Menstrual and Reproductive Factors and Fracture Risk: The Leisure World Cohort Study

Paganini‐Hill, Annlia; Atchison, Kathryn A.; Gornbein, Jeffery A.; Nattiv, Aurelia; White, Stuart C.

doi:10.1089/jwh.2005.14.808

Cited by 41 publications

(47 citation statements)

References 79 publications

(107 reference statements)

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“…Age at the last menstrual period was not a statistically significant predictor of hip fracture in the fully adjusted model (Table 3). This agrees with several earlier studies showing no statistically significant association between age at menopause and hip fracture risk [19,21,29,42]; however, age at the last menstrual period appeared to modify the association between parity and hip fracture risk. Women with three or more births and aged over 50 on the (Table 4).…”

Section: Discussionsupporting

confidence: 92%

“…Also, similar to earlier studies [15,19], we found that parity appears to be protective against hip fractures even according to models adjusted for BMI. Pregnancy can have favorable effects on bone size and geometry and therefore reduce the long-term fracture risk [40,41].…”

Section: Discussionsupporting

confidence: 91%

“…Nulliparity has been proposed to be a risk factor for hip fractures [13,[15][16][17][18][19], and some studies have shown gradually reduced risks along with increasing parity [17,20]; however, the results have not been uniform [21][22][23], and this question therefore remains unresolved.…”

Section: Introductionmentioning

confidence: 99%

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Parity and risk of hip fracture in postmenopausal women

et al. 2010

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 91%

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Parity and risk of hip fracture in postmenopausal women

et al. 2010

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“…Our data are thus compatible with the notion that the time of menarche is inversely related to the risk of vertebral and nonvertebral fragility fractures, independent of the aging process. (8)(9)(10)(11) Both pubertal timing (39) and peak bone mass (40,41) are under the strong influence of hereditable factors and can be moderately affected by common environmental determinants. (42) The hereditable component of pubertal timing was well identified by both twin (43)(44)(45)(46)(47) and mother-daughter relationship (48)(49)(50)(51)(52) studies.…”

Section: Discussionmentioning

confidence: 99%

“…(4)(5)(6)(7) These findings are supported by observations that late pubertal maturation is linked to an increased risk of vertebral and nonvertebral fragility fractures. (8)(9)(10)(11) Retrospective epidemiological studies have shown that the inverse relationship between bone mineral mass or density and age of menarche seen in premenopausal women has generally been ascribed to the duration of sex hormone exposure up to the time of peak bone mass. (2,(12)(13)(14) These findings imply that, the longer the duration of sex hormone exposure, the higher peak bone mass will reach.…”

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confidence: 99%

Deleterious Effect of Late Menarche on Distal Tibia Microstructure in Healthy 20-Year-Old and Premenopausal Middle-Aged Women

Chevalley

Bonjour

Ferrari

et al. 2009

Journal of Bone and Mineral Research

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Late menarche is a risk factor for fragility fractures. We hypothesized that pubertal timingdependent alterations in bone structural components would persist from peak bone mass to menopause, independent of premenopausal bone loss. We studied the influence of menarcheal age (MENA) on femoral neck BMD (FN aBMD) by DXA and microstructure of distal tibia by HR-pQCT in healthy young adult (YAD; 20.4 ± 0.6 [SD] yr, n ‫ס‬ 124) and premenopausal middle-aged (PREMENO; 45.8 ± 3.4 yr, n ‫ס‬ 120) women. Median of MENA was 13.0 ± 1.2 and 13.1 ± 1.7 yr in YAD and PREMENO, respectively. In YAD and PREMENO (n ‫ס‬ 244), FN aBMD (R ‫ס‬ −0.29, p ‫ס‬ 0.013), as well as total volumetric BMD (Dtot; R ‫ס‬ −0.23, p ‫ס‬ 0.006) and cortical thickness (Ct.Th; R ‫ס‬ −0.18, p ‫ס‬ 0.011) of distal tibia were inversely correlated to MENA. After segregation by the median of MENA in EARLY and LATE subgroups, the significant influences of both MENA (p ‫ס‬ 0.004) and chronological age (p < 0.0001) were observed for FN aBMD and trabecular bone volume fraction of the distal tibia with similar differences in T-scores between LATE and EARLY subgroups in YAD (−0.36 and −0.31 T-scores) and PREMENO (−0.35 and −0.42 T-scores) women. Ct.Th was negatively influenced by MENA, whereas trabecular thickness (Tb.Th) was negatively influenced by chronological age. There was a striking inverse relationship between cross-sectional area and Ct.Th (R ‫ס‬ −0.57, p < 0.001). In conclusion, the negative influence of late menarcheal age at weight-bearing sites as observed by the end of skeletal growth remains unattenuated a few years before menopause and is independent of premenopausal bone loss. Alterations in both bone mineral mass and microstructural components may explain the increased risk of fragility fractures associated with later menarcheal age.

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Cumulative Endogenous Estrogen Exposure Is Associated With Postmenopausal Fracture Risk: The Women's Health Initiative Study

LeBlanc

Hovey

Cauley

et al. 2020

Journal of Bone and Mineral Research

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We aimed to evaluate the relationship between cumulative endogenous estrogen exposure and fracture risk in 150,682 postmenopausal women (aged 50 to 79 years at baseline) who participated in the Women's Health Initiative. We hypothesized that characteristics indicating lower cumulative endogenous estrogen exposure would be associated with increased fracture risk. We determined ages at menarche and menopause as well as history of irregular menses from baseline questionnaires and calculated years of endogenous estrogen exposure from ages at menarche and menopause. Incident clinical fractures were self‐reported over an average 16.7 years of follow‐up. We used multivariable proportional hazards models to assess the associations between the estrogen‐related variables and incidence of any clinical fracture. In fully adjusted models, those with the fewest years of endogenous estrogen exposure (<30) had an 11% higher risk of developing central body fractures and a 9% higher risk of lower extremity fractures than women with 36 to 40 years of endogenous estrogen exposure (the reference category). In contrast, women with the most years of endogenous estrogen exposure (more than 45 years) had a 9% lower risk of lower extremity fractures than the reference category. Women with irregular (not monthly) menstrual cycles were 7% to 8% more likely to experience lower extremity fractures than women with regular monthly cycles. Our findings support the hypothesis that characteristics signifying lower cumulative endogenous estrogen exposure are associated with higher fracture risk. © 2022 American Society for Bone and Mineral Research (ASBMR).

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Menstrual and Reproductive Factors and Fracture Risk: The Leisure World Cohort Study

Abstract: The estrogen-related events of menarche, pregnancy, and menopause were not associated with osteoporotic fracture risk in a consistent manner. Other factors related to these events may be influencing development of osteoporosis and the likelihood of sustaining a fracture in older women.

Cited by 41 publications

References 79 publications

Parity and risk of hip fracture in postmenopausal women

Parity and risk of hip fracture in postmenopausal women

Deleterious Effect of Late Menarche on Distal Tibia Microstructure in Healthy 20-Year-Old and Premenopausal Middle-Aged Women

Cumulative Endogenous Estrogen Exposure Is Associated With Postmenopausal Fracture Risk: The Women's Health Initiative Study

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