INTRODUCTION: In men, idiopathic osteoporosis (IOP) is often associated with low serum insulin-like growth factor (IGF-1) and reduced bone formation. The characteristics of premenopausal women with IOP are not well defined. We aimed to define the clinical, reproductive, and biochemical characteristics of premenopausal women with unexplained osteoporosis. METHODS: This is a cross-sectional study of 64 women with unexplained osteoporosis, 45 with fragility fractures, 19 with low bone mineral density (BMD; Z-score less than or equal to -2.0) and 40 normal controls. The following are the main outcome measures: clinical and anthropometric characteristics, reproductive history, BMD, gonadal and calciotropic hormones, IGF-1, and bone turnover markers (BTMs). RESULTS: Subjects had lower BMI and BMD than controls, but serum and urinary calcium, serum estradiol, vitamin D metabolites, IGF-1, and most BTMs were similar. Serum parathyroid hormone (PTH) and the resorption marker, tartrate-resistant acid phosphatase (TRAP5b), were significantly higher in both groups of subjects than controls and directly associated in all groups. Serum IGF-1 and all BTMs were directly associated in controls, but the association was not significant after controlling for age. There was no relationship between serum IGF-1 and BTMs in subjects. There were few differences between women with fractures and low BMD. CONCLUSIONS: Higher serum TRAP5b and PTH suggest that increased bone turnover, possibly related to subclinical secondary hyperparathyroidism could contribute to the pathogenesis of IOP. The absence of differences between women with fractures and those with very low BMD indicates that this distinction may not be clinically useful to categorize young women with osteoporosis.
INTRODUCTION: In men, idiopathic osteoporosis (IOP) is often associated with low serum insulin-like growth factor (IGF-1) and reduced bone formation. The characteristics of premenopausal women with IOP are not well defined. We aimed to define the clinical, reproductive, and biochemical characteristics of premenopausal women with unexplained osteoporosis. METHODS: This is a cross-sectional study of 64 women with unexplained osteoporosis, 45 with fragility fractures, 19 with low bone mineral density (BMD; Z-score less than or equal to -2.0) and 40 normal controls. The following are the main outcome measures: clinical and anthropometric characteristics, reproductive history, BMD, gonadal and calciotropic hormones, IGF-1, and bone turnover markers (BTMs). RESULTS: Subjects had lower BMI and BMD than controls, but serum and urinary calcium, serum estradiol, vitamin D metabolites, IGF-1, and most BTMs were similar. Serum parathyroid hormone (PTH) and the resorption marker, tartrate-resistant acid phosphatase (TRAP5b), were significantly higher in both groups of subjects than controls and directly associated in all groups. Serum IGF-1 and all BTMs were directly associated in controls, but the association was not significant after controlling for age. There was no relationship between serum IGF-1 and BTMs in subjects. There were few differences between women with fractures and low BMD. CONCLUSIONS: Higher serum TRAP5b and PTH suggest that increased bone turnover, possibly related to subclinical secondary hyperparathyroidism could contribute to the pathogenesis of IOP. The absence of differences between women with fractures and those with very low BMD indicates that this distinction may not be clinically useful to categorize young women with osteoporosis.
Authors: A G Johansson; E F Eriksen; E Lindh; B Langdahl; W F Blum; A Lindahl; O Ljunggren; S Ljunghall Journal: J Clin Endocrinol Metab Date: 1997-09 Impact factor: 5.958
Authors: E S Kurland; C J Rosen; F Cosman; D McMahon; F Chan; E Shane; R Lindsay; D Dempster; J P Bilezikian Journal: J Clin Endocrinol Metab Date: 1997-09 Impact factor: 5.958
Authors: P Peris; N Guañabens; A Monegal; X Suris; L Alvarez; M J Martinez de Osaba; M V Hernandez; J Muñoz-Gomez Journal: Br J Rheumatol Date: 1995-10
Authors: Claudie Berger; Linda S Greene-Finestone; Lisa Langsetmo; Nancy Kreiger; Lawrence Joseph; Christopher S Kovacs; J Brent Richards; Nick Hidiroglou; Kurtis Sarafin; K Shawn Davison; Jonathan D Adachi; Jacques Brown; David A Hanley; Jerilynn C Prior; David Goltzman Journal: J Bone Miner Res Date: 2012-06 Impact factor: 6.741
Authors: Adi Cohen; David W Dempster; Emily M Stein; Thomas L Nickolas; Hua Zhou; Donald J McMahon; Ralph Müller; Thomas Kohler; Alexander Zwahlen; Joan M Lappe; Polly Young; Robert R Recker; Elizabeth Shane Journal: J Clin Endocrinol Metab Date: 2012-06-14 Impact factor: 5.958
Authors: Adi Cohen; David W Dempster; Robert R Recker; Emily M Stein; Joan M Lappe; Hua Zhou; Andreas J Wirth; G Harry van Lenthe; Thomas Kohler; Alexander Zwahlen; Ralph Müller; Clifford J Rosen; Serge Cremers; Thomas L Nickolas; Donald J McMahon; Halley Rogers; Ronald B Staron; Jeanette LeMaster; Elizabeth Shane Journal: J Clin Endocrinol Metab Date: 2011-08-10 Impact factor: 5.958
Authors: Barbara M Misof; Sonja Gamsjaeger; Adi Cohen; Birgit Hofstetter; Paul Roschger; Emily Stein; Thomas L Nickolas; Halley F Rogers; David Dempster; Hua Zhou; Robert Recker; Joan Lappe; Donald McMahon; Eleftherios P Paschalis; Peter Fratzl; Elizabeth Shane; Klaus Klaushofer Journal: J Bone Miner Res Date: 2012-12 Impact factor: 6.741
Authors: Daniel G Whitney; Harshvardhan Singh; Freeman Miller; Mary F Barbe; Jill M Slade; Ryan T Pohlig; Christopher M Modlesky Journal: Bone Date: 2016-10-11 Impact factor: 4.398
Authors: Adi Cohen; Thomas F Lang; Donald J McMahon; X Sherry Liu; X Edward Guo; Chiyuan Zhang; Emily M Stein; David W Dempster; Polly Young; Isra Saeed; Joan M Lappe; Robert R Recker; Elizabeth Shane Journal: J Clin Endocrinol Metab Date: 2012-09-07 Impact factor: 5.958