Published online Jan 18, 2024. doi: 10.5312/wjo.v15.i1.45
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
The onset of sarcopenia, a multifactorial condition related to the loss of muscle mass and quality, has been intimately linked to menopause.
Compared with the anabolic effects of androgens on the skeletal muscle mass in men, the effects of estrogens on the skeletal muscle mass in women are less clearly understood. Moreover, previous studies on the association between the loss of estrogen at menopause and skeletal muscle mass or function came to contradictory conclusions.
We aimed to evaluate the association between serum E2 level and appendicular lean mass index (ALMI) in middle-aged postmenopausal women using population-based data.
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 and 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.
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.
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.
The molecular mechanism of the impact of E2 on muscle function needs to be further explored.