{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,20]],"date-time":"2025-09-20T20:44:54Z","timestamp":1758401094098,"version":"3.37.3"},"reference-count":48,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2023,12,8]],"date-time":"2023-12-08T00:00:00Z","timestamp":1701993600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Departmental scholarship from Monash University"},{"DOI":"10.13039\/100019688","name":"Department of Medicine","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100019688","id-type":"DOI","asserted-by":"publisher"}]},{"name":"School of Clinical Sciences"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,2,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Women with premature ovarian insufficiency (POI) lack oestrogen, which is a key determinant of bone growth, epiphyseal closure, and bone tissue organisation. Although dual-energy X-ray absorptiometry (DXA)\u2013derived areal bone mineral density (BMD) remains the gold standard for fracture risk evaluation, it does not fully characterise the skeletal abnormalities present in these women. Hence, we aimed to assess hip\/femur anatomy, strength, and geometry and femoral alignment using advanced hip analysis (AHA).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We conducted a cross-sectional, case\u2013control study including 89 women with spontaneous normal karyotype POI (s-POI) or iatrogenic POI (i-POI), aged 20-50 years compared with 89 age- and body mass index (BMI)\u2013matched population-based female controls. Hip anatomy, strength, geometrical parameters, and femur alignment were measured using hip DXA images and Lunar AHA software. Femoral orientation angle (FOA) was quantified as the overall orientation of the femur with respect to the axis of the forces transmitted from the upper body.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The median age of POI diagnosis was 35 (18-40) years; the mean POI duration at the time of DXA was 2.07 (range 0-13) years, and 84% of POI women received oestrogen therapy. Areal BMD at all sites was significantly lower in the POI group (all P &amp;lt; .05). Indices of compressive and bending strength were lower in women with POI compared with controls, specifically the cross-sectional area (CSA, mm2) and section modulus (SM, mm3) (139.30 \u00b1 29.08 vs 157.29 \u00b1 22.26, P &amp;lt; .001 and 665.21 \u00b1 129.54 vs 575.53 \u00b1 150.88, P &amp;lt; .001, respectively). The FOA was smaller (124.99 \u00b1 3.18) in women with POI as compared with controls (128.04 \u00b1 3.80; P &amp;lt; .001) at baseline and after adjusting for height and femoral neck BMD.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Alongside lower BMD at multiple sites, the femora of women with POI demonstrate reduced strength and a misalignment with forces transmitted from the upper body. Further research is needed to establish the role of these newly identified features and their role in fracture risk prediction in this population.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ejendo\/lvad158","type":"journal-article","created":{"date-parts":[[2023,12,8]],"date-time":"2023-12-08T19:11:35Z","timestamp":1702062695000},"page":"182-191","source":"Crossref","is-referenced-by-count":2,"title":["Femora of women with premature ovarian insufficiency exhibit reduced strength and misalignment with the transmitted vertical forces from the upper body"],"prefix":"10.1093","volume":"190","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1160-1210","authenticated-orcid":false,"given":"Navira","family":"Samad","sequence":"first","affiliation":[{"name":"Department of Endocrinology, Monash Health , Clayton, 3168 VIC , Australia"},{"name":"Department of Medicine, School of Clinical Sciences, Monash University , Clayton, 3168 VIC , Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hanh H","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Monash Health , Clayton, 3168 VIC , Australia"},{"name":"Department of Medicine, School of Clinical Sciences, Monash University , Clayton, 3168 VIC , Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jasna","family":"Aleksova","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Monash Health , Clayton, 3168 VIC , Australia"},{"name":"Department of Medicine, School of Clinical Sciences, Monash University , Clayton, 3168 VIC , Australia"},{"name":"Hudson Institute of Medical Research , Melbourne, 3168 VIC , Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julie A","family":"Pasco","sequence":"additional","affiliation":[{"name":"Deakin University, IMPACT\u2014Institute for Physical and Mental Health and Clinical Translation , Geelong, 3220 VIC , Australia"},{"name":"Department of Medicine, Western Health, The University of Melbourne , St Albans, 3021 VIC , Australia"},{"name":"Department of Epidemiology and Preventive Medicine, Monash University , Clayton, 3168 VIC , Australia"},{"name":"Barwon Health, University Hospital Geelong , Geelong, 3220 VIC , Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark A","family":"Kotowicz","sequence":"additional","affiliation":[{"name":"Deakin University, IMPACT\u2014Institute for Physical and Mental Health and Clinical Translation , Geelong, 3220 VIC , Australia"},{"name":"Department of Medicine, Western Health, The University of Melbourne , St Albans, 3021 VIC , Australia"},{"name":"Department of Endocrinology & Diabetes, University Hospital Geelong, Barwon Health , Geelong, 3220 VIC , Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2921-3742","authenticated-orcid":false,"given":"Peter R","family":"Ebeling","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Monash Health , Clayton, 3168 VIC , Australia"},{"name":"Department of Medicine, School of Clinical Sciences, Monash University , Clayton, 3168 VIC , Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amanda J","family":"Vincent","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Monash Health , Clayton, 3168 VIC , Australia"},{"name":"Monash Centre for Health Research and Implementation, Monash University , 3168 VIC , Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roger","family":"Zebaze","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Monash Health , Clayton, 3168 VIC , Australia"},{"name":"Department of Medicine, School of Clinical Sciences, Monash University , Clayton, 3168 VIC , 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