BACKGROUND: @entity604 increases after menopause. However, bone strength also depends on structural characteristics such as bone size. Whether bone size increases as a result of periosteal apposition and whether a strength index accounting for both bone density and bone size might predict the risk of @entity174 better than bone density alone are unclear. METHODS: Bone mass and the skeletal structure of the distal radius were evaluated by single-photon absorptiometry every other year in 108 @entity1 , all of whom were followed from the time of menopause for a mean period of 15 years. Postmenopausal serum @entity53 levels and @entity174 of the distal radius were noted. RESULTS: The mean (+/-SD) annual decrease in bone mineral density was 1.9+/-0.7 percent. The medullary bone diameter increased annually by 1.1+/-0.9 percent, and the periosteal diameter by 0.7+/-0.3 percent; the strength index decreased by 0.7+/-0.7 percent. The expansion of the medullary diameter and the expansion of the periosteal diameter were correlated with one another (r = 0.54, P<0.001), and @entity1 in the highest quartile of medullary expansion had more loss of bone mineral density and greater periosteal apposition than @entity1 in the lowest quartile (P<0.001 for both comparisons). The postmenopausal serum @entity53 level was correlated with changes in the periosteal diameter (r = -0.25, P=0.009) and with changes in bone mineral density (r = 0.34, P<0.001). A 1-SD decrement in the strength index at base line was associated with a risk ratio for @entity174 of the distal radius of 3.8 (95 percent confidence interval, 1.8 to 8.0). CONCLUSIONS: Increased @entity604 after menopause is associated with increased periosteal apposition, which partially preserves bone strength. A strength index may be a helpful predictor of the risk of @entity174 .

XXXX and bone size after menopause.

@entity1 :: ('9606', 'Species') :: ['women'] @entity604 :: ('MESH:D016301', 'Disease') :: ['Bone loss', 'bone loss'] @entity174 :: ('MESH:D050723', 'Disease') :: ['fractures', 'fracture'] @entity53 :: ('MESH:D004958', 'Chemical') :: ['estradiol']
@entity604 :: (MESH:D016301,Disease) :: ['Bone loss']
