Type 1

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The page below is a sample from the LabCE course Osteoporosis and the Clinical Laboratory. Access the complete course and earn ASCLS P.A.C.E.-approved continuing education credits by subscribing online.

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Type 1

Type 1 (postmenopausal osteoporosis) occurs in 5% to 20% of women, affecting those within 15 to 20 years of menopause, with a peak incidence in the 60s and early 70s. The incidence in women is eight times higher than that in men. The frequency of postmenopausal osteoporosis accounts for the overall female-male ratio of 2:1 to 3:1.
The decrease in estrogen is thought to cause this form of osteoporosis, making the skeletal bones more sensitive to parathyroid hormone (PTH), resulting in increased calcium resorption from bone. This then turns on a negative feedback mechanism which decreases PTH secretion, 1,25-dihydroxy vitamin D production, and calcium absorption and ultimately causes loss of bone, leading to fractures and osteoporosis.
Women can lose around 2% to 3% of their bone per year for the first 5 years after menopause. Because of the drop in estrogen production, women lose nearly 50% of their trabecular (spongy) bone and 35% of their cortical (outer covering of the bone) bone throughout their lifetime, whereas men lose only 25% of both types of bone. At least 75% of the bone loss that occurs in women during the first two decades after menopause can be attributed to a lack of estrogen rather than to aging. Bone loss associated with menopause does not begin with the onset of amenorrhea but may occur 1 to 3 years before the actual cessation of menstrual periods.