Menopausal Status-Dependent Alterations in Bone Mineral Density in Women Transitioning from Menopause to Postmenopause: An Observational Multicenter Study.

Introduction: Bone loss begins between 30 and 40 years of age in men and women, with women experiencing an accelerated decline in bone mass and density after menopause. Understanding the interplay of hormonal changes, inflammation, and other factors during this period is critical for addressing bone health. The objective was to investigate the impact of menopausal transition and postmenopausal status on bone mineral density (BMD) and its associations with biochemical, anthropometric, and lifestyle factors among Pakistani women.

Methods: This cross-sectional study involves 632 Pakistani women, equally divided into menopausal transition (MPT) and postmenopausal (PM) groups. Data on Body Mass Index (BMI), blood pressure, BMD, hormonal levels (estrogen, (Follicle stimulating hormone (FSH), Osteoprotegerin (OPG), Receptor activator of nuclear factor kappa (RANK-L)), inflammation markers (Interleukin-6 (IL-6), C-reactive protein (CRP)), vitamin D, and demographic factors were collected. Statistical analysis included ANOVA, chi-square tests, correlation analysis, and regression modeling to evaluate predictors of BMD while adjusting for confounders.

Results: Postmenopausal women had higher BMI, blood pressure, and a greater prevalence of obesity compared to MPT women. Osteopenia was prevalent (49%), and osteoporosis affected 21.2% of participants. BMD was inversely correlated with FSH, RANK-L, IL-6, CRP, BMI, and parity, and positively associated with estrogen, OPG, vitamin D, and education. Regression analysis identified waist-to-hip ratio, BMI, and parity as significant predictors of reduced BMD.

Conclusion: Menopause significantly impacts bone health, with hormonal changes, inflammation, and anthropometric factors contributing to BMD decline. Early identification of modifiable risk factors, such as high BMI, low education levels, and multiparity, is crucial for implementing targeted interventions. These findings emphasize the need for preventive strategies, including lifestyle modifications and early screening, to mitigate bone loss and its associated health risks in postmenopausal women.