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Association between rapid increase in bone turnover during menopause transition and fracture.

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eMediNexus    21 December 2019

Bone turnover increases rapidly during the menopause transition (MT) and plateaus above premenopausal levels in early post-menopause.

A new study published in The Journal of Clinical Endocrinology and Metabolism examined if faster increases in bone turnover during the MT—two years before to two years after the final menstrual period [FMP]—and greater bone turnover during early post-menopause—more than two years after the FMP—are risk factors for subsequent fracture, accounting for bone mineral density (BMD).

This was a longitudinal cohort study of the MT that included bone turnover data – urine collagen type I N-telopeptide (U-NTX), BMD and fracture data of 484 women who were pre- or early peri-menopausal and transitioned to post-menopause. Incident fracture after the MT was the main outcome.

The results after adjusting for age, race/ethnicity, fracture prior to the MT, cigarette use, body mass index and study site showed that each standard deviation (SD) increment in the rate of increase in bone turnover during the MT was associated with a 24% greater hazard of incident fracture post menopause. Additionally, each SD increment in bone turnover during early menopause was associated with a 27% greater hazard of fracture. These associations remained significant after controlling for the MT rate of change and early postmenopausal level of BMD.

From the findings, it was inferred that rapid increases in bone turnover during the MT and greater bone turnover during early menopause can predict future fractures.

Source: Shieh A, Greendale G, Cauley J, Karlamangla A. The association between fast increase in bone turnover during the menopause transition and subsequent fracture. The Journal of Clinical Endocrinology & Metabolism. 2019. doi:10.1210/clinem/dgz281

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