of concomitant hypercalciuria
J. Zerwekh (2005)
10.1210/JCEM.82.9.4253
Insulin-like growth factor-I in men with idiopathic osteoporosis.
E. Kurland (1997)
10.1097/00007611-200406000-00006
Low Bone Mineral Density in Premenopausal Women
E. Lewiecki (2004)
10.1210/JCEM-65-1-53
Bone histomorphometry in hypogonadal and eugonadal men with spinal osteoporosis.
J. A. Jackson (1987)
10.1002/JBMR.5650020617
Bone histomorphometry: Standardization of nomenclature, symbols, and units: Report of the asbmr histomorphometry nomenclature committee
A. Parfitt (1987)
10.1001/ARCHINTE.164.6.603
Clinical considerations in premenopausal osteoporosis.
M. Gourlay (2004)
10.1007/BF01623434
Bone mass measurement for premenopausal women
R. Lindsay (1994)
10.1002/NME.2101
A scalable multi‐level preconditioner for matrix‐free µ‐finite element analysis of human bone structures
P. Arbenz (2008)
10.1007/BF02555976
Health and hormonal characteristics of premenopausal women with lower bone mass
M. Sowers (2007)



This paper is referenced by
10.1016/j.bone.2012.09.020
A case-control study of fractures in men with idiopathic osteoporosis: fractures are associated with older age and low cortical bone density.
A. Ostertag (2013)
10.1007/s11914-017-0404-x
Vertebral Imaging in the Diagnosis of Osteoporosis: a Clinician’s Perspective
Sharon H. Chou (2017)
Baseline mineralizing surface determines the magnitude of the bisphosphonate effect on cortical bone mineralization in postmenopausal osteoporotic patients
B. Misof (2017)
10.1002/(issn)1523-4681
Journal of Bone and Mineral Research
Silvia Hayer (2019)
10.1002/jbmr.2549
Sclerostin Antibody Preserves the Morphology and Structure of Osteocytes and Blocks the Severe Skeletal Deterioration After Motor‐Complete Spinal Cord Injury in Rats
W. Qin (2015)
10.1002/jbmr.3750
Women With Pregnancy and Lactation–Associated Osteoporosis (PLO) Have Low Bone Remodeling Rates at the Tissue Level
A. Cohen (2019)
10.1002/jbmr.1673
Bone strength and surrogate markers: The first, second, and third fiddle
P. Miller (2012)
THE EFFECT OF VARIOUS PATHOLOGIES ON BONE QUALITY
D. Porter (2014)
RELATIONSHIPS OF LONG-TERM BISPHOSPHONATE TREATMENT WITH MEASURES OF BONE MICROARCHITECTURE AND MECHANICAL COMPETENCE
J. J. Ward (2014)
10.1002/jbmr.1699
Bone material properties in premenopausal women with idiopathic osteoporosis
B. Misof (2012)
10.1016/B978-0-12-397165-4.00028-9
The Differential Diagnosis of Adult Osteogenesis Imperfecta
Alan L. Burshell (2014)
10.1002/9781118453926.ch63
63. Premenopausal Osteoporosis
Adi Cohen and (2013)
10.1097/BOR.0000000000000400
Osteoporosis in premenopausal women
B. Langdahl (2017)
10.1210/jc.2015-2829
Bone Density After Teriparatide Discontinuation in Premenopausal Idiopathic Osteoporosis.
A. Cohen (2015)
10.2106/JBJS.L.01281
Low-energy fractures without low T-scores characteristic of osteoporosis: a possible bone matrix disorder.
H. Malluche (2013)
How to manage osteoporosis before the age of 50
S. Rozenberga (2020)
10.1210/jc.2013-1172
Teriparatide for idiopathic osteoporosis in premenopausal women: a pilot study.
A. Cohen (2013)
FINITE ELEMENT ANALYSIS OF CANCELLOUS BONE
Lucas T Wilkerson (2012)
10.1016/j.maturitas.2020.05.004
How to manage osteoporosis before the age of 50.
S. Rozenberg (2020)
10.1016/j.csm.2017.05.006
Osteopenia and Osteoporosis in Female Athletes.
J. Macknight (2017)
10.1210/jc.2011-1654
A population-based study examining calcaneus quantitative ultrasound and its optimal cut-points to discriminate osteoporotic fractures among 9352 Chinese women and men.
J. Liu (2012)
10.1016/j.jcms.2014.05.004
Osseous alterations in the condylar head after unilateral surgical directional change in rabbit mandibular condyles: preliminary study.
H. J. Yang (2014)
10.1016/j.jocd.2018.09.010
Proceedings of the 2018 Santa Fe Bone Symposium: Advances in the Management of Osteoporosis.
E. Lewiecki (2019)
10.1210/jc.2012-2099
Central QCT reveals lower volumetric BMD and stiffness in premenopausal women with idiopathic osteoporosis, regardless of fracture history.
A. Cohen (2012)
10.1210/jc.2015-3451
Insulin Resistance Negatively Influences the Muscle-Dependent IGF-1-Bone Mass Relationship in Premenarcheal Girls.
J. Kindler (2016)
10.3109/07435800.2015.1005746
Update on osteoporosis from the 2014 Santa Fe Bone symposium
E. Lewiecki (2015)
10.1210/clinem/dgaa489
Effect of Teriparatide on Bone Remodeling and Density in Premenopausal Idiopathic Osteoporosis: A Phase II Trial.
A. Cohen (2020)
10.1210/jc.2014-1041
Teriparatide increases strength of the peripheral skeleton in premenopausal women with idiopathic osteoporosis: a pilot HR-pQCT study.
K. Nishiyama (2014)
10.1007/s00198-015-3161-7
Marrow adiposity assessed on transiliac crest biopsy samples correlates with noninvasive measurement of marrow adiposity by proton magnetic resonance spectroscopy (1H-MRS) at the spine but not the femur
A. Cohen (2015)
10.1186/1476-511X-11-37
Low fatness, reduced fat intake and adequate plasmatic concentrations of LDL-cholesterol are associated with high bone mineral density in women: a cross-sectional study with control group
K. Sarkis (2011)
10.1016/B978-0-12-415853-5.00045-5
Osteoporosis in Premenopausal Women
A. Cohen (2013)
10.1002/jbmr.2144
Skeletal Structure in Postmenopausal Women With Osteopenia and Fractures Is Characterized by Abnormal Trabecular Plates and Cortical Thinning
E. Stein (2014)
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