Changes in forearm bone mass and bone size after menopause--a mean 24-year prospective study.

OBJECTIVE Bone loss and periosteal expansion is found after menopause. The accelerated early postmenopausal bone loss is not permanent but if the same accounts for the periosteal expansion is unknown. METHODS Bone mineral density (BMD) and skeletal structure of the distal forearm were followed from menopause and on average 24 years (range 18-28) by single-photon absorptiometry at 12 occasions in a population-based sample of 81 Caucasian women with no medication or disease affecting bone metabolism. A Strength Index based on areal BMD and bone structure was calculated. Postmenopausal serum-estradiol levels and incident distal radius fractures were registered. Data are presented as means with 95% confidence interval (95% CI). RESULTS The annual BMD loss in three periods, 0-8, 8-16 and 16-28 years after menopause, was 2.0% (1.6, 2.4), 1.0% (0.6, 1.4) and 1.0% (0.7, 1.3), respectively. The annual periosteal expansion was 1.0% (0.8, 1.3), 0.0% (-0.3, 0.3) and 0.0% (-0.2, 0.2), respectively. Mean post-menopausal oestrogen levels correlated moderately with annual loss in aBMD (r=0.51, p<0.001) but less with the annual changes in bone width (r= -0.22, p=0.06). CONCLUSION Postmenopausal periosteal expansion in the distal forearm seems to occur only in the first postmenopausal decade.