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This version published online on July 5, 2005
Journal of Clinical Endocrinology & Metabolism, doi:10.1210/jc.2005-0396
A more recent version of this article appeared on September 1, 2005
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Submitted on February 23, 2005
Accepted on June 24, 2005

Relationship of Volumetric Bone Density and Structural Parameters at Different Skeletal Sites to Sex Steroid Levels in Women

Sundeep Khosla MD*, B. Lawrence Riggs MD, Richard A. Robb PhD, Jon J. Camp BSE, Sara J. Achenbach MS, Ann L. Oberg PhD, Peggy A. Rouleau MD, and L. Joseph Melton III MD

Endocrine Research Unit, Division of Endocrinology and Metabolism, Department of Internal Medicine (S.K., B.L.R.), Biomedical Imaging Resource, Department of Physiology and Biophysics (R.A.R., J.J.C.), Department of Health Sciences Research (L.J.M., S.J.A., A.L.O.), and the Department of Radiology (P.A.R.), Mayo Clinic College of Medicine, Rochester, MN 55905

* To whom correspondence should be addressed. E-mail: khosla.sundeep{at}mayo.edu.

Context Although estrogen clearly plays a central role in regulating bone mass in women, studies in men have suggested that there may be a "threshold" bioavailable estradiol (bio E2) level below which aging men begin to lose bone and that the threshold for estrogen deficiency in cortical bone may be considerably lower than that in trabecular bone. There are no data testing this in women.

Objective To assess vBMD and bone geometry by quantitative computerized tomography and relate these to circulating bio E2 and bio testosterone (T) levels.

Design Cross-sectional, age-stratified population sample of 235 women (age 21 to 97 yr).

Results vBMD/structural parameters were not related to sex steroid levels in young premenopausal women (age 20-39 yr) with a median bio E2 level of 17 pg/mL (63 pmol/L). By contrast, bio E2 and bio T levels were both significantly associated with trabecular and cortical vBMD and cortical area at multiple sites in late postmenopausal women (age ≥ 60 yr) who had a median bio E2 level of 3 pg/mL (11 pmol/L). Late pre- and early postmenopausal women (age 40-59 yr) with an intermediate median bio E2 level of 11 pg/mL (42 pmol/L) showed age-adjusted correlations of bio E2 levels with trabecular but not with cortical vBMD.

Conclusions In women, bio E2 levels are associated with vBMD and some structural bone parameters at low, but not high bio E2 levels. Similar to findings in men, the "threshold" for estrogen deficiency in cortical bone in women appears to be lower than that in trabecular bone.
Key words: osteoporosis • aging • women • sex steroids • bone QCT




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