Sex steroids, bone mass, and bone loss. A prospective study of pre-, peri-, and postmenopausal women.

Slemenda, Charles W.; Longcope, Christopher; Hui, Siu L.; Johnston, C. Conrad

doi:10.1172/jci118382

Cited by 288 publications

(166 citation statements)

References 18 publications

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“…It is well known that the rate of bone loss varies considerably between early postmenopausal and older women and different mechanisms may be involved in each of these periods. (13) The ORIGINAL ARTICLE…”

Section: Introductionmentioning

confidence: 99%

Effects of age on genetic influence on bone loss over 17 years in women: The Healthy Ageing Twin Study (HATS)

Moayyeri

Hammond

Hart

et al. 2012

Journal of Bone and Mineral Research

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The rate of bone loss varies across the aging period via multiple complex mechanisms. Therefore, the role of genetic factors on bone loss may also change similarly. In this study, we investigated the effect of age on the genetic component of bone loss in a large twin-based longitudinal study. During 17 years of follow-up in TwinsUK and Healthy Ageing Twin Study (HATS), 15,491 hip and lumbar spine dualenergy X-ray absorptiometry (DXA) scans were performed in 7056 twins. Out of these subjects, 2716 female twins aged >35 years with at least two scans separated for >4 years (mean follow-up 9.7 years) were included in this analysis. We used a mixed-effects randomcoefficients regression model to predict hip and spine bone mineral density (BMD) values for exact ages of 40, 45, 50, 55, 60, 65, 70, 75, and 80 years, with adjustment for baseline age, weight, height, and duration of hormone replacement therapy. We then estimated heritability of the changes in BMD measures between these age ranges. Heritability estimates for cross-sectional hip and spine BMD were high (ranging between 69% and 88%) at different ages. Heritability of change of BMD was lower and more variable, generally ranging from 0% to 40% for hip and 0% to 70% for spine; between age 40 and 45 years genetic factors explained 39.9% (95% confidence interval [CI], 25%-53%) of variance of BMD loss for total hip, 46.4% (95% CI, 32%-58%) for femoral neck, and 69.5% (95% CI, 59%-77%) for lumbar spine. These estimates decreased with increasing age, and there appeared to be no heritability of BMD changes after the age of 65 years. There was some evidence at the spine for shared genetic effects between cross-sectional and longitudinal BMD. Whereas genetic factors appear to have an important role in bone loss in early postmenopausal women, nongenetic mechanisms become more important determinants of bone loss with advanced age. ß

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Section: Introductionmentioning

confidence: 99%

Effects of age on genetic influence on bone loss over 17 years in women: The Healthy Ageing Twin Study (HATS)

Moayyeri

Hammond

Hart

et al. 2012

Journal of Bone and Mineral Research

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“…In addition, although women and men both lose bone mineral during aging because of endocrine [6][7][8], paracrine [9,10], and cellular factors [11,12], the effect is more profound in women, beginning even before menopause [13,14], but notably accelerating afterward with rapid decline in estrogen [15,16]. Bone strength, however, is determined not only by the amount of bone mineral, but also by its spatial distribution with respect to the loading forces that may be encountered [17].…”

Section: Introductionmentioning

confidence: 99%

Hip structural geometry in old and old-old age: Similarities and differences between men and women

Yates

Karasik

Beck

et al. 2007

Bone

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Introduction-Changes in hip structure and geometry during aging contribute to decreased bone strength. Little is known, however, about these characteristics at advanced age, when fragility fractures are common. We examined hip structural geometry in men and women of old (72-84 years) and old-old (85-96 years) age to determine (1) gender differences; 2) whether or not these differences are consistent with the increased occurrence of hip fracture in elderly women, compared to men; and (3) whether or not gender-specific changes are consistent with the increased occurrence of fragility fractures after age 80 in both men and women.

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“…Some investigators have reported lower sex steroids and higher sex hormone-binding globulin (SHBG) associated with bone loss (5)(6)(7)(8)(9)(10)(11)(12)(13)(14) and increased fracture risk but this is not consistently reported (15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25), perhaps because many factors influence fracture risk, particularly falls (26,27). However, few prospective data are available examining the contribution of sex steroids and SHBG on fracture risk (15,18,20,22,24).…”

Section: Introductionmentioning

confidence: 99%

A prospective study of sex steroids, sex hormone-binding globulin, and non-vertebral fractures in women and men: the Tromsø Study

Bjørnerem¹,

Ahmed²,

Joakimsen³

et al. 2007

eur j endocrinol

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Objectives: As bone fragility is partly the result of sex hormone deficiency, we sought to determine whether circulating sex steroids or sex hormone-binding globulin (SHBG) predicts non-vertebral fractures. Methods: Forearm bone mineral density (BMD), total estradiol and testosterone, calculated free levels, and SHBG were measured in 1386 postmenopausal women and 1364 men aged 50-84 years at baseline in the Tromsø Study (1994)(1995). Non-vertebral fractures were documented between 1994 and 2005. Results: During 8.4 years (range 0.01-10.4) of follow-up, 281 women and 105 men suffered non-vertebral fractures. For both sexes, fracture cases had lower BMD and higher SHBG, but sex steroids were not lower. Each standard deviation (S.D.) increase in SHBG increased non-vertebral fracture risk in women (hazards ratio (HR) 1.17; 95% confidence interval (CI) 1.03-1.33) and men (HR 1.26; 95% CI 1.03-1.54). After further adjustment for BMD, the risk was not statistically significant in women (HR 1.09; 95% CI 0.95-1.24) or men (HR 1.22; 95% CI 0.99-1.49). Each S.D. decrease in BMD increased fracture risk in women (HR 1.36; 95% CI 1.19-1.56) and men (HR 1.41; 95% CI 1.15-1.73). Fracture rates were highest in participants with SHBG in the highest tertile and BMD in the lowest tertile and were 37.9 and 17.0 per 1000 person-years in women and men respectively. However, in both sexes the combination of BMD and SHBG was no better predictor of fracture risk than BMD alone. Sex steroids were not associated with fracture risk. Conclusions: Measurements of sex steroids or SHBG are unlikely to assist in decision making regarding fracture risk susceptibility.

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Sex steroids, bone mass, and bone loss. A prospective study of pre-, peri-, and postmenopausal women.

Cited by 288 publications

References 18 publications

Effects of age on genetic influence on bone loss over 17 years in women: The Healthy Ageing Twin Study (HATS)

Effects of age on genetic influence on bone loss over 17 years in women: The Healthy Ageing Twin Study (HATS)

Hip structural geometry in old and old-old age: Similarities and differences between men and women

A prospective study of sex steroids, sex hormone-binding globulin, and non-vertebral fractures in women and men: the Tromsø Study

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