By: 19 August 2016
New index could help identify women at risk for rapid bone loss

Researchers have developed an index to better predict which women may experience faster bone loss as they go through the menopause, according to a new study published in the Endocrine Society’s Journal of Clinical Endocrinology & Metabolism.

“Researchers have previously shown that it is difficult to predict an individual’s bone loss by testing the blood or urine for proteins that reflect either bone breakdown or bone formation alone,” said study author Albert Shieh of the University of California, Los Angeles. “Since both bone breakdown and bone formation occur at the same time in the body, we created an index that accounts for both processes, and tested whether this new index can help predict bone loss.”

The researchers call the index a Bone Balance Index and found that it was most useful for predicting bone loss in the spine.

To create the index, data was taken from a cohort of women as they went through menopause, a period when women are prone to bone loss. The 685 women who participated in the Study of Women’s Health across the USA were between the ages of 42 and 52. The women were either premenopausal or in early perimenopause when they enrolled in the study, and all of the participants included in this analysis had their final menstrual period during the follow-up portion of the study.

Urine and blood samples were taken from the women to measure for bone turnover markers. The women also had their bone mineral density measured every year during the course of the study.

The researchers combined measurements of bone breakdown and bone formation in a Bone Balance Index to determine each individual’s net bone balance before they stopped menstruating. They found that the index was a stronger predictor of bone loss from two years before the final menstrual period to three to four years later – a time when bone density typically declines – than a measurement of bone breakdown alone.

“This novel approach to assessing an individual’s bone health may help identify which women are at risk of losing vertebral bone mineral density across the menopause transition,” said Shieh. “Since markers of bone breakdown alone have limited utility in predicting bone loss at an individual level, better approaches are needed to ensure individuals at highest risk of rapid bone loss are identified as quickly as possible.”

Source: The Endocrine Society


Reference: Shieh, A., et al. (2016) Quantifying the balance between total bone formation and total bone resorption: an index of net bone formation. J. Clin. Endocrinol. Metabol. doi: 10.1210/jc.2015-4262