The authors would also like to thank Merijn de Bakker and Gerda Lamers for technical assistance, Remco de Linsitinib Zwijger for help with imaging, Daisy van der Heijden and Senna van der Heijden for the Western blot and Hans Von den Hoff for his assistance with MMP zymography and supplying hrMMPs. “
“A lactating mother secretes about 200–300 mg/day of calcium into her breast milk [1]. This extra demand for calcium represents a considerable proportion of the calcium intake for many lactating women [2]. Dual-energy X-ray absorptiometry (DXA) studies have demonstrated that during

the first 3–6 months of lactation, there are temporary decreases of bone mineral (reported as areal bone mineral density [BMDa] or bone area adjusted bone mineral content [BA-adj BMC]) at the total hip (–1% to −4%) and femoral neck (–2% to –7%) [2], [3], [4], [5], [6], [7], [8] and [9]. The bone mineral changes during lactation are greater and more rapid than the average annual bone mineral loss of about 1–3% experienced

by postmenopausal women [2] and [10]. This release of calcium from the maternal skeleton may provide some of Olaparib mw the extra calcium required for breast milk production. There has been concern that this decrease in bone mineral could lead to reductions in the bone strength of lactating mothers and make them more prone to fracture in later life. Although uncommon, fractures during lactation are well documented [11] and [12]. However, in one of these studies some women were

known to have low bone density and/or other risk factors for osteoporosis [11]. In addition, retrospective studies investigating the relationship between parity and/or lactation history and fracture risk and bone mineral status are conflicting. Several studies show no relationship [13] and [14]. Other studies report an increased risk of lower bone mineral [15]. However, many studies report an improved bone status [16] or a reduced fracture risk as a result of breast feeding or high Mirabegron parity [17], [18], [19], [20] and [21]. Bone strength is related not only to bone mass but also to bone structural geometry. Bone structural geometry is the architectural arrangement of bone tissue around the bone axis along, or about which it is loaded. Hence, if there are compensating changes to bone structural geometry it is possible for bone mineral mass to decrease with no, or minimal compromise to mechanical strength [22] and [23]. It is now possible to use biomechanical engineering principles to investigate bone geometry from projected 2-D images of the hip generated from DXA scans using the Hip Structural Analysis (HSA) method [24] and [25]. This uses raw spatial and mineral mass DXA information from the proximal femur to compute structural geometrical variables at three specific sites: the narrow neck, intertrochanteric and proximal shaft regions.