HR-pQCT reveals marked trabecular and cortical structural deficits in women with pregnancy and lactation-associated osteoporosis (PLO)
Authors' conclusion
This structural study increases our mechanistic understanding of the severe bone fragility presentation that characterizes PLO and also highlights areas of potential mechanistic heterogeneity that require additional investigation.
Study context
- Population
- Women with PLO (aged 34 ± 6 yr) vs healthy premenopausal controls and premenopausal women with idiopathic osteoporotic fractures
- Participants
- 59 / 28 / 50
- Exposure
- PLO vs healthy premenopausal controls and vs non-PLO IOP
- PLOn = 59
- Controlsn = 28reference
- non-PLO IOPn = 50
- Outcome
- DXA aBMD and HR-pQCT volumetric BMD (vBMD), microarchitecture and strength at distal radius and tibia
Main finding
As reported in the abstract
- Vs non-PLO IOP, PLO had significant deficits in trabecular microstructure and cortical thickness at the radius only
- PLO vs Controls: all p<.001
- PLO vs non-PLO IOP: all p<.05
- PLO vs Controls: all p<.001
- PLO vs non-PLO IOP: all p ≤ .01
Observational data: associations, not effects.
Further findings
| Outcome | P value |
|---|---|
| Clinical presentation: vertebral and multiple fractures in PLOPLO vs non-PLO IOP · more severe presentation with PLO | P < 0.001 |
- Clinical presentation: vertebral and multiple fractures in PLO — PLO with vertebral fractures
- 80%
- Clinical presentation: vertebral and multiple fractures in PLO — PLO with multiple fractures
- 92%
PLO subgroups by clinical factors
- Vertebral fractures: lower spine areal BMD (aBMD) and higher tibial cortical porosity, otherwise structurally similar to nonvertebral group
- Prior heparin exposure: larger bone size and trabecular area
- Renal stones: smaller bone size and lower 1/3 radius aBMD
Recent PLO (≤12 M postpartum; n = 25) vs distant PLO (>12 M postpartum; n = 34)
- Recent PLO had significantly lower aBMD than distant PLO
- Radial/tibial HR-pQCT measures did not differ
Original publication
HR-pQCT reveals marked trabecular and cortical structural deficits in women with pregnancy and lactation-associated osteoporosis (PLO). J Bone Miner Res. Published 18 October 2024. doi:10.
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