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A bone resorption marker as predictor of rate of change in femoral neck size and strength during the menopause transition

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Abstract

Summary

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.

Purpose

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.

Methods

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.

Results

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.

Conclusions

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.

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Acknowledgements

We thank the study staff at each site and all the women who participated in SWAN.

Funding

The Study of Women’s Health Across the Nation (SWAN) has grant support from the National Institutes of Health (NIH), DHHS, through the National Institute on Aging (NIA), the National Institute of Nursing Research (NINR), and the NIH Office of Research on Women’s Health (ORWH) (Grants U01NR004061; U01AG012505, U01AG012535, U01AG012531, U01AG012539, U01AG012546, U01AG012553, U01AG012554, U01AG012495). Additional support for this project was provided by NIA through P30-AG028748; UCLA Claude Pepper Older Adults Independence Center (PI: Reuben) funded by the National Institute of Aging (5P30AG028748); NIH/NCATS UCLA CTSI Grant Number UL1TR000124; and NIH Grant Number 5RO1AG033067 (PI: Karlamangla and Crandall). Dr. Shieh was supported by the UCLA Specialty Training and Advanced Research Program and the Iris Cantor-UCLA Women’s Health Center Executive Advisory Board. The content of this manuscript is solely the responsibility of the authors and does not necessarily represent the official views of the NIA, NINR, ORWH, or NIH.

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Authors and Affiliations

  1. UCLA Division of Geriatrics, Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, CA, 90095-1687, USA

    A. Shieh, G.A. Greendale & A.S. Karlamangla

  2. Department of Geriatric Medicine, Graduate School of Medicine, University of Tokyo, Tokyo, Japan

    S. Ishii

  3. Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA

    J.A. Cauley

  4. University of Michigan, Ann Arbor, MI, USA

    C. Karvonen-Gutierrez

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  1. A. Shieh
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Corresponding author

Correspondence to A. Shieh.

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All participants provided written informed consent, and each site obtained institutional review board approval.

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Clinical Centers: University of Michigan, Ann Arbor—Siobán Harlow, PI 2011–present, MaryFran Sowers, PI 1994–2011; Massachusetts General Hospital, Boston, MA—Joel Finkelstein, PI 1999–present; Robert Neer, PI 1994–1999; Rush University, Rush University Medical Center, Chicago, IL—Howard Kravitz, PI 2009–present; Lynda Powell, PI 1994–2009; University of California, Davis/Kaiser–Ellen Gold, PI; University of California, Los Angeles—Gail Greendale, PI; Albert Einstein College of Medicine, Bronx, NY—Carol Derby, PI 2011–present, Rachel Wildman, PI 2010–2011; Nanette Santoro, PI 2004–2010; University of Medicine and Dentistry—New Jersey Medical School, Newark—Gerson Weiss, PI 1994–2004; and the University of Pittsburgh, Pittsburgh, PA—Karen Matthews, PI.

NIH Program Office: National Institute on Aging, Bethesda, MD—Chhanda Dutta 2016–present; Winifred Rossi 2012–2016; Sherry Sherman 1994–2012; Marcia Ory 1994–2001; National Institute of Nursing Research, Bethesda, MD—Program Officers.

Central Laboratory: University of Michigan, Ann Arbor—Daniel McConnell (Central Ligand Assay Satellite Services).

Coordinating Center: University of Pittsburgh, Pittsburgh, PA—Maria Mori Brooks, PI 2012–present; Kim Sutton-Tyrrell, PI 2001–2012; New England Research Institutes, Watertown, MA—Sonja McKinlay, PI 1995–2001.

Steering Committee: Susan Johnson, Current Chair

Chris Gallagher, Former Chair

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Shieh, A., Ishii, S., Greendale, G. et al. A bone resorption marker as predictor of rate of change in femoral neck size and strength during the menopause transition. Osteoporos Int 30, 2449–2457 (2019). https://doi.org/10.1007/s00198-019-05099-z

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  • DOI: https://doi.org/10.1007/s00198-019-05099-z

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