Idiopathic osteoporosis (IOP) in premenopausal women is an uncommon disorder of uncertain pathogenesis. These authors examined the microarchitectural and remodeling features of premenopausal women with IOP. Transiliac biopsies after tetracycline labeling were performed in 104 women: 45 with fragility fractures (IOP), 19 with idiopathic low bone mineral density (Z score ≤-2.0) and 40 controls. Compared with controls, affected women had thinner cortices; fewer, thinner, more widely separated, and heterogeneously distributed trabeculae; reduced stiffness; and lower osteoid width and mean wall width. All parameters were indistinguishable between women with IOP and idiopathic low bone mineral density. The authors conclude that women with IOP may have high, normal or low bone turnover. However, those with low bone turnover have the most marked deficits in microarchitecture and stiffness.
Cohen A, Dempster DW, Recker RR, Stein EM, Lappe JM, Zhou H, et al