TY - JOUR
T1 - Longitudinal changes in hip geometry in relation to the final menstrual period
T2 - Study of Women's Health Across the Nation (SWAN)
AU - Nagaraj, Nayana
AU - Boudreau, Robert M.
AU - Danielson, Michelle E.
AU - Greendale, Gail A.
AU - Karlamangla, Arun S.
AU - Beck, Thomas J.
AU - Cauley, Jane A.
N1 - Funding Information:
The Study of Women's Health Across the Nation (SWAN) has grant support from the National Institutes of Health (NIH), DHHS, through the National Institute on Aging (NIA), the National Institute of Nursing Research (NINR) and the NIH ORWH (Grants NR004061 ; AG012505 , AG012535 , AG012531 , AG012539 , AG012546 , AG012553 , AG012554 , AG012495 ). The Hip Strength Through the Menopausal Transition has grant support from the NIA ( AG026463 ). Additional support for this project provided by NIA through P30-AG028748 . Dr. Nagaraj was supported by the Bone Strength Through the Menopausal Transition: Trabecular Bone Score from the NIA (( AG026463 ). The content of this article is solely the responsibility of the authors and does not necessarily represent the official views of the NIA, NINR, ORWH or the NIH. Clinical Centers: University of Michigan, Ann Arbor – Siobán Harlow, PI 2011, MaryFran Sowers, PI 1994–2011; Massachusetts General Hospital, Boston, MA – Joel Finkelstein, PI 1999 – present; Robert Neer, PI 1994–1999; Rush University, Rush University Medical Center, Chicago, IL – Howard Kravitz, PI 2009 – present; Lynda Powell, PI 1994–2009; University of California, Davis/Kaiser – Ellen Gold, PI; University of California, Los Angeles – Gail Greendale, PI; Albert Einstein College of Medicine, Bronx, NY – Carol Derby, PI 2011, Rachel Wildman, PI 2010 –2011; Nanette Santoro, PI 2004–2010; University of Medicine and Dentistry – New Jersey Medical School, Newark – Gerson Weiss, PI 1994–2004; and the University of Pittsburgh, Pittsburgh, PA – Karen Matthews, PI. NIH Program Office: National Institute on Aging, Bethesda, MD – Sherry Sherman 1994 – present; Marcia Ory 1994–2001; National Institute of Nursing Research, Bethesda, MD – Program Officers. Central Laboratory: University of Michigan, Ann Arbor – Daniel McConnell (Central Ligand Assay Satellite Services). Coordinating Center: University of Pittsburgh, Pittsburgh, PA – Kim Sutton-Tyrrell, PI 2001 – present; New England Research Institutes, Watertown, MA - Sonja McKinlay, PI 1995–2001. Steering Committee: Susan Johnson, Current Chair; Chris Gallagher, Former Chair. We thank the study staff at each site and all the women who participated in SWAN.
Funding Information:
The Study of Women's Health Across the Nation (SWAN) has grant support from the National Institutes of Health (NIH), DHHS, through the National Institute on Aging (NIA), the National Institute of Nursing Research (NINR) and the NIH ORWH (Grants NR004061; AG012505, AG012535, AG012531, AG012539, AG012546, AG012553, AG012554, AG012495). The Hip Strength Through the Menopausal Transition has grant support from the NIA (AG026463). Additional support for this project provided by NIA through P30-AG028748. Dr. Nagaraj was supported by the Bone Strength Through the Menopausal Transition: Trabecular Bone Score from the NIA ((AG026463). The content of this article is solely the responsibility of the authors and does not necessarily represent the official views of the NIA, NINR, ORWH or the NIH. Clinical Centers: University of Michigan, Ann Arbor – Siobán Harlow, PI 2011, MaryFran Sowers, PI 1994–2011; Massachusetts General Hospital, Boston, MA – Joel Finkelstein, PI 1999 – present; Robert Neer, PI 1994–1999; Rush University, Rush University Medical Center, Chicago, IL – Howard Kravitz, PI 2009 – present; Lynda Powell, PI 1994–2009; University of California, Davis/Kaiser – Ellen Gold, PI; University of California, Los Angeles – Gail Greendale, PI; Albert Einstein College of Medicine, Bronx, NY – Carol Derby, PI 2011, Rachel Wildman, PI 2010 –2011; Nanette Santoro, PI 2004–2010; University of Medicine and Dentistry – New Jersey Medical School, Newark – Gerson Weiss, PI 1994–2004; and the University of Pittsburgh, Pittsburgh, PA – Karen Matthews, PI. NIH Program Office: National Institute on Aging, Bethesda, MD – Sherry Sherman 1994 – present; Marcia Ory 1994–2001; National Institute of Nursing Research, Bethesda, MD – Program Officers. Central Laboratory: University of Michigan, Ann Arbor – Daniel McConnell (Central Ligand Assay Satellite Services). Coordinating Center: University of Pittsburgh, Pittsburgh, PA – Kim Sutton-Tyrrell, PI 2001 – present; New England Research Institutes, Watertown, MA - Sonja McKinlay, PI 1995–2001. Steering Committee: Susan Johnson, Current Chair; Chris Gallagher, Former Chair. We thank the study staff at each site and all the women who participated in SWAN.
Publisher Copyright:
© 2019 Elsevier Inc.
PY - 2019/5
Y1 - 2019/5
N2 - Background: In SWAN, we showed that accelerated loss of bone mineral density (BMD) begins 1 year before the final menstrual period (FMP) to 2 years after the FMP and slows thereafter. However, the risk of fracture depends on both BMD and bone geometry. The hip structural analysis (HSA) measures important geometric properties of bone. Changes in HSA parameters across the menopausal transition have not been previously assessed. Methods: The current analysis uses data from SWAN, 5 years before to 5 years after FMP (N = 900, Age (mean(SD)) = 46.85(2.60), 44% White). HSA parameters at the femoral narrow neck were obtained from 2D DXA scans and normalized to baseline values. FMP was determined from annual interviews. Changes in HSA were assessed over 3 periods, 5 to 2 years before FMP (pre-transmenopausal), 2 years before to 1 years after FMP (transmenopausal), 1 to 5 years after FMP (postmenopausal). Mixed linear models with random slopes were used to estimate the rate of change in HSA parameters relative to FMP. Results: Loss of BMD, cross-sectional area (CSA), and section modulus (SM) and increases in outer diameter (OD) were greatest in the transmenopausal period (p for all<0.05). Changes continued in the postmenopausal period but were not statistically significant. The cumulative percentage changes over 10 years in BMD (−10.67%), CSA (−9.01), SM (−7.03) and OD (+1.95) were statistically significant. Conclusion: Changes in hip geometry across the menopause transition parallel changes in BMD and provide insight into mechanisms that may increase risk of fragility fracture.
AB - Background: In SWAN, we showed that accelerated loss of bone mineral density (BMD) begins 1 year before the final menstrual period (FMP) to 2 years after the FMP and slows thereafter. However, the risk of fracture depends on both BMD and bone geometry. The hip structural analysis (HSA) measures important geometric properties of bone. Changes in HSA parameters across the menopausal transition have not been previously assessed. Methods: The current analysis uses data from SWAN, 5 years before to 5 years after FMP (N = 900, Age (mean(SD)) = 46.85(2.60), 44% White). HSA parameters at the femoral narrow neck were obtained from 2D DXA scans and normalized to baseline values. FMP was determined from annual interviews. Changes in HSA were assessed over 3 periods, 5 to 2 years before FMP (pre-transmenopausal), 2 years before to 1 years after FMP (transmenopausal), 1 to 5 years after FMP (postmenopausal). Mixed linear models with random slopes were used to estimate the rate of change in HSA parameters relative to FMP. Results: Loss of BMD, cross-sectional area (CSA), and section modulus (SM) and increases in outer diameter (OD) were greatest in the transmenopausal period (p for all<0.05). Changes continued in the postmenopausal period but were not statistically significant. The cumulative percentage changes over 10 years in BMD (−10.67%), CSA (−9.01), SM (−7.03) and OD (+1.95) were statistically significant. Conclusion: Changes in hip geometry across the menopause transition parallel changes in BMD and provide insight into mechanisms that may increase risk of fragility fracture.
KW - Bone mineral density
KW - Final menstrual period
KW - Hip geometry
KW - Hip strength
KW - Hip structure analysis
KW - Menopausal transition
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U2 - 10.1016/j.bone.2019.02.016
DO - 10.1016/j.bone.2019.02.016
M3 - Article
C2 - 30840919
AN - SCOPUS:85062845444
SN - 8756-3282
VL - 122
SP - 237
EP - 245
JO - Bone
JF - Bone
ER -