J Clin Endocrinol Metab. 2022 May 4:dgac248. doi: 10.1210/clinem/dgac248. Online ahead of print.
ABSTRACT
CONTEXT: Although it is well documented that estrogen hormone is positively associated with bone mineral density and lower risk of fracture, there are limited studies on the association between duration of endogenous estrogen exposure (EEE) and fracture, especially by longitudinal design.
OBJECTIVE: This study aimed to investigate the relationship between EEE with fracture incidence by longitudinal design in a community-based study.
METHODS: A total of 5,269 eligible post-menarcheal women, including 2,411 premenopausal and 2,858 menopausal women were recruited from among Tehran-Lipid and Glucose-Study. Cox proportional hazards regression model with adjustment of potential confounders was performed to assess the relationship between duration of EEE and incident of any hospitalized fractures.
RESULTS: A total of 26.7 % (1409 out of 5269) women were menopause at the baseline and 2858 of the remaining participants reached menopause at the end of follow-up. Results of the unadjusted model demonstrated that the EEE z-score was negatively associated with fracture incidence (unadjusted hazard ratio (HR): 0.81, 95% CI: 0.68-0.96) in post-menarcheal women, indicating that per one SD increase of EEE z-score, the hazard of fracture reduced by 19%. Results remained statistically unchanged after adjustment for potential confounders (adjusted HR: 0.70, 95% CI: 0.58-0.86).
CONCLUSION: The findings of this cohort study suggest that a longer duration of EEE has a protective effect on fracture incidence; a point that needs to be considered in fracture risk assessment.
PMID:35512228 | DOI:10.1210/clinem/dgac248
