Adult Premenopausal Bone Health Related to Reproductive Characteristics-Population-Based Data from the Canadian Multicentre Osteoporosis Study (CaMos).

Azita Goshtasebi,Christopher S Kovacs,Tanveer Towheed,Susan I Barr,K Shawn Davison,Claudie Berger,Jerilynn C Prior

doi:10.3390/ijerph15051023

Abstract

Amenorrhea is important for women’s bone health. However, few have reported reproductive, anthropometric (body mass index [BMI], height) and bone health (areal bone mineral density [BMD], prevalent fractures) in a population-based study. The purposes of this cross-sectional study of women in the randomly-selected Canadian Multicentre Osteoporosis Study (CaMos) population were: (1) to describe reproductive, demographic, anthropometric and lifestyle variables; and (2) in menstruating women, to relate reproductive and other variables to BMD at the lumbar spine (L1-4, LS), femoral neck (FN) and total hip (TH) sites and to prevalent fragility fractures. This study describes the reproductive characteristics of 1532 women aged 30–60 years. BMD relationships with reproductive and other variables were described in the 499 menstruating women. Mean menarche age was 12.8 years, 96% of women were parous and 95% had used combined hormonal contraceptives (CHC). Infertility was reported by 9%, androgen excess by 13%, amenorrhea by 8% and nulliparity by 4%. LS BMD was negatively associated with amenorrhea and androgen excess and positively related to current BMI and height. A later age at menarche negatively related to FN BMD. BMI and height were strongly related to BMD at all sites. Prevalent fragility fractures were significantly associated with quartiles of both LS and TH BMD.

Highlights

A few excellent population-based studies have described reproductive characteristics in adolescent [1], mixed adolescent-adult [2] andInt
Ever experiencing amenorrhea occurred for eight percent of women; 10 percent had a history of ever experiencing oligomenorrhea
Osteoporosis Study assessed both bone mineral density (BMD) and prevalent fragility fractures in almost 500 still-menstruating women

Summary

Introduction

A few excellent population-based studies (meaning a random sample from an entire population) have described reproductive characteristics in adolescent [1], mixed adolescent-adult [2] andInt. Res. Public Health 2018, 15, 1023 premenopausal [3] cohorts identifying menarche age, the proportion with amenorrhea, oligomenorrhea and infertility as well as parity, lactation and reproductive surgeries. Earlier age at menarche in Canadian population data was found to relate to a higher risk for adult obesity [4]; it has been associated with higher mortality [5]. When BMI increases into the obese range (BMI ≥ 30) the fracture risk was found to be significantly increased, based on BMD-adjusted international data from large epidemiological cohorts [7]. There are complex interrelationships among reproductive and body weight/height variables, BMD and fracture risk

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Discussion

Conclusion