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Natural versus surgical menopause: implications for the pathogenesis of osteoporosis

It is well established that accelerated bone loss occurs in association with oestrogen deprivation as seen following the natural menopause and in premenopausal women undergoing surgical oophorectomy. We have measured serum levels of insulin-like growth factor-I (IGF-I) which is considered to be the local regulator of osteoblast activity (Hock et al. 1988) and one of its binding proteins, insulinlike growth factor binding protein-4 (IGFBP-4), which binds to IGF-I and suppresses its biological activity (Mohan et al. 1989) after either natural menopause or surgical menopause (bilateral oophorectomy). Additionally, the relation between these values and bone mineral density was determined.