Bone Loss in Black South African women: Transition from Perimenopause to Menopause

Volume 5, Issue 6, December 2020     |     PP. 160-172      |     PDF (901 K)    |     Pub. Date: December 1, 2020
DOI:    198 Downloads     4742 Views  

Author(s)

Lineo Matsela, Department of Obstetrics & Gynaecology, School of Medicine, Sefako Makgatho Health Sciences University, Pretoria, South Africa
Olakunle A. Towobola, Department of Internal Medicine, School of Medicine, Sefako Makgatho Health Sciences University, Pretoria, South Africa
Ephraim T. Mokgokong, Department of Obstetrics & Gynaecology, School of Medicine, Sefako Makgatho Health Sciences University, Pretoria, South Africa

Abstract
ABSTRACT Objective: Loss of bone mineral density follows as a consequence of hormonal changes, as women transit from perimenopause to menopause. This study investigated the effect of such a transition on bone demineralisation among Black South African women.Methods: Two groups of women stratified by their menstrual history into perimenopause (n = 28) and postmenopause (n = 32), were enrolled for the study. Each of the study participants had her Body Mass Index (BMI) determined and a sample of blood was taken and analysed for follicle stimulating hormone (FSH). Bone mineral density was assessed for the hip bone using the Dual-Energy X-ray Absorptiometry machine (DEXA; Hologic 4500). Results: The mean age (± SD) of perimenopausal women was 44.6 years (± 3.6) compared with 63.4 years (± 7.2) for postmenopausal women. There was no statistical significant difference in the BMI of women in the two groups (p = 0.4671) and the serum FSH concentration of 46 to 100 mIu/mL (mean = 78 mIu/Ml; ± 0.69) confirmed the status of postmenopause. The negative slope of the change in hip BMD amongst perimenopausal women (-0.0006) translates to BMD loss of 0.06% per annum. This compares with hip BMD loss of -0.0025 (i.e. BMD loss of 0.25%/annum) amongst the postmenopausal women. This represents a 4-fold loss of BMD in postmenopausal compared with perimenopausal women.Conclusions: This study provides evidence that black South African women would begin to experience loss of bone mineral density of the hip in their transition from perimenopause to postmenopausal state. Key words: Bone Mineral Density; perimenopause; postmenopause, Dual Energy Absorptiometry

Keywords
Key words: Bone Mineral Density; perimenopause; postmenopause, Dual Energy Absorptiometry

Cite this paper
Lineo Matsela, Olakunle A. Towobola, Ephraim T. Mokgokong, Bone Loss in Black South African women: Transition from Perimenopause to Menopause , SCIREA Journal of Clinical Medicine. Volume 5, Issue 6, December 2020 | PP. 160-172.

References

[ 1 ] NIH Consensus Development Panel. JAMA, 2001; 285: 785–795.
[ 2 ] Epidemiology reviews. The Johns Hopkins University of Hygiene and Public Health, 1985; 7: 178–208.
[ 3 ] Melton L.J. and Riggs B.L. Clinical spectrum. In: Riggs B.L., Melton, L.J. (Eds), Osteoporosis: Etiology, Diagnosis, and Management. New York: Raven Press, 1988: 155–179.
[ 4 ] Evans J.G. Epidemiology of proximal femoral fractures. Recent Advances in Geriatric Medicine, 1982; 2: 201–214.
[ 5 ] Cummings S.R., Kelsey J.L., Nevilt M.C. and O’Dowd K.J. Epidemiology of osteoporosis and osteoporotic fractures. Epidemiology Review, 1985; 7: 178–208.
[ 6 ] Stott S. and Gray D.H. The incidence of femoral neck fractures in New Zealand. New Zealand Medical Journal, 1980; 91: 6–9.
[ 7 ] Solomon, L. Osteoporosis and fracture of the femoral neck in the South Africa Bantu. Journal of Bone and Joint Surgery, 1968; 50: B2–B12.
[ 8 ] Hough S. Osteoporosis in South Africa. In: Fourie, J., Steyn, K. and Temple, N.J. (Eds), Chronic diseases of lifestyle in South Africa since 1995–2005, Chapter 13. Tygerberg: Medical Research Council, 2006, pp 186–193.
[ 9 ] Nelson D.A., Pettifor J.M., Barondess D.A., Cody D.D., Uusi-Rasi K. and Beck T.J. Comparison of cross-sectional geometry of the proximal femur in white and black women from Detroit and Johannesburg. Journal of Bone and Mineral Research, 2004; 19(4): 560–565.
[ 10 ] Constant D., Rosenberg L., Zhang Y., Cooper D., Kalla A.A., Micklesfield L. and Hoffman M. Quantitative ultrasound in relation to risk factors for low bone mineral density in South African pre-menopausal women. Archives of Osteoporosis, 2009; 4(1–2): 55–65.
[ 11 ] Kruger I.M., Kruger M.C., Doak C.M. and Kruger A. Cut-off values of distal forearm bone density for the diagnosis of central osteoporosis in black postmenopausal South African women. Journal of Endocrinology, Metabolism and Diabetes of South Africa, 2012; 17(2): 65–112
[ 12 ] Matsela, L. Towobola, O. Mokgokong, E. Osteoporosis in Black South African Women: Myth or Reality. Journal of South Asian Federation of Menopause Societies, 2017; 5(2): 111-116
[ 13 ] Compston, J.E. Osteoporosis. Journal of Clinical Endocrinology. 1990; (33): 653-682
[ 14 ] Barker D.P.J. Programming the baby. In: Barker D.P.J. (Ed), Mothers, Babies and Disease in Later Life, London: British Medical Journal Publishing Group. 1994, pp 14-36
[ 15 ] Barker D.J.P. The Wellcome Foundation Lecture 1994. The fatal organics of adult disease. British Medical Journal, 1995; 262: 34-37
[ 16 ] Cooper c; Fall C; Egges P; et al. Growth in infancy and bone mass in later life. Annuals of Rheumatic Diseases. 1997; 56: 17-21S
[ 17 ] Cooper C. & Woolf A.D. (Eds). Epidemiology of Osteoporosis, Best Practice & Research Compendium, Amsterdam: Elsevier, 2006, 15-16
[ 18 ] Hadjikas D.J., Kokkinakis E.P., Sfakianakis M.E. and Rafitis S.A. Bone density patterns after normal tand premature menopause, Maturitas, 2003; 44: 279-286.
[ 19 ] Matsela, L. Towobola, O. Mokgokong, E. – Knowledge and attitudes of Black South African women toward Menopause: Impact of Culture and Traditions. Journal of South Asian Federation of Menopause Societies, 2017; 5(2): 117-122
[ 20 ] Harlow S. D; Gass M; Hall J.E; Lobo R; Maki P; Rebar R.W; Sherman S; Sluss PM. and De Villiers T.J. Executive summary of the stages of reproductive aging workshop +10. Addressing theUnfinished agenda of staging reproductive aging. Climacteric, 2012; (15): 105 -114
[ 21 ] Sowers M. R; Zheng H; Jannaush M.I et al. Amount of bone loss in relation to time around the final menstrual period and follicle stimulating hormone of the transmenopause Journal of clinical endocrinology and metabolism 2010; 95(5): 2155-2162
[ 22 ] Sowers MR, Zheng H,Greendale GA, Neer MR, Cauley JA, Ellis J, Johnson S and Finkelstein JS. Changes in bone resorption Across the Menopause Transition: Effects of Reproductive Hormones; Body size and Ethnicity. Journal Clinical Endocrinology and Metabolism, 2013,98(7): 2854-2863
[ 23 ] Seifert-Klauss V, Fillenberg S, Schneider H, Luppa P,Mueller and Kiechle M. Bone loss in premenopausal ;perimenopausal and postmenopausal women: results of a prospective observational study over 9 years. Climacteric, 2012; (15): 433-443
[ 24 ] Vasikaran S; Eastell R; Bruyere O; et al. Markers of bone turnover for the prediction of fracture risk and monitoring of osteoporosis treatment: a need for international reference standards. Journal of osteoporosis international 2011;22 (2) 391-420.
[ 25 ] Lo J.C; Burnett-Bowie S.M; Finkelstein J.S. Bone and the perimenopause. North American Clinics of Obstetrics and Gynecology, 2011; 38 (3): 503-517
[ 26 ] Nelson D.A, Pettifor J.M, Baroness D.A, Cody D.D. Uusi –Rasi K, and Beck T.J. Comparison of cross-sectional geometry of the proximal femur in white and black women from Detroit and Johannesburg. Journal of Bone and Mineral Research, 2004; 19 (4): 560-565.
[ 27 ] Ettinger B, Pressman A, Sklarin P, Bauer D.C, Cauley J.A, Cummings S.R. Associations between low levels of serum oestradiol, bone density,and fractures among elderly women: the study of osteoporotic fractures. Journal of Clinical Endocrinology and Metabolism, 1998; 83: 2239-2243.
[ 28 ] Rogers A,Saleh G,Hannon R.A, Greenfield , Eastell R. Circulating estradiol and osteoprotegerin as determinants of bone turnover and bone density in postmenopausal women. Journal of Clinical Endocrinology and Metabolism, 2002; 87: 4470-4475.
[ 29 ] Ahlborg H.G; Johnell O; Turner C.H; Rannevik G; Karlsson M.K. Bone loss and bone size after menopause. The New England Journal of Medicine, 2003;,349(4): 327-334.