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
ARTICLE HIGHLIGHTS
Research background

The onset of sarcopenia, a multifactorial condition related to the loss of muscle mass and quality, has been intimately linked to menopause.

Research motivation

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.

Research objectives

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.

Research 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 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.

Research 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.

Research conclusions

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.

Research perspectives

The molecular mechanism of the impact of E2 on muscle function needs to be further explored.