Science & Technology: Urine Test Can Indicate a Woman’s Risk of Bone Fracture, Cauley-Led Study Finds

A simple urine test can indicate a premenopausal woman’s risk of suffering bone fractures as she ages, according to new research led by University of Pittsburgh Graduate School of Public Health (GSPH) epidemiologists.

Women in their 40s and early 50s had a 59 percent greater risk of bone fracture as they aged when they had above-normal levels of N-telopeptide—the byproduct of bones breaking down—in their urine, compared with women who had low N-telopeptide levels. When women with high N-telopeptide levels also had a low spinal bone density measurement, their risk of fracture increased nearly threefold.

 The study is the first to look for signs of bone breakdown in younger, premenopausal women in an effort to determine whether such signs can predict the risk that these women will suffer fractures as they age.

 The results were published in the November edition of Menopause, the journal of The North American Menopause Society.

 “Bone fractures—particularly in the hip, wrist, and back—have serious consequences, including disability and death,” said Jane Cauley, a GSPH professor of epidemiology and lead author of the study. “Knowing a woman’s risk of fracture can help doctors determine the best course of action to protect her bones as she enters menopause, a time when estrogen deficiency negatively affects skeletal health.”

 By the time a woman turns 50, her risk of a fracture at some point in the remainder of her life is estimated to be at least 40 percent. Fractures are more common for these women than heart attacks, strokes, and breast cancer combined.

During menopause, bone remodeling increases, leading to an imbalance between bone formation and bone resorption, or the process by which bones are broken down and their minerals are returned to the blood. This remodeling persists for several years and is associated with an increased rate of bone loss, making it easier for bones to fracture.

 Cauley and her colleagues used data from 2,305 premenopausal or perimenopausal women ages 42 to 52 collected over an average of 7.6 years as part of the Study of Women’s Health Across the Nation. Participants were from Boston, Detroit, Los Angeles, Pittsburgh, and Oakland, Calif.

 The Study of Women’s Health Across the Nation examines the physical, biological, psychological, and social health of women during their middle years. The goal is to help scientists, health care providers, and women learn how midlife experiences affect health and quality of life during aging.