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FRIMED-Klinisk medisin og folkehelse

Effects of Pregnancy, Lactation and Menopause on Bone Health

Tildelt: kr 3,1 mill.

Fragility fractures are a common public health problem particularly in Scandinavia. The pathogenesis of bone fragility is multi-factorial. Two factors will be studied ? the effect of pregnancy and menopause. Whether pregnancy and lactation result in bo ne loss is not clear, and if so, whether calcium supplementation prevents bone loss is uncertain. After menopause, bone loss accelerates, but the structural basis underlying this loss of bone and the hormonal factors that contribute are not known. Advan ces in non-invasive technology provide a measurement of the three dimensional architecture of bone and improves the sensitivity of fracture risk prediction. We will recruit pregnant and non-pregnant women from fertility clinics in Melbourne, and random ize the pregnant women to calcium supplementation or placebo in double blind fashion. To study the effects of menopause, twins discordant for menopause will be recruited from the Australian National Health and Medical Research Council Twin Registry. Tro msø Osteoporosis Study has longitudinal data on parity, menopausal status, sex hormones, forearm BMD and fractures, which makes is possible to study the long-term effects of parity on bone health, and the hormones relation to menopausal bone loss and frac ture risk. We address the following questions. Pregnancy 1. During pregnancy and lactation, is there trabecular or cortical bone loss? 2. Is bone loss prevented by calcium supplementation? 3. After pregnancy and after lactation, is any bone lost resto red? 4. Is greater parity associated with deficits in BMD and fractures later in life? Menopause 5. What is the structural basis of bone loss in women during menopause? 6. Does the bone loss occur similarly at weight-bearing and non-weight-bearing sites ? 7. Is estradiol or FSH associated with trabecular, but not cortical structural changes? 8. Is the amount and structural basis of bone loss heritable? 9. Is estradiol the only hormonal change related

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FRIMED-Klinisk medisin og folkehelse