title: Bone mineral density loss in relation to the final menstrual period in a multiethnic cohort: results from the Study of Women's Health Across the Nation (SWAN).
abstract: The objective of this study was to describe the time of onset and offset of bone mineral density (BMD) loss relative to the date of the final menstrual period (FMP); the rate and amount of BMD decline during the 5 years before and the 5 years after the FMP; and the independent associations between age at FMP, body mass index (BMI), and race/ethnicity with rates of BMD loss during this time interval. The sample included 242 African American, 384 white, 117 Chinese, and 119 Japanese women, pre- or early perimenopausal at baseline, who had experienced their FMP and for whom an FMP date could be determined. Loess-smoothed curves showed that BMD loss began 1 year before the FMP and decelerated (but did not cease) 2 years after the FMP, at both the lumbar spine (LS) and femoral neck (FN) sites. Piecewise, linear, mixed-effects regression models demonstrated that during the 10-year observation period, at each bone site, the rates and cumulative amounts of bone loss were greatest from 1 year before through 2 years after the FMP, termed the transmenopause. Postmenopausal loss rates, those occurring between 2 and 5 years after the FMP, were less than those observed during transmenopause. Cumulative, 10-year LS BMD loss was 10.6%; 7.38% was lost during the transmenopause. Cumulative FN loss was 9.1%; 5.8% was lost during the transmenopause. Greater BMI and African American heritage were related to slower loss rates, whereas the opposite was true of Japanese and Chinese ancestry.
authors: Division of Geriatrics, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095-1687, USA. ggreenda@mednet.ucla.edu
authors: Gail A
authors: GA
authors: Greendale
authors: MaryFran
authors: M
authors: Sowers
authors: Weijuan
authors: W
authors: Han
authors: Mei-Hua
authors: MH
authors: Huang
authors: Joel S
authors: JS
authors: Finkelstein
authors: Carolyn J
authors: CJ
authors: Crandall
authors: Jennifer S
authors: JS
authors: Lee
authors: Arun S
authors: AS
authors: Karlamangla
mesh_terms: D000328:Adult; D015992:Body Mass Index; D015519:Bone Density / Q000502:physiology*; D015331:Cohort Studies; D005006:Ethnicity; D005260:Female; D005272:Femur Neck / Q000502:physiology; D006801:Humans; D008159:Lumbar Vertebrae / Q000502:physiology; D008598:Menstruation / Q000502:physiology*; D008875:Middle Aged; D016387:Women's Health