×
Home Current Archive Editorial board
News Contact
Review paper

Association of age at menopause and age at menarche with later-life skeletal fragility fractures in Bosnian postmenopausal women

By
Amila Kapetanović Orcid logo ,
Amila Kapetanović
Contact Amila Kapetanović

Health Center of Sarajevo Canton , Sarajevo , Bosnia and Herzegovina

Gordan Bajić ,
Gordan Bajić

Faculty of Health Studies, Pan European University Apeiron , Banjaluka , Bosnia and Herzegovina

Sabina Sarić ,
Sabina Sarić

Health Center of Sarajevo Canton , Sarajevo , Bosnia and Herzegovina

Rubina Alimanović-Alagić ,
Rubina Alimanović-Alagić

Clinical Center, University of Sarajevo , Sarajevo , Bosnia and Herzegovina

Martina Bonić ,
Martina Bonić

Therapiezentrum Unterhaching , Unterhaching Kreis München , Germany

Dženan Pleho
Dženan Pleho

Health Center of Sarajevo Canton , Sarajevo , Bosnia and Herzegovina

Abstract

Aim
To investigate the effects of estrogen-related events (age at menopause, age at menarche) on later-life skeletal fragility in Bosnian postmenopausal women.
Methods
A total of 100 postmenopausal Bosnian women, aged between 55 and 75 years, were included. The women in the study group (n=50) had fragility fractures, and in the control group (n=50) were without fragility fractures. Bone mineral density
(BMD) was measured using Dual Energy X-ray Absorptiometry (DXA) on the lumbar spine (L2-L4) and proximal femur.
Results
No statistically significant difference relating to the age between the groups was found. The average age at menopause was 44.70 years in women with fragility fractures and 51.76 years in women without fragility fracture (p=0.0001). The average age at menarche was 14.30 years in women with fragility fractures and 13.70 years in women without fragility fractures (p=0.140). T score of ≤-2.5 SD was found in 40 (80%) women in the study group, and in eight (16%) women in the control group (p=0.0001).
Conclusions
Age at menopause, but not age at menarche, was risk factors for later-life fragility fracture in postmenopausal Bosnian
women. In addition, fragility fractures correlated with low BMD in this population group.

References

1.
Lu L, Tian L. Postmenopausal osteoporosis coexisting with sarcopenia: the role and mechanisms of estrogen. J Endocrinol. 2023;259:e230116.
2.
Iolascon G, Paoletta M, Liguori S, Gimigliano F, Moretti A. Bone fragility: conceptual framework, therapeutic implications, and COVID19-related issues. Ther Adv Musculoskelet Dis. 2022;14(1759720).
3.
Brown JP, Josse RG. clinical practice guidelines for the diagnosis and management of osteoporosis in Canada. CMAJ. 2002;167(10 Suppl).
4.
Ratti C, Vulcano E, Canton G, Marano M, Murena L, Cherubino P. Factors affecting bone strength other than osteoporosis. Aging Clin Exp Res. 2013;25(Suppl 1).
5.
Tran T, Ho-Le T, Bliuc D, Abrahamsen B, Hansen L, Vestergaard P, et al. “Skeletal Age” for mapping the impact of fracture on mortality. Elife. 2023;12:e83888.
6.
Kanis JA, Norton N, Harvey NC, Jacobson T, Johansson H, Lorentzon M, et al. SCOPE 2021: a new scorecard for osteoporosis in Europe. Arch Osteoporos. 2021;16(82).
7.
Song S, Guo Y, Yang Y, Fu D. Advances in pathogenesis and therapeutic strategies for osteoporosis. Pharmacol Ther. 2022;237(108168).
8.
Williams C, Sapra A. Osteoporosis markers. Updated. 2023;
9.
Clarke BL, Khosla S. Female reproductive system and bone. Arch Biochem Biophys. 2010;503:118–28.
10.
Wang LT, Chen LR, Chen KH. Hormone-related and drug-induced osteoporosis: a cellular and molecular overview. Int J Mol Sci. 2023;24(5814).
11.
Seeman E, Delmas PD. Bone quality: the material and structural basis of bone strength and fragility. N Engl J Med. 2006;354:2250–61.
12.
Long G, Liu C, Liang T, Zhang Z, Qin Z, Zhan X. Predictors of osteoporotic fracture in postmenopausal women: a meta-analysis. J Orthop Surg Res. 2023;18(574).
13.
Shieh A, Ruppert KM, Greendale GA, Lian Y, Cauley JA, Burnett-Bowie SA, et al. Associations of age at menopause with postmenopausal bone mineral density and fracture risk in women. J Clin Endocrinol Metab. 2022;107:e561-9.
14.
Paganini-Hill A, Atchison KA, Gornbein JA, Nattiv A, Service SK, White SC. Menstrual and reproductive factors and fracture risk: the leisure world cohort study. J Womens Health (Larchmt. 2005;14:808–19.
15.
Vesco KK, Marshall LM, Nelson HD, Humphrey L, Rizzo J, Pedula KL, et al. Study of osteoporotic fractures. Surgical menopause and nonvertebral fracture risk among older US women. Menopause. 2012;19:510–6.
16.
Fakkert IE, Teixeira N, EM A, Slart R, Mourits M, Bock GH. Bone mineral density and fractures after surgical menopause: systematic review and meta-analysis. BJOG. 2017;124:1525–35.
17.
Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. Report of a WHO Study Group Geneva, World Health Organization, 1994 (WHO Technical Report Series. (843)).
18.
Anagnostis P, Siolos P, NK G, Kosmidou N, AM A, K C, et al. Association between age at menopause and fracture risk: a systematic review and meta-analysis. Endocrine. 2019;63:213–24.
19.
Kotsopoulos J, Hall E, FinchA H, H M, J R, B N, et al. Changes in bone mineral density after prophylactic bilateral salpingo-oophorectomy in carriers of a BRCA mutation. Psychooncology. 2013;22:212–9.
20.
Farahmand M, Rahmati M, Azizi F, Gandevani BS, Tehrani RF. The impact of endogenous estrogen exposure duration on fracture incidence: a longitudinal cohort study. J Clin Endocrinol Metab. 2022;107:e3321-9.
21.
MA AA, HS S, MF A, WW A, AH MM, WE AE. Proportion and risk factors of silent vertebral fractures among Egyptian females with fragility hip fracture presenting to the emergency room of Ain Shams University Hospitals. Cureus. 2023;15 46214.
22.
Yoo JE, Shin DW, Han K, Kim D, Yoon JW, Lee DY. Association of female reproductive factors with incidence of fracture among postmenopausal women in Korea. JAMA Netw Open. 2021;4:e2030405.
23.
Kanis JA, Cooper C, Rizzoli R, Abrahamsen B, AlDaghri NM, Brandi ML, et al. European Society for Clinical and Economic Aspects of Osteoporosis. In: Osteoarthritis and Musculoskeletal Diseases (ESCEO) Identification and management of patients at increased risk of osteoporotic fracture: outcomes of an ESCEO expert consensus meeting Osteoporos Int 2017. p. 2023–34.
24.
Mayhew PM, Thomas CD, Clement JG, Loveridge N, Beck TJ, Bonfield W, et al. Relation between age, femoral neck cortical stability, and hip fracture risk. Lancet. 2005;366:129–35.
25.
Cauley JA. Defining ethnic and racial differences in osteoporosis and fragility fractures. Clin Orthop Relat Res. 2011;469:1891–9.
26.
Lo JC, Chandra M, Lee DR, Darbinian JA, Gordon NP, Zeltser DW, et al. Sex- and ethnic-specific patterns in the incidence of hip fracture among older US Asian and non-Hispanic white adults. J Am Geriatr Soc. 2023;71:1910–6.
27.
Kanis JA, Johnell O, Leat C, Jonsson B, Oden A, Ogelsby AK. International variations in hip fracture probabilities: implications for risk assessment. J Bone Miner Res. 2002;17:1237–44.
28.
Barrett-Connor E, Siris ES, Wehren LE, Miller PD, Abbott TA, Berger ML, et al. Osteoporosis and fracture risk in women of different ethnic groups. J Bone Miner Res. 2005;20:185–94.

Citation

Authors retain copyright. This work is licensed under a Creative Commons Attribution 4.0 International License. Creative Commons License

 

Article metrics

Google scholar: See link

The statements, opinions and data contained in the journal are solely those of the individual authors and contributors and not of the publisher and the editor(s). We stay neutral with regard to jurisdictional claims in published maps and institutional affiliations.