{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T22:05:47Z","timestamp":1782770747434,"version":"3.54.5"},"reference-count":27,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2017,12,8]],"date-time":"2017-12-08T00:00:00Z","timestamp":1512691200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["ID 628911"],"award-info":[{"award-number":["ID 628911"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005416","name":"Norges Forskningsr\u00e5d","doi-asserted-by":"publisher","award":["178588\/V50"],"award-info":[{"award-number":["178588\/V50"]}],"id":[{"id":"10.13039\/501100005416","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,4,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:sec>\n                  <jats:title>\u2003<\/jats:title>\n                  <jats:p>After menopause, remodeling becomes unbalanced and rapid. Each of the many remodeling transactions deposits less bone than it resorbed, producing microstructural deterioration. Trabecular bone is said to be lost more rapidly than cortical bone. However, because 80% of the skeleton is cortical, we hypothesized that most menopause-related bone loss and changes in bone microstructure are cortical, not trabecular in origin, and are the result of intracortical remodeling. Distal tibial and distal radial microstructure were quantified during 3.1 years (range, 1.5 to 4.5 years) of follow-up using high-resolution peripheral quantitative computed tomography and StrAx software in 199 monozygotic and 125 dizygotic twin pairs aged 25 to 75 years in Melbourne, Australia. The annual increases in tibial cortical porosity accelerated, being 0.44%, 0.80%, and 1.40% in women remaining premenopausal, transitioning to perimenopause, and from perimenopausal to postmenopause, respectively. Porosity increased in the compact-appearing, outer, and inner transitional zones of the cortex (all p\u2009&amp;lt;\u20090.001). The annual decrease in trabecular bone volume\/tissue volume (BV\/TV) also accelerated, being 0.17%, 0.26%, and 0.31%, respectively. Little bone loss was observed before menopause. The reduction in BV\/TV was due to a decrease in trabecular number (p\u2009&amp;lt;\u20090.001). The greatest bone loss, 7.7\u2009mg hydroxyapatite (HA) annually, occurred in women transitioning from perimenopausal to postmenopause and of this, 6.1\u2009mg HA (80%) was cortical. Results were similar for the distal radius. Despite microarchitectural changes, no significant bone loss was observed before menopause. Over 90% of appendicular bone loss occurs during and after menopause, over 80% is cortical, and this may explain why 80% of fractures are appendicular. \u00a9 2017 American Society for Bone and Mineral Research.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1002\/jbmr.3333","type":"journal-article","created":{"date-parts":[[2017,12,8]],"date-time":"2017-12-08T05:58:50Z","timestamp":1512712730000},"page":"598-605","source":"Crossref","is-referenced-by-count":48,"title":["Menopause-Related Appendicular Bone Loss is Mainly Cortical and Results in Increased Cortical Porosity"],"prefix":"10.1093","volume":"33","author":[{"given":"\u00c5shild","family":"Bj\u00f8rnerem","sequence":"first","affiliation":[{"name":"Department of Obstetrics and GynaecologyUniversity Hospital of North NorwayTroms\u00f8Norway"},{"name":"Department of Clinical MedicineUiT The Arctic University of NorwayTroms\u00f8Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaofang","family":"Wang","sequence":"additional","affiliation":[{"name":"Endocrine CentreAustin Health, University of MelbourneMelbourneAustralia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minh","family":"Bui","sequence":"additional","affiliation":[{"name":"Centre for Epidemiology and BiostatisticsSchool of Population and Global HealthUniversity of MelbourneMelbourneAustralia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Ghasem-Zadeh","sequence":"additional","affiliation":[{"name":"Endocrine CentreAustin Health, University of MelbourneMelbourneAustralia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John L","family":"Hopper","sequence":"additional","affiliation":[{"name":"Centre for Epidemiology and BiostatisticsSchool of Population and Global HealthUniversity of MelbourneMelbourneAustralia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roger","family":"Zebaze","sequence":"additional","affiliation":[{"name":"Endocrine CentreAustin Health, University of MelbourneMelbourneAustralia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ego","family":"Seeman","sequence":"additional","affiliation":[{"name":"Institute for Health and Ageing (IHA)Australian Catholic UniversityMelbourneAustralia"},{"name":"Endocrine CentreAustin Health, University of MelbourneMelbourneAustralia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2017,12,8]]},"reference":[{"key":"2024021014355553200_jbmr3333-bib-0001","first-page":"71","author":"Parfitt"},{"issue":"(1)","key":"2024021014355553200_jbmr3333-bib-0002","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1016\/S8756-3282(01)00642-1","article-title":"Targeted and non-targeted bone remodeling: relationship to basic multicellular unit origination and progression","volume":"30","author":"Parfitt","year":"2002","journal-title":"Bone"},{"issue":"(4)","key":"2024021014355553200_jbmr3333-bib-0003","doi-asserted-by":"crossref","first-page":"1396","DOI":"10.1172\/JCI111096","article-title":"Relationships between surface, volume, and thickness of iliac trabecular bone in aging and in osteoporosis. 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