UCLA Division of Geriatrics, Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, CA, 90095-1687, USA.
Department of Geriatric Medicine, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
Osteoporos Int. 2019 Dec;30(12):2449-2457. doi: 10.1007/s00198-019-05099-z. Epub 2019 Aug 31.
We assessed whether a bone resorption marker, measured early in the menopause transition (MT), is associated with change in femoral neck size and strength during the MT. Higher levels of bone resorption were associated with slower increases in femoral neck size and faster decreases in femoral neck strength.
Composite indices of the femoral neck's ability to withstand compressive (compression strength index, CSI) and impact (impact strength index, ISI) forces integrate DXA-derived femoral neck width (FNW), bone mineral density (BMD), and body size. During the menopause transition (MT), FNW increases, and CSI and ISI decrease. This proof-of-concept study assessed whether a bone resorption marker, measured early in the MT, is associated with rates of change in FNW, CSI and ISI during the MT.
We used previously collected bone resorption marker (urine collagen type I N-telopeptide [U-NTX]) and femoral neck strength data from 696 participants from the Study of Women's Health Across the Nation (SWAN), a longitudinal study of the MT in a multi-ethnic cohort of community-dwelling women.
Adjusted for MT stage (pre- vs. early perimenopause), age, body mass index (BMI), bone resorption marker collection time, and study site in multivariable linear regression, bone resorption in pre- and early perimenopause was not associated with transmenopausal decline rate in femoral neck BMD. However, each standard deviation (SD) increase in bone resorption level was associated with 0.2% per year slower increase in FNW (p = 0.03), and 0.3% per year faster declines in CSI (p = 0.02) and ISI (p = 0.01). When restricted to women in early perimenopause, the associations of bone resorption with change in FNW, CSI, and ISI were similar to those in the full sample.
Measuring a bone resorption marker in pre- and early perimenopause may identify women who will experience the greatest loss in bone strength during the MT.
股骨颈抗压（压缩强度指数，CSI）和抗冲击（冲击强度指数，ISI）能力的综合指数综合了 DXA 测量的股骨颈宽度（FNW）、骨密度（BMD）和体型。在绝经过渡期间（MT），FNW 增加，CSI 和 ISI 降低。这项概念验证研究评估了在 MT 早期测量的骨吸收标志物是否与 MT 期间 FNW、CSI 和 ISI 的变化率相关。
我们使用了来自妇女健康研究全国性研究（SWAN）的先前收集的骨吸收标志物（尿型胶原 I N 末端肽[U-NTX]）和股骨颈强度数据，该研究是一项多民族社区居住妇女 MT 的纵向研究。
在多变量线性回归中，调整 MT 阶段（绝经前 vs. 早期绝经）、年龄、体重指数（BMI）、骨吸收标志物采集时间和研究地点后，绝经前和早期绝经时的骨吸收与跨绝经期间股骨颈 BMD 的下降率无关。然而，骨吸收水平每增加一个标准差（SD），FNW 的增加速度就会减慢 0.2%/年（p=0.03），CSI 和 ISI 的下降速度分别加快 0.3%/年（p=0.02）和 0.1%/年（p=0.01）。当仅限于早期绝经的女性时，骨吸收与 FNW、CSI 和 ISI 变化的相关性与全样本相似。
在绝经前和早期绝经期间测量骨吸收标志物可能可以识别出在 MT 期间经历最大骨强度损失的女性。
