1
|
Anagnostis P, Lallas K, Pappa A, Avgeris G, Beta K, Damakis D, Fountoukidou E, Zidrou M, Lambrinoudaki I, Goulis DG. The association of vasomotor symptoms with fracture risk and bone mineral density in postmenopausal women: a systematic review and meta-analysis of observational studies. Osteoporos Int 2024:10.1007/s00198-024-07075-8. [PMID: 38563960 DOI: 10.1007/s00198-024-07075-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 03/21/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND/AIMS Vasomotor symptoms (VMS) adversely affect postmenopausal quality of life. However, their association with bone health has not been elucidated. This study aimed to systematically review and meta-analyze the evidence regarding the association of VMS with fracture risk and bone mineral density (BMD) in peri- and postmenopausal women. METHODS A literature search was conducted in PubMed, Scopus and Cochrane databases until 31 August 2023. Fracture, low BMD (osteoporosis/osteopenia) and mean change in lumbar spine (LS) and femoral neck (FN) BMD were assessed. The results are presented as odds ratio (OR) and mean difference (MD), respectively, with a 95% confidence interval (95% CI). The I2 index quantified heterogeneity. RESULTS Twenty studies were included in the qualitative and 12 in the quantitative analysis (n=49,659). No difference in fractures between women with and without VMS was found (n=5, OR 1.04, 95% CI 0.93-1.16, I2 16%). However, VMS were associated with low BMD (n=5, OR 1.54, 95% CI 1.42-1.67, I2 0%). This difference was evident for LS (MD -0.019 g/cm2, 95% CI -0.03 to -0.008, I2 85.2%), but not for FN BMD (MD -0.010 g/cm2, 95% CI -0.021 to 0.001, I2 78.2%). These results were independent of VMS severity, age and study design. When the analysis was confined to studies that excluded menopausal hormone therapy use, the association with BMD remained significant. CONCLUSIONS The presence of VMS is associated with low BMD in postmenopausal women, although it does not seem to increase fracture risk.
Collapse
Affiliation(s)
- Panagiotis Anagnostis
- 1st Department of Obstetrics and Gynecology, Medical School, Unit of Reproductive Endocrinology, Aristotle University of Thessaloniki, Thessaloniki, Greece.
| | - Konstantinos Lallas
- Department of Medical Oncology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Anna Pappa
- 1st Department of Obstetrics and Gynecology, Medical School, Unit of Reproductive Endocrinology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Georgios Avgeris
- 1st Department of Obstetrics and Gynecology, Medical School, Unit of Reproductive Endocrinology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Kristina Beta
- 1st Department of Obstetrics and Gynecology, Medical School, Unit of Reproductive Endocrinology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Dimitrios Damakis
- 1st Department of Obstetrics and Gynecology, Medical School, Unit of Reproductive Endocrinology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Eirini Fountoukidou
- 1st Department of Obstetrics and Gynecology, Medical School, Unit of Reproductive Endocrinology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Maria Zidrou
- 1st Department of Obstetrics and Gynecology, Medical School, Unit of Reproductive Endocrinology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Irene Lambrinoudaki
- 2nd Department of Obstetrics and Gynecology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitrios G Goulis
- 1st Department of Obstetrics and Gynecology, Medical School, Unit of Reproductive Endocrinology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| |
Collapse
|
2
|
Everett BG, Jenkins V, Hughes TL. Reproductive Aging Among Sexual Minority Women. CURRENT OBSTETRICS AND GYNECOLOGY REPORTS 2021. [DOI: 10.1007/s13669-021-00306-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
3
|
Women's Mid-Life Night Sweats and 2-Year Bone Mineral Density Changes: A Prospective, Observational Population-Based Investigation from the Canadian Multicentre Osteoporosis Study (CaMos). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15061079. [PMID: 29861446 PMCID: PMC6025051 DOI: 10.3390/ijerph15061079] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 05/14/2018] [Accepted: 05/19/2018] [Indexed: 11/17/2022]
Abstract
Women’s hot flushes and night sweats, collectively called vasomotor symptoms (VMS), are maximal (79%) in late perimenopause. The evidence describing whether VMS are associated with loss of areal bone mineral density (BMD) is mixed. We examined baseline and 2-year data for 1570 randomly selected women aged 43–63 in the Canadian Multicentre Osteoporosis Study (CaMos), a prospective Canada-wide study; we used linear regression to assess the relationship of night sweats (VMSn) with BMD and its changes. Clinically important VMSn occurred for 12.2%. Women with VMSn were slightly younger (54.5 vs. 55.3 years, p = 0.02) and less likely to use sex steroid therapies (39.8% vs. 51.4%, p < 0.05). BMD at the lumbar spine (L1-4), femoral neck (FN) and total hip (TH) were similar between those with/without VMSn. In adjusted models, we did not find a significant association between VMSn and 2-year change in L1-4, FN and TH BMD. Age, reproductive status, weight, sex steroid therapy and smoking status were associated with 2-year change in BMD. Incident fractures over 2 years also did not differ by VMSn. Our analyses were restricted to VMSn and may not truly capture the relationship between VMS and BMD. Additional research involving VMS, bone loss and fracture incidence is needed.
Collapse
|