Year: 2014
Type: article
Abstract: CONTEXT: Vasomotor symptoms (VMS) are common. Whether VMS are associated with fracture incidence or bone mineral density (BMD) levels is unknown. OBJECTIVE: This study aimed to examine associations of baseline VMS with fracture incidence and BMD. DESIGN: This was a prospective observational study with mean (SD) followup of 8.2 (1.7) years (1993-2005). SETTING: Forty United States clinical centers. PARTICIPANTS: We examined data from Women's Health Initiative Clinical Trial participants (n = 23 573) age 50-79 years not using menopausal hormone therapy, and 4,867 participants of the BMD sub-study. INTERVENTIONS: None. MAIN OUTCOME MEASURES: We measured baseline VMS, incident adjudicated fractures, and BMD (baseline, annual visits 1, 3, 6, and 9). RESULTS: After adjustment for baseline age, body mass index, race/ethnicity, smoking, and education, the hazard ratio for hip fracture among women with baseline moderate/severe VMS (vs no VMS) was 1.78 (95% confidence interval [CI], 1.20-2.64; P = .01). There was no association between VMS and vertebral fracture. VMS severity was inversely associated with BMD during followup (P = .004 for femoral neck, P = .045 for lumbar spine). In repeated measures models, compared with women who reported no VMS, women with moderate/severe VMS had 0.015 g/cm(2) lower femoral neck BMD (95% CI, -0.025--0.005) and 0.016 g/cm(2) lower lumbar spine BMD (95% CI, -0.032--0.004). CONCLUSIONS: Women with moderate/severe VMS have lower BMD and increased hip fracture rates. Elucidation of the biological mechanisms underlying these associations may inform the design of preventive strategies for at-risk women prior to occurrence of fracture.
DOI: 10.1210/jc.2014-3062
Institutions: University of Iowa, Brigham and Women's Hospital, University of California, Los Angeles, University of Pittsburgh, Fred Hutch Cancer Center, Women's Health Initiative, University at Buffalo, State University of New York, Harvard University, Kaiser Permanente, Kaiser Permanente Center for Health Research, University of Miami, Wake Forest University Health Sciences, Wake Forest University, Mercy Health
Language: English
Subfield: Endocrinology, Diabetes and Metabolism
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
Funders: U.S. Department of Health and Human Services, Amgen, Bristol-Myers Squibb, Eli Lilly and Company, Pfizer, Brigham and Women's Hospital, Ohio State University, Wake Forest University, University of Pittsburgh, MedStar Health Research Institute, Amarin Corporation, National Institutes of Health, University of California, Los Angeles, University at Buffalo, National Institute on Aging, National Heart, Lung, and Blood Institute, David Geffen School of Medicine, University of California, Los Angeles
OpenAlex ID: W1972113633