To construct a bone balance index (BBI) using reference bone turnover markers and assess its relation with bone mineral density (BMD) change during menopause, highlighting its clinical significance.
Key Findings:
More negative BBI values were associated with greater annual BMD loss: 0.26% decline in lumbar spine and 0.42% decline in femoral neck per SD decrement in BBI (P < .0001).
Greater CTX and PINP levels predicted increased bone loss, with significant declines in BMD associated with each SD increment in CTX and PINP (P < .0001).
Interpretation:
The BBI effectively estimates bone balance and predicts BMD loss, while CTX and PINP individually reflect overall bone turnover.
Limitations:
The study is limited to a specific cohort of women transitioning through menopause, which may affect generalizability to other populations.
Potential measurement errors associated with biochemical markers could influence the accuracy of BBI.
Conclusion:
The study supports the utility of a combined BBI for predicting bone health changes during menopause, emphasizing the importance of assessing both resorption and formation markers for clinical practice.
