Abstract
Using dual x-ray absorptiometry (DXA), quantitative computed tomography (QCT), and microdensitometry (MD) methods, we performed a 3-year longitudinal study of bone changes induced by surgical menopause, i.e., hysterectomy with unilateral or bilateral oophorectomy (OVX), in 52 nonmenopausal women. In the trabecular spine, bone mineral content (Dc) and bone mineral density (Dd) were determined by DXA, and bone mineral density (L2 and L3) was determined by QCT. In the cortical metacarpals, cortical thickness (MCI) and bone mineral density (GSmin/max and ∑ GS/D) were determined by MD. Bone reduction in axial and peripheral body sites was evaluated by all determinations 2.92 years after OVX. In the bilateral OVX group, accelerated bone changes began to appear immediately after OVX, and this rapid phase of bone loss persisted in the follow-up period. In the unilateral OVX group, however, no accelerated changes were detected and the slow phase of bone loss continued throughout the follow-up period; bone reduction in the bilateral group was thus greater than that in the unilateral group. Although there was a significant correlation between trabecular and cortical bone changes, the discrepancies between DXA, QCT, and MD determinations at the two body sites meant that it was not possible to precisely predict one bone measurement from another. The reliability of DXA and QCT determinations was not significantly different, and these two determinations afforded better discrimination than MD for detecting accelerated trabecular bone changes in the rapid phase early after OVX. The sensitivity of indices in MD for detecting cortical bone mass change was found to be, in descending order, MCI, GSmin/max, and ∑ GS/D, whereas on the MD determination, the sensitivity for the follow-up of bone changes was in the reverse order. MD was more suitable for discriminating the small cortical bone changes in the prolonged slow phase after OVX. To evaluate the influence of surgical menopause by determining differential trabecular and cortical bone changes, simultaneous assessment at both vertebral and peripheral sites was indispensable. Changes in the peripheral metacarpals did not prove to be a reliable indicator of changes in the axial spine.
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Dokou, S., Satou, Y. & Soeda, Y. Trabecular and cortical bone changes in vertebral and peripheral skeletons induced by surgical menopause. J Bone Miner Metab 12, 83–93 (1994). https://doi.org/10.1007/BF02383414
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DOI: https://doi.org/10.1007/BF02383414