Novel Index Can Identify Bone Loss Risk

The Bone Balance Index can strongly predict patients at risk for bone loss after menopause.

An index created in a recent study could potentially predict which women will undergo faster bone loss than others.

"Researchers have previously shown that it is difficult to predict an individual's bone loss by testing the blood or urine for proteins that reflect either bone breakdown or bone formation alone," said study author Albert Shieh, MD. "Since both bone breakdown and bone formation occur at the same time in the body, we created an index that accounts for both processes, and tested whether this new index can help predict bone loss."

The Bone Balance Index was deemed the most useful tool to predict bone loss in the spine, according to the study published in the Journal of Clinical Endocrinology & Metabolism. Researchers collected data from 685 pre or perimenopausal women in the Study of Women’s Health Across the Nation.

Women included had their final menstrual period during the follow-up of the study. Researchers analyzed blood and urine samples to measure for bone turnover markers, which are proteins that show bone breakdown and bone formation.

These measurements help to determine each patient’s bone balance before their final menstruation. Investigators discovered that information in the index was able to strongly predict bone loss from 2 years prior to the final menstrual period to 3 to 4 years after when bone density typically declines.

"This novel approach to assessing an individual's bone health may help identify which women are at risk of losing vertebral bone mineral density across the menopause transition," Shieh said. "More studies are needed to test whether this index is useful for predicting bone loss after the menopause transition, and if it is useful for predicting fractures. Since markers of bone breakdown alone have limited utility in predicting bone loss at an individual level, better approaches are needed to ensure individuals at highest risk of rapid bone loss are identified as quickly as possible."