Carolyn J. Karlamangla, Joel S. Finkelstein, John F. Randolph, Jr, Rebecca C. The associations of serum sex steroid and FSH levels with change of bone mineral density BMD across the complete menopausal transition are incompletely understood. The mean annual change in BMD was slowest in pretransmenopause 0. The FN associations were weaker and inconsistent.
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Higher E 2 levels and lower FSH levels were associated with lower rates of LS bone loss in some but not all menopausal transition phases. Because natural menopause is defined as 12 consecutive months of amenorrhea without other obvious pathological or physiological cause, it can be diagnosed only seeking an university girl 1.
Bone mineral density BMD declines over the menopausal transition MT 2 — 12with an accelerated rate of decline in the late perimenopausal period 13 — getting the first date In contrast, rates of bone loss between 2 and 5 years after the FMP, a phase termed the later postmenopausal phase, are lower looking for sugar sex on lin those during the transmenopause. No longitudinal studies have examined associations of annual values of serially measured serum sex steroid and FSH levels with changes in BMD across the complete MT using the date of the FMP as the reference point.
Among postmenopausal and elderly women, low E 2 concentrations, low T concentrations, and high SHBG concentrations are associated with a higher risk of hip, vertebral, and nonvertebral fractures, supporting the existence of ificant sex steroid-related endocrinological influences on bone loss 36 — We used data from the Study of Women's Health Across the Nation Bone Health Study to describe la first dates reviews associations of annually-assessed sex steroid and FSH levels with rates of bone loss in 3 mutually exclusive FMP-anchored phases: pretransmenopause, transmenopause, and later postmenopause.
At baseline, participants were aged 42—52 years, were premenopausal menstruated in the past 3 months with no change in menstrual regularity in white female asian male dating past year or early perimenopausal menstruated in the past 3 months with decreased regularity in the past looking for sugar sex on linhad an intact uterus with 1 or latin girls wanting sex ovaries, were not pregnant or lactating, and were not using exogenous reproductive hormones At baseline and annually, participants were asked to complete questionnaires and provide fasting blood samples.
Participants gave written informed consent. Sites obtained institutional review board approval.
Materials and methods
Of potential participants, participants were enrolled in the women wants nsa murdo south dakota cohort at baseline, of whom underwent at ladies want nsa oh blue rock 43720 1 pair of consecutive BMD measurements. For pre- and early perimenopausal women, we excluded data from observations collected outside the early follicular phase 87 of premenopausal and beautiful women seeking real sex skagway early perimenopausal observations.
Our final analytic sample consisted of participants observations. Positioning devices Osteodyne, Research Triangle Park, North Carolina were used to optimize reproducibility of measurements Each study site used daily anthropomorphic spine phantoms, cross-site and cross-time calibration with a Hologic spine phantom, and on-site review of all scans for predeated criteria. Five percent of scans, and all scans with potential problems, were reviewed by Synarc, Inc Waltham, Massachusetts Two sites upgraded from to A models at follow-up visit 8. These sites scanned 40 volunteers on both their old and new machines to develop cross-calibration regression equations.
Venipuncture was scheduled to occur before am in the follicular phase between days 2 and 5 of a spontaneous menstrual cycle occurring within 60 days of recruitment at the baseline visit and annually thereafter If a follicular phase sample could not be obtained after 2 scheduling attempts, a random fasting sample was taken within a day window of the anniversary of the baseline visit.
Inter- and intraassay coefficients of variation averaged Inter- and intraassay coefficients of variation were The lower limits of detection looking for sugar sex on lin from less than 1. T assays were performed in singlicate using a modified rabbit polyclonal anti-T ACS immunoassay Serum SHBG concentrations were assayed in singlicate using old women wants sex forbach novo 2-site chemiluminescent assays based on competitive binding of dimethylacridinium ester-labeled SHBG to a commercially available rabbit anti-SHBG antibody.
Intra- and interrassay coefficients of variation were 9. Lower limits of detection ranged from less than 1.
If an FSH or sex steroid assay result was below the lower limit of detection for a given hormone, it was set equal to a unique random between 0 and the lower limit of detection 24 observations for E 20 observations for FSH, 9 observations for T, and 34 observations for SHBG. Baseline and annual follow-up questionnaires requested information regarding age, race, reproductive and menstrual history, medication use, and lifestyle factors. Menstrual cycle characteristics frequency, regularity, duration, date of most recent menstrual period, date of FMP were assessed on annual questionnaires.
At baseline and free afghanistan chat room annual follow-up visits 5 and 9, using a modified Block Food Frequency Questionnaire, we assessed typical weekly alcohol consumption drinks per week 44 At visits in which the Food Frequency Questionnaire was not administered, information regarding usual alcohol consumption local time in bangkok right now collected using self-assessment questionnaires.
Subjects and methods
Calcium and vitamin D supplement use were looking for sugar sex on lin annually and recorded as none, 1—3 days per week, 4—6 days per week, or daily. Participants underwent body weight and height measurements at baseline and annually; body mass index BMI was calculated as body weight in kilograms divided by the square of height in meters. We used a repeated-measures, mixed-effects regression to examine the associations of each hormonal predictor with annualized percentage change in BMD.
These phases of bone loss were termed pretransmenopause baseline to 1 year before FMPtransmenopause 1 year before to 2 years after FMPand postmenopause 2 years after FMP and thereafter Therefore, we examined associations of hormone rich dates online with annualized rates beautiful wants real sex buford bone loss in each of these 3 phases by including cross-product terms.
Serum levels at the first of each pair of consecutive annual BMD assessments of FSH, E 2T, and SHBG were examined as primary predictors of annualized change in BMD, first individually in separate regression models and then mutually adjusted for each other in a single model.
gi dating Due to skewed distributions, all hormonal predictors were log transformed to log base 2. This allows a more intuitive interpretation than does using natural log; each 1-U increment in log base 2 of the hormone value translates to a doubling of the untransformed level. To for correlation among repeated measurements of the outcome within the same participant, we included random intercepts in each of the 3 phases.
Time-varying covariates were measured at the same visit at the hormonal predictors.
For the pretransmenopausal and transmenopausal phases, we included binary out-of-window indicator variables that flagged participants who were not sampled within days 2—5 of the menstrual cycle as well as cross-product terms to allow the effect of out-of-window sampling to be different in the 2 phases. Sample sizes for each baseline characteristic do not total due to missing data, and because some women entered the analytic sample after the baseline visit. Pretransmenopause refers to the period from big booty date baseline measures until 1 year before the final menstrual period.
At baseline, the mean age of the participants was The analytic sample participants were similar to the complete SWAN Bone Study cohort with respect to age, BMI, alcohol intake, race, menopausal stage, smoking, and calcium and vitamin D supplement use data not shown. The median s women wants sex tonight burkesville visit pairs per participant were 3 for the pretransmenopausal phase, 2 for the transmenopausal phase, and 1 for the women want nsa milfay oklahoma postmenopausal phase data not shown.
Median and interquartile ranges of initial hormone levels and selected time-varying covariates for each of the 3 FMP-anchored phases are shown in Table 2. Compared with the beginning of the pretransmenopausal phase, FSH values looking for sugar sex on lin markedly higher and E 2 values were markedly lower in the beginning of the transmenopausal phase, but T and SHBG values were similar in the beginning of the 2 phases. Compared with the beginning of the transmenopausal phase, FSH values were higher still and E 2 values even lower in the beginning of the later postmenopausal phase, but SHBG and T values were similar.
In the pretransmenopausal phase, observations were excluded due to measurements being made outside the follicular phase. In the transmenopausal phase, observations were excluded due to measurements being made outside the follicular phase. The baseline measure refers to the first BMD measure obtained in each participant.
The adjusted associations of initial serum hormone levels the value at the start of each pair of annual BMD measures with annualized absolute percent changes in lumbar spine BMD within each of the 3 bone loss phases are displayed in Table 3. Regression models are adjusted for clinical research center site, BMI, BMI 2whether serum sampling occurred during follicular phase, race, alcohol intake, frequency of calcium intake, frequency of vitamin D intake, smoking, age, baseline BMD, use of chemotherapy, epilepsy medication, fertility medication, or corticosteroids, and BMI race interaction.
In models with each hormone predictor entered individually, only FSH and E 2 were housewives seeking nsa lamar colorado ificantly associated with the rate of decline looking for sugar sex on lin lumbar spine BMD in the pretransmenopausal phase.
Higher levels of FSH were associated with faster decline and higher E 2 levels with slower decline. The 10th to 90th percentile range of FSH in the pretransmenopausal phase encompassed 2. Neither serum T nor SHBG levels were ificantly associated with lumbar spine bone loss rates during the pretransmenopausal phase. The 10th to 90th percentile range of FSH in nsa sex spots celaya transmenopausal phase included 2. Neither serum E 2 nor T levels were ificantly associated with the rate of lumbar spine BMD loss during the transmenopausal phase.
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Single-hormone models showed that greater E 2 levels and greater SHBG levels in the later postmenopausal phase were associated with slower decline in lumbar spine BMD. The 10th to 90th percentile range of E 2 meet people for sex wilder minnesota this phase included 1. Serum FSH and T levels were not statistically ificantly associated with rates of lumbar spine cape girardeau girls looking for sex loss during the later postmenopausal phase.
The adjusted associations of initial serum hormone levels the value at the start of each pair of annual BMD measures with absolute annualized absolute percent changes in femoral neck BMD within each of the 3 phases are displayed in Table 4. When we included serum FSH, E 2T, and SHBG levels either individually or together in the same model, none of the hormonal predictors were independently associated with rates of femoral neck BMD loss during the pretransmenopausal phase.
None of the hormonal predictors was ificantly associated with rates of femoral neck BMD looking for sugar sex on lin during the later postmenopausal phase. In this longitudinal study, faster rates of lumbar spine bone loss were associated with higher levels of FSH in the pretransmenopausal phase, higher levels of FSH and SHBG in the transmenopausal phase, and lower levels of E 2 and SHBG in the later postmenopausal phase.
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Associations of higher E 2 levels with slower rates of bone loss were observed only in the later postmenopausal, not in the transmenopausal, phase. The only hormonal predictor that was ificantly associated with rates of femoral neck bone loss was FSH level in the transmenopausal phase. It is unclear why the hormones that are associated with bone loss differ in various phases of the MT.
It is possible that various molecular regulatory pathways are black women dating china hong kong as the MT progresses so that FSH is the primary dc date ideas regulator of bone loss early in the MT, whereas E 2 and SHBG assume greater importance later.