Bone Mass In Postmenopausal Women Research Articles

Baseline Psychosocial Factors Associated with Long-term Physical Activity Adherence in Post-Menopausal Women

2063 Physical activity adherence has been associated with positive health outcomes, including, maintenance of bone mass in post-menopausal women. However, many do not either begin or fail to maintain the physical activity regimens commonly recommended to post-menopausal women for the prevention of osteoporosis. Underlying psychosocial factors involved in long-term physical activity adoption or rejection are yet to be determined. PURPOSE: We examined the psychosocial factors associated with long-term physical activity adherence in post-menopausal women. METHODS: 320 post-menopausal, sedentary women were administered a comprehensive psychometric battery before being randomized to control or a strength training program and followed 4 years. The 177 randomized to exercise were divided into two groups, 4-year completers (n = 60) and non-completers. These two groups were compared based on responses to the baseline psychometric battery. RESULTS: Average age, weight, and body fatness were significantly different between completers and non-completers (56.4 ± 4.1 and 54.1 ± 4.5 years; 65.4 ± 10.0 and 69.8 ± 12.2 kg; 37.0% ± 5.8% and 39.9% ± 6.4% body fat, respectively, p < 0.05). Hormone replacement therapy (HRT) use was equal between groups. Completers scored statistically significantly higher on US SF-36 and WHI psychosocial variables of general health and emotional well being, with fewer physical limitations, than noncompleters. Non-completers were more likely to state that they do not work any harder than they have to, on the Dishman Questionnaire. Results of the Martin Questionnaire revealed that non-completers rated highly on not believing that they could change their habits and become more active. These key questions contribute significantly to the logistic regression model, and in addition, when exercise attendance and baseline covariates are added to the model, all questions remain significant. CONCLUSIONS: Independent of adherence to exercise, completers of the 4-year exercise intervention appear to have a better overall quality of life score at baseline and are more motivated and willing to work, while non-completers appear to doubt ability to change their lifestyle. Supported by NIH Grant AR39559 and Mission Pharmacal.

To What Extent Is Bone Mineral Density Determined By Body Composition In Brazilian Postmenopausal Women?

2051 Previous study of the relative importance of fat mass (FM) and Fat Free Mass (FFM) as a determinant of bone mineral density (BMD) have yielded discordant results. Additionally, Aloia et al. (1995) reported that bone mass may be partially influenced by race. PURPOSE: The aim of this study was to determine to what extent bone mineral density (BMD) is determined by body mass (BM), FM, and FFM in healthy Brazilian postmenopausal women. METHODS: Total body composition and regional bone mass were measured in 97 sedentary, healthy postmenopausal women recruited from the general community. The mean age was 66.41 ± 4.82 years, range 60–79. Total body composition (fat and lean tissue) and regional bone density in the lumbar spine and femur were measured by dual energy X-ray absorptiometry (DXA) on a Lunar DPX-IQ. The participants were screened for medical conditions that may alter BMD, and were excluded from the study if they had been on hormone-replacement therapy (HRT). Contraindications also included: cigarette smoking and alcohol abuse. The relationship of BM, FM and FFM with BMD were first generated separately using linear regression (bivariate). Multiple linear regression then was used to determine the relative contribution of BM, FM and FFM to the variance in BMD. RESULTS: Total BM was more strongly correlated with femur and lumbar spine BMD (r = 0.54 and 0.37, respectively) than FM (r = 0.30 and 0.19) and FFM (r = 0.44 and 0.26). CONCLUSION: Both fat and lean tissue mass are related to femur bone mass in postmenopausal women, however the relationship being strongest for body weight. FM shows weaker correlations for both femur and lumbar BMD. In view of the direction and magnitude of changes in body composition and bone mineral after the menopause, body weight and muscularity are more likely to be determinants of peak bone mass of postmenopausal Brazilian women.

Baseline Psychosocial Factors Associated with Long-term Physical Activity Adherence in Post-Menopausal Women

2063 Physical activity adherence has been associated with positive health outcomes, including, maintenance of bone mass in post-menopausal women. However, many do not either begin or fail to maintain the physical activity regimens commonly recommended to post-menopausal women for the prevention of osteoporosis. Underlying psychosocial factors involved in long-term physical activity adoption or rejection are yet to be determined. PURPOSE: We examined the psychosocial factors associated with long-term physical activity adherence in post-menopausal women. METHODS: 320 post-menopausal, sedentary women were administered a comprehensive psychometric battery before being randomized to control or a strength training program and followed 4 years. The 177 randomized to exercise were divided into two groups, 4-year completers (n = 60) and non-completers. These two groups were compared based on responses to the baseline psychometric battery. RESULTS: Average age, weight, and body fatness were significantly different between completers and non-completers (56.4 ± 4.1 and 54.1 ± 4.5 years; 65.4 ± 10.0 and 69.8 ± 12.2 kg; 37.0% ± 5.8% and 39.9% ± 6.4% body fat, respectively, p < 0.05). Hormone replacement therapy (HRT) use was equal between groups. Completers scored statistically significantly higher on US SF-36 and WHI psychosocial variables of general health and emotional well being, with fewer physical limitations, than noncompleters. Non-completers were more likely to state that they do not work any harder than they have to, on the Dishman Questionnaire. Results of the Martin Questionnaire revealed that non-completers rated highly on not believing that they could change their habits and become more active. These key questions contribute significantly to the logistic regression model, and in addition, when exercise attendance and baseline covariates are added to the model, all questions remain significant. CONCLUSIONS: Independent of adherence to exercise, completers of the 4-year exercise intervention appear to have a better overall quality of life score at baseline and are more motivated and willing to work, while non-completers appear to doubt ability to change their lifestyle. Supported by NIH Grant AR39559 and Mission Pharmacal.

Effect of osteoprotegerin gene polymorphism on bone mass in postmenopausal women

To investigate the effect of promoter region polymorphism of osteoprotegerin (OPG) gene on bone mineral density (BMD) and markers of bone turnover in postmenopausal women. The OPG genotype were determined by PCR-RFLP in 259 postmenopausal women of Han race in Shanghai area, and BMD at lumbar-spine, femoral neck, trochanter and Ward's triangle etc., were measured by dual-energy X-ray absorptiometry (DEXA). Some markers of bone turnover were also detected. Hardy-Weinberg equilibrium was evident for OPG polymorphism. The frequency of the genotype is as following: TT59%, TC28%, CC13%. Postmenopausal women were divided into two groups. Women aged less than 65 years old were in group I, and aged 65 years old and over were in group II. In group I the BMD at femur neck area was 0.64 g/cm(2) +/- 0.11 g/cm(2), 0.67 g/cm(2) +/- 0.11 g/cm(2), 0.68 g/cm(2) +/- 0.14 g/cm(2) of TT, TC, CC genotypes respectively, among which a significant difference was observed (P < 0.05 by ANOVA), and the significant difference also presented after adjusted by age and BMI, but not found the significant difference in other markers. In group II, significant link was not observed between OPG polymorphism and BMD with markers of bone turnover. OPG polymorphism may have an effect on the BMD of postmenopausal women aged less than 65. It is possibly that the role of OPG gene mainly on the obtaining of peak BMD in women.

Lack of dose-responsive effect of dietary phyto-oestrogens on transepithelial calcium transport in human intestinal-like Caco-2 cells.

Ca absorption has been shown to be unaffected by high luminal concentrations of two commonly consumed soyabean phyto-oestrogens (PO) (genistein and daidzein) in Caco-2 cells grown under oestrogen-depleted conditions. However, these compounds exhibit dose-dependent biphasic effects in some tissues, such as reproductive tissue and bone. Thus, in light of this biphasic activity, the effect of lower concentrations of genistein and daidzein on Ca absorption requires further investigation. Therefore, the aim of the present study was to investigate the effect of a range of concentrations of genistein and daidzein on Ca absorption in the human Caco-2 intestinal-like cell model. Caco-2 cells were seeded onto permeable filter supports and allowed to differentiate into monolayers. On day 21, the Caco-2 monolayers (n 12 per treatment), grown in oestrogen-deplete media, were then exposed to 10 nm-1,25-dihydroxycholecalciferol (1,25 (OH)2D3), or 1, 10 and 50 microm-genistein or -daidzein for 24 h. After exposure, transepithelial and transcellular transport of (45)Ca and fluorescein transport were measured. As expected, 1,25 (OH)2D3 stimulated Ca absorption in Caco-2 cells, by up regulating transcellular transport. Ca absorption was unaffected by either PO at luminal concentrations of 1, 10 or 50 microm, typical of intakes by Western and Asian populations as well as supplemental levels, respectively. The results of this model suggest that the proposed beneficial effects of supplemental levels of these PO compounds on bone mass in postmenopausal women more probably arise from direct effects on bone cells, and not by an indirect effect of these compounds on Ca absorption.

Effects of aging and postmenopausal hypoestrogenism on skin elasticity and bone mineral density in Japanese women.

Skin collagen content and bone mass decrease with aging. Loss of collagen from the skin might decrease its elasticity. We investigated associations between skin elasticity, bone mineral density (BMD), age, and menopausal hypoestrogenism. Thirty-eight healthy Japanese postmenopausal women were studied (mean age, 55.7 +/- 5.9 yr; range, 48 to 71). Skin elasticity was measured using a suction device applied to the dorsal right forearm. BMD values of L2 to 4 vertebral bodies were measured by dual-energy X-ray absorptiometry. Age showed significant negative correlations with both skin elasticity and BMD (r = -0.57, p<0.001 and r = -0.40, p<0.05, respectively). Years since menopause also showed significant negative correlations with both skin elasticity and BMD (r = -0.51, p<0.01 and r = -0.41, p<0.05, respectively). We also found a positive correlation between skin elasticity and BMD in these postmenopausal women (r = 0.44, p<0.01). In conclusion, we demonstrated declining skin elasticity and bone mass in postmenopausal women to possibly be age- and estrogen-related. Additionally, decreased skin elasticity might serve as a predictor of bone loss in postmenopausal women.

Preoperative Evaluation of Bone Mass Using Dual X-Ray Absorptiometry and Quantitative Ultrasound in Postmenopausal Women with Primary Hyperparathyroidism

BACKGROUND: Primary hyperparathyroidism (PHPT) is the third most frequently diagnosed endocrine disorder worldwide. The aim of our study was to evaluate quantitative ultrasound (QUS) parameters of the hand in postmenopausal women with PHPT preoperatively, so that we may develop an effective method to compare the benefits of the patients after a successful parathyroidectomy. We hypothesized in this study that QUS evaluation of the hand may have an extra advantage in the assessment of cortical bone quality in patients with PHPT than standard bone density measurements with dual-energy X-ray absorptiometry (DXA). METHODS: Sixteen postmenopausal women who had been diagnosed with primary hyperparathyroidism and 16 age-matched post-menopausal women were enrolled in the study. Bone mineral density (BMD) measurements were performed by dual-energy X-ray absorptiometry (DXA) at the lumbar spine (L1–L4) and proximal femur (neck and total). Ultrasound measurements were performed at the 1/3 distal radius (RAD) and proximal phalanges of the third finger (PLX) on the non-dominant hand. RESULTS: All parameters of the QUS measurements (T-scores for RAD and PLX, ORI™) were significantly lower in the PHPT group than in the control group (p < 0.05). However, there was no significant difference between the patients with PHPT and the control group when evaluated by DXA. CONCLUSIONS: This study indicates that QUS could be an alternative diagnostic approach in evaluating bone mass in post-menopausal women with PHPT since it reflects early bone loss in these patients better than DXA measurement.

Safety and efficacy of estrogen therapy in preventing bone loss in primary biliary cirrhosis

Objectives Estrogen therapy has been found to be useful in the treatment of postmenopausal osteoporosis. However, concern about its potential for worsening cholestasis has limited its use in postmenopausal women with primary biliary cirrhosis. The aim of the present study was to determine the safety as well as the efficacy of estrogen replacement therapy with respect to bone mass in postmenopausal women with primary biliary cirrhosis. Methods Bone mineral density of the lumbar spine (measured using dual energy x-ray absorptiometry) of 46 unselected postmenopausal women with primary biliary cirrhosis receiving estrogen replacement therapy was compared with 46 age-matched women with primary biliary cirrhosis not receiving estrogen replacement therapy, and with the expected normal bone mineral density adjusted for age and ethnic group. Results The mean duration of follow-up was 4.8 ± 0.4 yr. Treatment with estrogens resulted in a significantly lower rate of bone loss (0.002 g/cm 2/yr ± 0.028 vs 0.009 g/cm 2/yr ± 0.020, p = 0.05). Worsening cholestasis attributable to estrogen replacement therapy did not occur in any patient. One patient (2%) discontinued therapy because of side effects. Conclusions Estrogen replacement therapy in postmenopausal patients with primary biliary cirrhosis is safe and may be effective in decreasing the rate of bone loss.

Safety and efficacy of estrogen therapy in preventing bone loss in primary biliary cirrhosis.

Estrogen therapy has been found to be useful in the treatment of postmenopausal osteoporosis. However, concern about its potential for worsening cholestasis has limited its use in postmenopausal women with primary biliary cirrhosis. The aim of the present study was to determine the safety as well as the efficacy of estrogen replacement therapy with respect to bone mass in postmenopausal women with primary biliary cirrhosis. Bone mineral density of the lumbar spine (measured using dual energy x-ray absorptiometry) of 46 unselected postmenopausal women with primary biliary cirrhosis receiving estrogen replacement therapy was compared with 46 age-matched women with primary biliary cirrhosis not receiving estrogen replacement therapy, and with the expected normal bone mineral density adjusted for age and ethnic group. The mean duration of follow-up was 4.8 +/- 0.4 yr. Treatment with estrogens resulted in a significantly lower rate of bone loss (0.002 g/cm(2)/yr +/- 0.028 vs 0.009 g/cm(2)/yr +/- 0.020, p = 0.05). Worsening cholestasis attributable to estrogen replacement therapy did not occur in any patient. One patient (2%) discontinued therapy because of side effects. Estrogen replacement therapy in postmenopausal patients with primary biliary cirrhosis is safe and may be effective in decreasing the rate of bone loss.

Influence of pregnancy and breast-feeding on quantitative ultrasonometry of bone in postmenopausal women

Objective: Reproductive factors such as parity and breast-feeding may be associated with low bone mass and osteoporotic fractures in later years. In this study, os calcis quantitative ultrasonometry was used to elucidate the relationship between parity, lactation and bone mass in postmenopausal women. Design: This was a comparison study using subsequent matched pairs analysis as well as multiple linear regression analysis. The study was carried out at five centers in Germany. The study included 2080 postmenopausal women (age (mean ± SD) 58.8 ± 8.2 years), who were attending for routine check-up and in whom diseases and drug treatments known to affect bone metabolism had been excluded. Methods and outcome measures: Women underwent quantitative ultrasonometry (QUS) measurement at the heel. Values of the ultrasonometry variables –speed of sound, broadband ultrasound attenuation and stiffness index –were calculated and compared for nulliparous and parous women and for women who had and had not breast-fed. Because of some significant intergroup differences, and to determine any effect of the number of live births and the duration of breast-feeding on ultrasonometry results, second analyses were undertaken using equally sized samples, matched for possible confounding variables such as age and body mass index (matched pairs). In these analyses, nulliparous women were compared with parous women, grouped according to number of live births, and women who had never breast-fed were compared with women who had breast-fed, grouped according to duration of breast-feeding. Furthermore, a multiple linear regression analysis was performed to examine the combined effects of reproductive factors on QUS variables. Results: No statistically significant associations were found between ultrasonometry variables and parity or breast-feeding, even after controlling for confounding variables in matched-pairs analysis or in a multiple linear regression analysis.

Anabolic effects of recombinant human parathyroid hormone (1 - 84) and synthetic human parathyroid hormone (1 - 34) on the mandibles of osteopenic ovariectomized rats with maxillary molar extraction.

In rodent osteoporosis models such as ovariectomized (OVX) rats, intermittently administered human parathyroid hormone (hPTH) has an anabolic effect in vertebrae and long bones. In the present experiments, subcutaneously injected hPTH(1 - 34) or hPTH(1 - 84) dose- and time-dependently increased bone mineral density (BMD) as measured by dual energy X-ray absorptiometry in mandibles, L2 to L4 vertebrae and femurs of such rats. The highest dose (15.9 nmol/kg, s. c.) of either peptide given four times weekly for 10 weeks completely reversed the effects of overiectomy on BMD. Significant elevation in lumbar BMD after 10 weeks was observed with hPTH(1 - 34) or hPTH(1 - 84) at 1.1 nmol/kg, whereas hPTH(1 - 34) at 1.1 and 4.2 nmol/kg significantly increased BMD of the whole bone and the metaphysis of the femur and the diaphysis of the bone, respectively. In contrast, significant effects of hPTH(1 - 84) administration on BMD increase in the femur were observed at 4.2 and 15.9 nmol/kg in the whole bone and the metaphysis, and in the diaphysis, respectively. Maxillary molar extraction left mandibular BMD in rats with intact ovaries unchanged, but significantly decreased mandibular BMD in OVX rats. Administration of hPTH(1 - 84) for 10 weeks in OVX rats without or with extraction significantly increased BMD in the mandibular molar region at doses of 15.9 and 4.2 nmol/kg, respectively, indicating that efficacy was increased by extraction. A significant BMD increase in the molar region in OVX rats with extraction occurred at only 1.1 nmol/kg of hPTH(1 - 34) and 4.2 nmol/kg of hPTH(1 - 84). Also, BMD of the ramus region was increased by administration of both peptides to a lesser extent than that of the molar region in these rats. Thus, intermittent administration of hPTH, especially hPTH(1 - 34), has an anabolic effect on bone, particularly alveolar bone. Such treatment may increase alveolar bone mass in postmenopausal women with osteoporosis.

Effect of continuous combined therapy with vitamin K 2 and vitamin D 3 on bone mineral density and coagulofibrinolysis function in postmenopausal women

Objectives: To investigate the therapeutic effect of combined use of vitamin K 2 and D 3 on vertebral bone mineral density in postmenopausal women with osteopenia and osteoporosis. Subjects and methods: We enrolled 172 women with vertebral bone mineral density <0.98 g/cm 2 (osteopenia and osteoporosis) as measured by dual-energy X-ray absorptiometry. In this study, we employed the criteria for diagnosis of osteopenia and osteoporosis using dual energy X-ray absorptiometry proposed by the Japan Society of Bone Metabolism in 1996. Subjects were randomized into four groups (each having 43 subjects in vitamin K 2 therapy group, vitamin D 3 therapy group, vitamin K 2 and D 3 combined therapy group, or a control group receiving dietary therapy alone) and treated with respective agents for 2 years, with bone mineral density was measured prior to therapy and after 6, 12, 18, and 24 months of treatment. The bone metabolism markers analyzed were serum type 1 collagen carboxyterminal propeptide (P1CP), serum intact osteocalcin, and urinary pyridinoline. Tests of blood coagulation function consisted of measurement of activated partial thromboplastin time (APTT) and analysis of concentrations of antithrombin III (AT III), fibrinogen, and plasminogen. Results: Combined therapy with vitamin K 2 and D 3 for 24 months markedly increased bone mineral density (4.92±7.89%), while vitamin K 2 alone increased it only 0.135±5.44%. The bone markers measured, revealed stimulation of both bone formation and resorption activity. We observed an increase in coagulation and fibrinolytic activity that was within the normal range, suggesting that balance was maintained in the fibrinolysis–coagulation system. Conclusions: Continuous combination therapy with vitamin K 2 and D 3 may be useful for increasing vertebral bone mass in postmenopausal women. Furthermore, the increase in coagulation function observed during this therapy was within the physiological range, and no adverse reactions were observed.

The Relationship between Bone Adaptations to Resistance Exercise and Reproductive-Hormone Levels

This study examined the relationships between high-intensity resistance exercise and bone mass in postmenopausal women and serum reproductive-hormone levels and bone-mass changes in response to resistance exercise. Women 45–65 years old were assigned to an exercise or a control group. They trained 3 times weekly for 18 weeks at 90,70, and 80% of their 1-RM. Groups were not different in age, height, body mass, muscle strength, or lean body mass. Initial muscle strength increased significantly in the training group. Total hip and intertrochanter bone-mineral density (BMD) increased in the training group. Estradiol, testosterone, osteocalcin, and CrossLaps concentration did not change in either group. Serum estradiol was significantly related to change in BMD at the hip, femoral neck, and intertrochanter, as well as change in lean mass. Results suggest that high-intensity resistance exercise can increase BMD of the hip and that serum estrogen concentrations might influence bone and muscle adaptations to resistance exercise in postmenopausal women.

Effects of combination therapy with PTH and 17beta-estradiol on long bones of female mice.

Parathyroid hormone (PTH) is thought to increase trabecular bone mass in postmenopausal women by stimulating osteoblast function. A similar action may contribute to estrogen's protective effect on the skeleton, which we have explored in female mice, in which estrogen induces an exaggerated osteogenic response. In the present investigation, we used this model to determine whether an interaction exists between stimulatory effects of PTH and estrogen on osteoblast function in cancellous bone. An initial dose response study was performed where PTH (hPTH, 1-38) was administered to ten-week-old intact female mice by daily sc injection for 28 days, at doses of 1, 10, 100 microg/kg. In a subsequent study, intact female mice were given PTH and/or 17beta-estradiol (E2) 10 and 40 microg/kg/day respectively. Femoral BMD was assessed by peripheral DXA (PIXImus), and histomorphometry was performed to analyse changes in cancellous and cortical bone. PTH caused a small gain in femoral BMD, and increased the extent of periosteal bone formation surfaces, but had relatively little effect on other skeletal parameters when given alone. As previously found, E2 produced a large increase in femoral BMD, stimulated cancellous and endocortical bone formation, but inhibited periosteal bone formation. In mice treated with combination therapy, a greater increase in femoral BMD was observed compared to that following treatment with either agent alone. No differences in indices of cancellous bone were found between animals treated with E2 compared to the combination group. However, cortical area and periosteal bone formation rate were significantly greater in the latter group. We conclude that PTH and E2 exert an additive effect on bone mass in long bones of female mice, possibly reflecting an ability of PTH to oppose E2-induced suppression of periosteal bone formation.

Effects of Alendronate and Hormone Replacement Therapy, Alone or in Combination, on Bone Mass in Postmenopausal Women with Osteoporosis: A Prospective, Randomized Study

The effectiveness of hormone replacement therapy (HRT) and alendronate, alone and in combination, was evaluated in 120 postmenopausal patients with osteoporosis with bone mineral density (BMD) measurements at least 2 SD below the mean value for young premenopausal subjects. They had no contra-indications to HRT or alendronate use and were randomized to three different treatment groups. Group I was treated with micronized 17 beta-oestradiol 2 mg and norethisterone acetate 1 mg/day per os, group II received alendronate 10 mg/day per os and group III received micronized 17 beta-oestradiol 2 mg, norethisterone acetate 1 mg/day per os and alendronate 10 mg/day per os for 1 year. Elementary calcium 1500 mg/day was supplied to patients in all three groups. Spinal and femoral neck BMD and markers of bone mineral metabolism were measured on each patient before treatment and 6 and 12 months after treatment in 95 patients. At the end of the 12th month, significant increases in spinal and femoral neck BMD were found in all groups. Increases in spinal BMD were significantly higher in patients treated with alendronate and alendronate with HRT when compared with patients treated with HRT only. No significant difference was found in femoral neck BMD changes between the groups. Significant decreases in bone resorption and markers of bone formation were observed in all groups. Alendronate was found to be more effective than HRT and could have a very beneficial effect when added to the HRT regimen in patients with postmenopausal osteoporosis. Alendronate might also be used in postmenopausal patients with osteoporosis when HRT is contra-indicated or when there is reluctance to use hormonal treatment.

Soy intake related to menopausal symptoms, serum lipids, and bone mineral density in postmenopausal Japanese women

Objective: To evaluate the effects of dietary isoflavones in soy products on menopausal symptoms, lipid profiles, and bone mineral densities in postmenopausal Japanese women. Methods: We estimated the daily intakes of isoflavones in the diets of 478 postmenopausal Japanese women who reported soy consumption. We recorded serum values of fasting total cholesterol, triglyceride, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and apolipoproteins. Bone mineral density was measured at the lumbar spine (L2–L4) by dual energy x-ray absorptiometry. Women were assigned to two groups according to years since menopause (early and late postmenopausal groups), and each group was subcategorized into four groups according to dietary isoflavone intake. Relationships between isoflavone intake, menopausal symptoms, lipid profiles, and bone mineral density were examined in each group. Results: The mean estimated intake of isoflavones among 478 women was 54.3 mg/day. With stepwise regression analysis we found that weight and years since menopause were significant independent predictors of bone mineral density. Bone mineral densities adjusted to years since menopause and weight were significantly different in the highest intake compared with lowest intake category ( P < .001) within the early and late postmenopausal groups. In the early postmenopausal group, significant differences were found in palpitation and backaches between the high and low intake categories but were not significant in the late postmenopausal group. Conclusion: High consumption of soy products is associated with increased bone mass in postmenopausal women and might be useful for preventing hypoestrogenic effects.

Lack of association between interleukin-1 receptor antagonist protein gene polymorphism and bone mineral density in Hungarian postmenopausal women

The major determinant for risk of osteoporosis in later life is bone mineral density (BMD) attained during early adulthood. Bone mineral density is a complex trait that is presumably influenced by multiple genes. Interleukin-1 receptor antagonist protein (IL-1RN) is an attractive candidate gene for osteoporosis susceptibility, because IL-1RN completely inhibits the stimulatory effects of interleukin-1 (IL-1) on bone resorption in organ cultures and has been implicated in the pathogenesis of osteoporosis. In addition, the IL-1RN gene contains a variable-number tandem repeat polymorphism (VNTR) in intron 2 with three potential protein-binding sites. Recently, an association has been found between this polymorphism and postmenopausal bone loss in the spine. In this study, we use the previously described IL-1RN polymorphism to test for an association between this polymorphism and bone mineral density in our population of postmenopausal women. There was no correlation between alleles or genotypes and BMD in the 286 subjects. Dividing subjects into osteoporotic and healthy groups (osteoporotics and controls), we found no difference in the distribution of alleles or genotypes between groups. We found no association between IL-1RN alleles or genotypes and BMD either at the lumbar spine or the femoral neck within groups. Our data do not support the hypothesis that this IL-1RN gene VNTR polymorphism has an impact on bone mass in postmenopausal women.

Birth weight as a predictor of adult bone mass in postmenopausal women: the Rancho Bernardo Study.

Understanding the determinants of adult bone mass may help to identify women for prevention of osteoporosis. We postulated that birth weight would predict low adult bone mass in old age. Subjects were 305 postmenopausal Caucasian women (mean age 70 years). Bone mineral content (BMC) and bone mineral density (BMD) were measured at the wrist, forearm, hip and lumbar spine. Birth weight was assessed by self-report. Birth weight was positively correlated with BMC at the forearm (r = 0.15), hip (r = 0.12) and lumbar spine (r = 0.18), and the age-adjusted mean BMC increased significantly from the lowest to the highest birth weight tertile. Adjusting for adult weight diminished this association at the forearm and hip, but not at the spine. Adjustment for multiple other covariates, including height, did not materially change these associations. Adult weight and height were significantly correlated with birth weight (r = 0.19 and r = 0.24, respectively). Birth weight was not independently correlated with BMD. Birth weight was thus positively correlated with adult weight and BMC 70 years later. These findings suggest that low birth weight may be a marker for future low bone mass and that different mechanisms exist for establishing the adult bone envelope (estimated by BMC) versus its density (estimated by BMD).

Vasomotor symptoms are not associated with reduced bone mass in postmenopausal women: the Rancho Bernardo Study.

The association of menopause-related vasomotor symptoms with later bone mineral density (BMD) at axial and appendicular sites was examined in community-dwelling older women. Subjects were 894 postmenopausal women from the Rancho Bernardo Study who had BMD measured in 1988-1991 and responded to a 1989 mailed survey that included questions about menopause symptoms. Mean age was 73 years (SE +/- 9.5, range 47-97), and mean age at menopause was 47 years (SD +/- 6.8, range 21-62). Vasomotor symptoms were recalled by two thirds (68%) and night sweats by 36% of all women, with no significant differences in symptom frequency by age or type of menopause. Postmenopausal estrogen (PME) had been used by 644 women (72%) for an average duration of 12.3 (+/-11) years. Among women who reported current estrogen use with a duration >3 years, those who experienced vasomotor symptoms had significantly higher BMD at the lumbar spine (p = 0.01), femoral neck (p = 0.05) and midshaft radius (p = 0.05) compared with women who did not experience symptoms. Vasomotor symptoms were not associated with BMD among past or never PME users or among women who reported current PME use for 3 or fewer years. Analyses stratified by age, type of menopause, or when PME use began showed similar results. Women who reported night sweats also had no difference in BMD compared with women without night sweats. In conclusion, vasomotor symptoms are not a marker for low BMD years after menopause in women with access to healthcare. Vasomotor symptoms significantly increased the likelihood of continued use of PME, which was in turn associated with higher BMD levels.

Plasma leptin concentrations in postmenopausal women with osteoporosis.

The obese are usually protected against osteoporosis and have increased bone mineral density and plasma leptin concentrations. A recent in vitro study demonstrated that leptin acts on human marrow stromal cells to enhance differentiation to osteoblasts, suggesting an influence of leptin on bone mass. However, little is known about the relationship between plasma leptin and bone mass in postmenopausal women with osteoporosis. To investigate plasma leptin concentrations in postmenopausal women with osteoporosis to improve the understanding of the role of leptin in determining bone mass. Fifty postmenopausal women with osteoporosis (ages 61.18+/-6.51 years; body mass index (BMI) 28. 91+/-3.44kg/m(2), mean+/-s.d.) and 30 age- and BMI-matched healthy postmenopausal women were included in the study. Bone mineral densities (BMD) were measured by dual energy X-ray absorptiometry. Plasma leptin concentrations were determined using an immunoradiometric assay. The median spine BMD value in the patient group (0.695+/-8.26g/cm(2), median+/-s.e.m.) was significantly lower than that in the control group (1.006+/-1. 29g/cm(2), median+/-s.e.m.; z=-7.454, P<0.001). The median plasma leptin concentration in the patient group (18.70+/-1.78ng/ml, median+/-s.e.m.) was not significantly different from that in the control group (22.35+/-2.20ng/ml, median+/-s.e.m.; z=-1.630, P=0. 103). Plasma leptin concentrations were correlated with BMI in both groups (r(s)=0.394, P=0.031 in controls and r(s)=0.404, P=0.004 in the patient group). There was no correlation between plasma leptin concentrations and BMD values in controls (r(s)=-0.107, P=0.575) but a weak correlation was observed in the patient group (r(s)=0.285, P=0.045). Our data suggest that circulating plasma leptin does not have a significant direct influence on bone mass in postmenopausal women.