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Trabecular bone is more deteriorated in spinal cord injured versus estrogen-free postmenopausal women

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Abstract

The prevalence of osteoporosis is high among postmenopausal women and individuals sustaining a spinal cord injury (SCI). We assessed the effects of estrogen loss and unloading on the trabecular bone of the knee in women. Pre- and postmenopausal ambulatory women (n=17) were compared to pre- and postmenopausal women with SCI (n=20). High-resolution magnetic resonance imaging was used to compare groups on apparent measures of trabecular bone volume, trabecular number, trabecular spacing, and trabecular thickness in the distal femur and proximal tibia, regions with a high proportion of trabecular bone and the most common fracture site for SCI patients. Trabecular bone was deteriorated in women with SCI compared to ambulatory women. SCI groups had fewer, (−19 and −26% less) and thinner trabeculae (−6%) that were spaced further apart (40% and 62% more space between structures) resulting in less trabecular bone volume (−22% and −33%) compared to the ambulatory groups (tibia and femur, respectively). Postmenopausal women with SCI also had 34% greater trabecular spacing in the tibia compared to the 40-year-old premenopausal women with SCI, showing an interaction between unloading and estrogen loss. Middle-aged postmenopausal, ambulatory women, not taking estrogen or medications that affect bone, did not show the deteriorated trabeculae that were evident in women with SCI, nor did they show differences in distal femur and proximal tibia trabeculae compared to a premenopausal group. We conclude that the effect of unloading on bone architecture is greater than that of estrogen loss in middle-aged women.

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Acknowledgements

The authors would like to thank Carolyn Sharp for her technical expertise and Leslie VanHiel for assistance with subject recruitment. This study was supported by the Biomedical and Health Science Institute at the University of Georgia, Shepherd Center, and the National Institutes of Health (HD40323, GAD).

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Authors and Affiliations

  1. Department of Exercise Science, University of Georgia, 300 River Rd, Athens, GA, 30602, USA

    Jill M. Slade & Gary A. Dudley

  2. Department of Physical Therapy, Louisiana State University Health Sciences Center, 1900 Gravier Street, New Orleans, LA, 70112, USA

    C. Scott Bickel

  3. Department of Health, Nutrition and Exercise Sciences, University of Delaware, Newark, DE, 19716, USA

    Christopher M. Modlesky

  4. Department of Radiology, UC-San Francisco, 1 Irving Street, San Francisco, CA, 94143, USA

    Sharmila Majumdar

  5. Shepherd Center, 2020 Peachtree Rd NW, Atlanta, GA , 30309, USA

    Gary A. Dudley

  6. 2201 Biomedical and Physical Sciences, Department of Physiology, Michigan State University, East Lansing, MI, 48824, USA

    Jill M. Slade

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  1. Jill M. Slade
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Correspondence to Jill M. Slade.

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Slade, J.M., Bickel, C.S., Modlesky, C.M. et al. Trabecular bone is more deteriorated in spinal cord injured versus estrogen-free postmenopausal women. Osteoporos Int 16, 263–272 (2005). https://doi.org/10.1007/s00198-004-1665-7

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  • DOI: https://doi.org/10.1007/s00198-004-1665-7

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