Observational Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Jan 18, 2024; 15(1): 45-51
Published online Jan 18, 2024. doi: 10.5312/wjo.v15.i1.45
Association between serum estradiol level and appendicular lean mass index in middle-aged postmenopausal women
Fang Jin, Yan-Fei Wang, Zhong-Xin Zhu
Fang Jin, Yan-Fei Wang, Zhong-Xin Zhu, Department of Osteoporosis Care and Control, Xiaoshan Affiliated Hospital of Wenzhou Medical University, Hangzhou 311200, Zhejiang Province, China
Author contributions: Jin F, Wang YF, and Zhu ZX contributed to data collection, analysis and writing of the manuscript; Zhu ZX contributed to study design and editing of the manuscript.
Institutional review board statement: The Institutional Review Board of the National Center for Health Statistics (NCHS) approved the survey protocols (Protocol #2011-17).
Informed consent statement: The datasets analysed during the current study are available at NHANES website. In accordance with ethical guidelines and research standards, informed consent was not required for this database-based study.
Conflict-of-interest statement: All the authors declare that they have no competing interests.
Data sharing statement: The datasets analysed during the current study are available at NHANES website (https://www.cdc.gov/nchs/nhanes/index.htm).
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zhong-Xin Zhu, PhD, Doctor, Department of Osteoporosis Care and Control, Xiaoshan Affiliated Hospital of Wenzhou Medical University, No. 199 Shixin South Road, Xiaoshan District, Hangzhou 311200, Zhejiang Province, China. orthozzx@163.com
Received: August 20, 2023
Peer-review started: August 20, 2023
First decision: November 2, 2023
Revised: November 13, 2023
Accepted: December 13, 2023
Article in press: December 13, 2023
Published online: January 18, 2024
Processing time: 148 Days and 20 Hours
Abstract
BACKGROUND

Previous studies investigating the association between loss of estrogen at menopause and skeletal muscle mass came to contradictory conclusions.

AIM

To evaluate the association between serum estradiol level and appendicular lean mass index in middle-aged postmenopausal women using population-based data.

METHODS

This study included 673 postmenopausal women, aged 40-59 years, from the National Health and Nutrition Examination Survey between 2013 and 2016. Weighted multivariable linear regression models were used to evaluate the association between serum E2 Level and appendicular lean mass index (ALMI). When non-linear associations were found by using weighted generalized additive model and smooth curve fitting, two-piecewise linear regression models were further applied to examine the threshold effects.

RESULTS

There was a positive association between serum E2 level and ALMI. Compared to individuals in quartile 1 group, those in other quartiles had higher ALMI levels. An inverted U-shaped curve relationship between serum E2 Level and ALMI was found on performing weighted generalized additive model and smooth curve fitting, and the inflection point was identified as a serum E2 level of 85 pg/mL.

CONCLUSION

Our results demonstrated an inverted U-shaped curve relationship between serum E2 levels and ALMI in middle-aged postmenopausal women, suggesting that low serum E2 levels play an important in the loss of muscle mass in middle-aged postmenopausal women.

Keywords: Estradiol, Skeletal muscle, Menopause, Health, The National Health and Nutrition Examination Survey

Core Tip: This paper evaluated the association between serum E2 level and appendicular lean mass index in middle-aged postmenopausal women from the National Health and Nutrition Examination Survey between 2013 and 2016, and found an inverted U-shaped curve relationship between them, with the point of inflection at a serum E2 level of 85 pg/mL.