PURPOSE While weight-bearing physical activity (PA) benefits bone health, it remains unclear whether PA can counteract hormone-driven menopausal bone deterioration. This secondary analysis of a population-based prospective follow-up study examined changes in bone health indicators around menopause and evaluated whether accelerometer-measured habitual skeletal loading is associated with these changes. METHODS A total of 189 initially perimenopausal women without estrogen therapy (mean age 52 [SD 2] years) were followed until they became postmenopausal (mean follow-up time 15 [9] months). Femoral neck bone mineral density (FN BMD) and bone mineral content (BMC) were measured with dual x-ray absorptiometry (DXA). Femoral and tibial shaft volumetric BMD (vBMD), cross-sectional geometry, and stress-strain index (SSI) were assessed using quantitative computed tomography (QCT) in a subset of 61 women. Habitual skeletal loads (mean daily osteogenic index [OI] and low, medium, and high-intensity impact counts) were evaluated with multiple-day free-living accelerometry records. Longitudinal associations of habitual skeletal loads and bone outcomes were analyzed with GEE models. RESULTS Consistent decreases were observed in FN BMD and BMC, and femoral and tibial shaft vBMD and SSI (p < 0.001) over the follow-up. Slight decreases over the follow-up were also observed in OI and medium impacts in the full sample, and medium and high impact counts in the subsample (p < 0.05). Medium impacts were associated with tibial shaft vBMD and SSI (β = 0.204, 95% CI [0.018, 0.391] and β = 0.077 95% CI [0.000, 0.154], respectively). High impacts were associated with femoral shaft vBMD (β = 0.186 95% CI [0.006, 0.366]. However, no association was observed between habitual skeletal loads and changes in bone characteristics over the follow-up. CONCLUSIONS We observed a rather uniform skeletal response to the menopausal transition at all measured bone sites. Positive associations were found between medium and high-intensity impacts and bone characteristics at the femoral and tibial shafts. However, habitual skeletal loading did not seem to counteract bone deterioration during the menopausal transition.

中文翻译：

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更年期过渡期间习惯性骨骼负荷与骨骼变化的关联：一项后续研究。


目的 虽然负重体育活动 （PA） 有益于骨骼健康，但目前尚不清楚 PA 是否可以抵消激素驱动的更年期骨骼退化。这项基于人群的前瞻性随访研究的二次分析检查了更年期前后骨骼健康指标的变化，并评估了加速度计测量的习惯性骨骼负荷是否与这些变化相关。方法 共随访 189 例最初未接受雌激素治疗的围绝经期妇女 （平均年龄 52 [SD 2] 岁） 直至绝经后 （平均随访时间 15 [9] 个月）。股骨颈骨密度 （FN BMD） 和骨密度 （BMC） 采用双 X 线吸收测定法 （DXA） 测量。使用定量计算机断层扫描 （QCT） 评估 61 名女性的股骨和胫骨干体积 BMD （vBMD） 、横截面几何形状和应力应变指数 （SSI）。习惯性骨骼负荷 （平均每日成骨指数 [OI] 和低、中、高强度影响计数）用多日自由生活加速度测量记录进行评估。使用 GEE 模型分析习惯性骨骼负荷和骨骼结果的纵向关联。结果 在随访中观察到 FN BMD 和 BMC 以及股骨和胫骨干 vBMD 和 SSI （p < 0.001） 持续下降。在随访期间，也观察到全样品中的 OI 和中等影响以及子样品中的中高影响计数略有下降 （p < 0.05）。中等冲击与胫骨干 vBMD 和 SSI 相关 （β = 0.204， 95% CI [0.018， 0.391] 和 β = 0.077 95% CI [0.000， 0.154]）。高冲击与股骨干vBMD相关（β = 0.186 95% CI [0.006， 0.366]。 然而，在随访中未观察到习惯性骨骼负荷与骨骼特征变化之间的关联。结论 我们在所有测量的骨骼部位观察到对更年期过渡的骨骼反应相当均匀。发现中高强度冲击与股骨干和胫骨干的骨骼特征之间存在正相关。然而，习惯性的骨骼负荷似乎并没有抵消绝经过渡期间的骨骼退化。