|
| Author | Title | Design | Methods | Relevant findings | Conclusion |
|
| Ebeling et al. 1996 [64] | Bone turnover markers and bone density across the menopausal transition | 281 women, 45–57 years.
3 groups:
60 premenopausal
118 perimenopausal
103 postmenopausal
(of these, 36 with HRT) | DXA
E2, FSH, LH, inhibin on day 4–8 of menstrual cycle if applicable
Bone formation:
OC, BAP, PICP
Bone resorption:
PYD, DPD, NTX | Postmenopausal group: BMD.
Loss in BMD correlated with age in perimenopausal group.
Perimenopausal group: LH, FSH doubled versus premenopause;
E2, BAP did not differ between premenopausal and perimenopausal group.
PYD, DPD, NTX, BAP, and OC in postmenopausal versus premenopausal group.
perimenopausal group: Positive correlation of BMD with DPD.
All women: correlation of BMD with NTX, BAP, OC, FSH | Perimenopause: increased bone resorption rate and decreased bone density.
Other factors
apart from E2
are involved in
the development of postmenopausal osteoporosis |
|
| Khosla et al. 2005 [65] | Relationship of volumetric bone density and structural parameters at different skeletal sites to sex steroid levels in women | 235 untreated women
3 groups:
(i) premenopausal (20–39 years.)
(ii) mixed (40–59 years.)
(iii) postmenopausal (60 years.) | QCT
E2, Testosterone | Postmenopausal group: significant correlation of low bioavailable E2 and BMD (trabecular and cortical).
40–59 years: significant correlation between average rise in bioavailable E2 and loss in trabecular BMD. | Trabecular bone reacts faster to lowering E2.
The threshold for estrogen
deficiency in cortical bone in women appears to be lower than that in trabecular bone. |
|
| Kushida et al. 1995 [66] | Comparison of markers for bone formation and resorption in premenopausal and postmenopausal subjects, and osteoporosis patients | 95 premenopausal women, 30–53 years.
66 postmenopausal women, 50–69 years
29 untreated women with osteoporosis, 55–91 years.
No distinct perimenopausal group, but included in pre- and postmenopausal | No BMD measurement
Bone formation:
AP, OC, PICP,
Bone resorption:
PYD, DPD | Postmenopausal group: AP, OC, PICP, PYD, DPD significantly higher than in premenopausal group.
In osteoporosis: PICP, PYD, DPD significantly higher than in postmenopausal group.
Women 50 years: PYD, DPD higher than in women 30–49 years. | Markers in postmenopause higher than in premenopause. In women with osteoporosis resorption markers are higher than formation markers. |
|
| Löfman et al. 2005 [67] | Common biochemical markers of bone turnover predict future bone loss: a 5-year follow-up study | Cross sectional study
(+ longitudinal)
192 women, 21–79 years.
3 groups
(i) premenopausal
(ii) perimenopausal
(i.e., premenopausal at baseline and postmenopausal after 5 years).
(iii) postmenopausal | 2x DXA
Bone formation:
BAP, OC, AP
Bone remodelling: Hpr
Ca | Baseline values of markers correlated negatively with baseline BMD.
AP, OC, Hpr, Ca rise at the “beginning of menopause”
15 years after menopause: OC and Hpr are still elevated. | Bone markers and current BMD could give information about coming loss of BMD. |
|
| Melton et al. 1997 [68] | Relationship of bone turnover to bone density and fractures | 351 women, 20–80 years.
2 groups:
138 premenopausal
213 postmenopausal
(i) 47 with HRT
(ii) 166 without HRT
of these, 89 cases of osteoporosis
No distinct perimenopausal group | DXA
Bone formation:
OC, BAP, PICP
Bone resorption:
PYD, DPD, NTX | Premenopausal group: OC, NTX negatively correlated with BMD.
Postmenopausal group: increase of markers with age.
Postmenopausal group: OC, BAP, NTX, PICP negatively correlated with BMD.
Osteoporosis: markers↑, BMD↓. | Combination of markers with BMD measurement is sensible for prediction of individual fracture risk.
NTX is best predictor of loss in BMD. |
|
| Ravn et al. 1996 [69] | High bone turnover is associated with low bone mass in both pre- and postmenopausal women | 979 women, 30–75 years.
2 groups:
334 premenopausal
645 postmenopausal
5 year-longitudinal analysis.
No distinct perimenopausal group, but included in pre- and postmenopausal | DXA
Bone formation:
OC, AP
Bone remodelling: HydroxyProline
Bone resorption:
CTX | Premenopausal 50 years: markers stable.
Women with highest markers had significantly lower BMD.
OC and CTX correlated with BMD.
Postmenopausal group:
CTX, OC sign. higher than in premenopausal group.
5 years. after menopause: CTX, OC stable again. | Bone metabolism is accelerated in perimenopause and early postmenopause. |
|
| Sowers et al. 2003 [70] | The association of endogenous hormone concentrations and bone mineral density measures in pre- and perimenopausal women of four ethnic groups: SWAN | 2336 women, multiethnic, 42–52 years.
2 groups:
(i) premenopausal
(ii) perimenopausal | DXA
E2, FSH, T, DHEAS, SHBG (day 2-7 of menstrual cycle if applicable) | Perimenopausal group: FSH higher and BMD lower than premenopausal group.
All women: negative correlation of FSH with BMD.
No correlation of E2 and BMD. | Loss of BMD starts before menopause. |
|
