TY - JOUR
T1 - The mediating effect of skeletal muscle index on the relationship between menarcheal age and bone mineral density in premenopausal women by race/ethnicity
AU - Ning, Hongting
AU - Du, Yan
AU - Zhao, Lan Juan
AU - Tian, Qing
AU - Feng, Hui
AU - Deng, Hong Wen
N1 - Publisher Copyright:
© 2021 Lippincott Williams and Wilkins. All rights reserved.
PY - 2021/10/26
Y1 - 2021/10/26
N2 - Objective:To examine the contribution of skeletal mass index (SMI) as a mediator in the relationship between menarcheal age and hip/spine bone mineral density (BMD) in premenopausal women by race/ethnicity.Methods:The data of 4,329 participants (age ≥ 18; mean age=35.7 ± 9.5) of Whites (n = 2,543), African Americans (n = 1,236), and Asians (n = 550) enrolled from October 2011 to January 2019 from the Louisiana Osteoporosis Study were analyzed. After adjustment for physiological and behavioral factors, multivariable linear regression analyses were conducted to evaluate each component of the proposed mediation models, and mediation was verified by the bootstrapping resampling approach.Results:Premenopausal women with early menarcheal age tended to have higher SMI and BMD than women with normal menarcheal age among all races/ethnicities included. Women with late menarcheal age were, however, more likely to have a lower SMI than their counterparts with normal menarcheal age (r = -0.212, 95% CI = [-0.321 to-0.103] for White women; r = -0.181, 95% CI = [-0.410 to-0.008] for African-American women; r = -0.174, 95% CI = [-0.343 to-0.006] for Asian women). Similar results were found for both spine and hip BMD. SMI fully mediated the difference in BMD due to different menarcheal ages among Whites, African Americans, and Asian women with early menarcheal age; however, no mediating effects were observed for Asian women with late menarcheal age.Conclusions:SMI, as a full mediator, affected the relationship between menarcheal age and BMD among premenopausal women, and the mediating effects varied by race/ethnicity. To prevent or slow down the loss of hip/spine BMD and the development of osteoporosis, measures aiming at minimizing the risk for muscle mass loss should be recommended, especially for White and African-American women with late menarcheal age.
AB - Objective:To examine the contribution of skeletal mass index (SMI) as a mediator in the relationship between menarcheal age and hip/spine bone mineral density (BMD) in premenopausal women by race/ethnicity.Methods:The data of 4,329 participants (age ≥ 18; mean age=35.7 ± 9.5) of Whites (n = 2,543), African Americans (n = 1,236), and Asians (n = 550) enrolled from October 2011 to January 2019 from the Louisiana Osteoporosis Study were analyzed. After adjustment for physiological and behavioral factors, multivariable linear regression analyses were conducted to evaluate each component of the proposed mediation models, and mediation was verified by the bootstrapping resampling approach.Results:Premenopausal women with early menarcheal age tended to have higher SMI and BMD than women with normal menarcheal age among all races/ethnicities included. Women with late menarcheal age were, however, more likely to have a lower SMI than their counterparts with normal menarcheal age (r = -0.212, 95% CI = [-0.321 to-0.103] for White women; r = -0.181, 95% CI = [-0.410 to-0.008] for African-American women; r = -0.174, 95% CI = [-0.343 to-0.006] for Asian women). Similar results were found for both spine and hip BMD. SMI fully mediated the difference in BMD due to different menarcheal ages among Whites, African Americans, and Asian women with early menarcheal age; however, no mediating effects were observed for Asian women with late menarcheal age.Conclusions:SMI, as a full mediator, affected the relationship between menarcheal age and BMD among premenopausal women, and the mediating effects varied by race/ethnicity. To prevent or slow down the loss of hip/spine BMD and the development of osteoporosis, measures aiming at minimizing the risk for muscle mass loss should be recommended, especially for White and African-American women with late menarcheal age.
KW - Bone mineral density
KW - Mediating effect
KW - Menarcheal age
KW - Race/ethnicity
KW - Skeletal muscle index
UR - http://www.scopus.com/inward/record.url?scp=85117740071&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85117740071&partnerID=8YFLogxK
U2 - 10.1097/GME.0000000000001814
DO - 10.1097/GME.0000000000001814
M3 - Article
C2 - 34313616
AN - SCOPUS:85117740071
SN - 1072-3714
VL - 28
SP - 1143
EP - 1149
JO - Menopause
JF - Menopause
IS - 10
ER -