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Bone mass, structure, and quality contribute to bone strength, and these parameters act together in various ways during growth to optimize strength. Thus, women with narrow femoral neck widths have proportionately thicker bone cortex but similar areal bone-mineral density (aBMD) as measured by dual-energy x-ray absorptiometry (DXA) than do women with wider femoral necks.
In a study involving 198 women (mean baseline age, 46) who were followed across the menopausal transition, changes in bone-mineral content (BMC) and bone area, but not aBMD, were correlated with femoral neck size. Those with wider femoral necks experienced greater bone loss and smaller compensatory increases in cortical diameter during the 14-year follow-up than did women wi…