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Estradiol, testosterone levels tied to fracture risk in women
High levels of bioavailable estradiol and testosterone are associated with a decreased risk for fracture among women independent of race or ethnicity, study data show.
Jane A. Cauley, DrPH, of the department of epidemiology in the Graduate School of Public Health, University of Pittsburgh, and colleagues evaluated data from the Women’s Health Initiative study on 381 black, 192 Hispanic, 112 Asian and 46 Native American women with incident nonspine fractures and a random sample of 400 white women with incident fracture to determine whether sex steroids are associated with fracture risk independent of race or ethnicity. A sample of control participants who were matched by age, race or ethnicity, and blood draw date also was collected.
The risk for fractures was decreased with increasing bioavailable estradiol (P for trend = .014). Compared with participants with the lowest bioavailable estradiol levels, participants with bioavailable estradiol in the second tertile (> 4.89-8.25 pg/mL) had a 20% lower risk (OR = 0.8; 95% CI, 0.63-1.02) and participants in the third tertile (> 8.25 pg/mL) had a 35% lower risk for fracture (OR = 0.65; 95% CI, 0.5-0.85). The risk for fracture was 45% lower among white participants with bioavailable estradiol in the highest tertile (> 8.25 pg/mL) compared with white participants with the lowest bioavailable estradiol ( 4.89 pg/mL). Similarly, black participants with the highest bioavailable estradiol had a 39% lower risk for fracture compared with black participants with the lowest bioavailable estradiol (P for trend = .04).
The risk for fractures was 25% lower among participants with bioavailable testosterone in the top tertile (> 13.3 pg/mL; P for trend = .02).
No association was found between the risk for fracture and sex hormone-binding globulin.
“Higher circulating levels of [bioavailable estradiol] and [bioavailable testosterone] were associated with a decreased risk of nonspine clinical fractures,” the researchers wrote. “Our results were independent of race/ethnicity extending previous findings in primarily U.S. white and European women to include a diverse group of postmenopausal women.” – by Amber Cox
Disclosure: The researchers report no relevant financial disclosures.