Research Shows Status of Skin Revelatory of BMD in Early Menopause

   Examination of the skin of early postmenopausal women offers clues into the status of the skeleton, a relationship not previously described. Researchers from several American institutions presented the results of their research to that effect at ENDO 2011: the 93rd Annual Meeting & Expo of the Endocrine Society in Boston.

   The role of collagen scaffolding in maintaining tissue architecture is well described for the skin and skeleton. And alterations in skin wrinkling and texture as well as reduced bone mineral density (BMD) are known to accompany reproductive and chronological aging.

   Researchers from four American institutions and the NIH performed a cross-sectional analysis of baseline data from KEEPS, the Kronos Early Estrogen Prevention Study (KEEPS) a longitudinal trial of menopausal hormone therapy, who also participated in a Skin Ancillary study. Their objective was to explore the relationship between skin wrinkling or rigidity and BMD in a cohort (N=114) of early menopausal women (within three years of last period).

   Skin wrinkles were assessed at 11 sites on the face and neck using the Lemperle wrinkle scale. Skin rigidity was assessed at the forehead and cheek using a durometer. Participants underwent BMD assessment by dual X-ray absorptiometery (DXA) at the lumbar spine, left hip, and total body, as well as by quantitative heel ultrasound (QUS). The relationship of BMD to skin wrinkles and rigidity was assessed.

   Following data analysis, the investigators found that skin wrinkling showed an inverse relationship with BMD at the spine (r -0.27, P<0.01), femoral neck (r -0.29, P<0.01), and total body BMD (r -0.26, P=0.01). In contrast, significant positive correlations were observed between skin rigidity, as reflected by the total durometer score (face and forehead), and BMD at the spine (r 0.40, P<0.001), left femoral neck (r 0.48, P<0.001), and with BUA (bone ultrasound attenuation by QUS) (r 0.28, P=0.006). Increasing forehead glabellar wrinkles were found to relate independently to lower femoral neck BMD. Increasing skin rigidity at the face and forehead was identified as an independent determinant of BMD at the hip.

   The researchers concluded that “In a population of early postmenopausal women, study of the skin is observed to provide a glimpse into the status of the skeleton, a relationship not previously described.”