Skin wrinkling may help predict bone health in menopause

ENDO 2011

BOSTON — Women who have severe skin wrinkles during the first few years of menopause also appear to have lower bone mineral density, according to data presented here.

Lubna Pal, MD, and colleagues explored the relationship of BMD with skin wrinkles and skin rigidity in a cohort of 114 menopausal women. Skin wrinkles were assessed using the Lemperle wrinkle scale at 11 sites on the face and neck; skin rigidity was measured by durometer at the forehead and cheek; and BMD was assessed via DXA scan at the lumbar spine, left hip and total body.

Their analysis revealed an inverse relationship between skin wrinkling and BMD at the spine and femoral neck, and also with total body BMD. The higher the score, or greater severity of the wrinkles, the lower the BMD. This finding was observed at all skeletal sites, including the hip, heel and lumbar spine, and was independent of risk factors known to affect BMD. Additionally, increased skin rigidity at the face and forehead was an independent determinant of BMD at the hip, the spine and of ultrasound attenuation.

“Although the connection between bones and skin may seem unclear, they share common building blocks – collagens,” Pal, who is a reproductive endocrinologist and associate professor at Yale School of Medicine, said in a press release. “As we age, changes in collagen occur that account for age-related skin changes, including worsening skin wrinkles and sagging skin. They also contribute to deterioration in bone quality and quantity.”

All of the women included in the study were enrolled in the Kronos Early Estrogen Prevention Study (KEEPS), a longitudinal trial of menopausal hormone therapy, and were also participating in a skin ancillary study. All of the women had their last menstrual period within the past 3 years and were not using HT.

“In postmenopausal women, the appearance of the skin may offer a glimpse of the skeletal well-being, a relationship not previously described,” Pal said in the release. “This information may allow for the possibility of identifying postmenopausal women at fracture risk at a glance, without dependence on costly tests.”

However, she cautioned that these study findings demonstrate only an association between bone density and skin wrinkling.

“It is a powerful potential relevance that needs to be substantiated,” she said at a press conference. Longer-term studies are needed to confirm a relationship between wrinkles and the risk for bone fractures, she said. – by Emily Shafer

Disclosure: Dr. Pal reports no relevant financial disclosures. Funding was provided by Aurora Foundation to the Kronos Longevity Research Institute.

For more information:

Pal L. #P3-126. Presented at: The Endocrine Society 93rd Annual Meeting & Expo; June 4-7, 2011; Boston.

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