Bone loss or lost bone: rationale and recommendations for the diagnosis and treatment of early postmenopausal bone loss.
Recent reports suggest that bone loss begins during late perimenopause at a dramatic rate, even before estrogen levels plummet. During the ensuing 5 years, there is evidence of the beginnings of microarchitectural deterioration, which impacts bone strength and ultimately enhances its propensity to fracture. The diagnosis of osteoporosis based on T-scores alone, or through stratification for a high fracture risk by FRAX, excludes these women who are rapidly losing bone. Because all antiosteoporosis therapies, in particular bisphosphonates, reduce bone loss, we propose aggressive, likely short-term therapy with a goal to reduce bone loss, stabilize bone density, and prevent microarchitectural deterioration.
Zaidi
Mone
M
The Mount Sinai Bone Program, Box 1055, Mount Sinai School of Medicine, One Gustave Levy Place, New York, NY 10029, USA. mone.zaidi@mssm.edu
Turner
Charles H
CH
Canalis
Ernesto
E
Pacifici
Roberto
R
Sun
Li
L
Iqbal
Jameel
J
Guo
X Edward
XE
Silverman
Stuart
S
Epstein
Solomon
S
Rosen
Clifford J
CJ
D015519:Bone Density; D050071:Bone Density Conservation Agents / Q000627:therapeutic use; D016723:Bone Remodeling; D005260:Female; D005598:Fractures, Spontaneous / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D015663:Osteoporosis, Postmenopausal / Q000175:diagnosis* / Q000188:drug therapy* / Q000503:physiopathology; D047648:Perimenopause; D018570:Risk Assessment
D050071:Bone Density Conservation Agents