Cortical bone resorption in osteoporosis

A study was made of 110 women: 35 healthy premenopausal, 40 healthy postmenopausal, and 35 women diagnosed as having postmenopausal osteoporosis. The postmenopausal women had similar ages and years since menopause (YSM). In all of the women, total bone mass was evaluated by dual-energy X-ray absorptiometry and metacarpal morphometry was evaluated by radiogrammetry on the second metacarpal of the nondominant hand, performed by computed radiography. An external metacarpal diameter of greater than or equal to 7.4 mm was required as proof of having developed an adequate peak bone mass, The endosteal diameter, which is indicative of bone resorption in both groups of postmenopausal women, obtained in the postmenopausal groups was subtracted from the endosteal diameter obtained in the premenopausal group and the resulting figure was divided by the years since menopause to calculate the rate of cortical bone resorption/year for each group. The endosteal diameters values differed in the three groups studied (P < 0.0001): 3.2 +/- 0.7 mm in the healthy premenopausal women; 3.9 +/- 0.6 mm in the healthy postmenopausal women; and 4.7 +/- 0.5 mm in the osteoporotic postmenopausal women. The rate of cortical bone resorption was 0.068 +/- 0.002 mm/YSM (years since menopause) in the osteoporotic postmenopausal women and 0.033 +/- 0.003 mm/YSM in the healthy postmenopausal women (P < 0.0001). These figures reflect the importance of bone resorption, as opposed to deficient bone formation, as a cause of osteoporosis.