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Open Access 02-04-2024 | Osteoporosis | Review

The association of vasomotor symptoms with fracture risk and bone mineral density in postmenopausal women: a systematic review and meta-analysis of observational studies

Authors: Panagiotis Anagnostis, Konstantinos Lallas, Anna Pappa, Georgios Avgeris, Kristina Beta, Dimitrios Damakis, Eirini Fountoukidou, Maria Zidrou, Irene Lambrinoudaki, Dimitrios G. Goulis

Published in: Osteoporosis International

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Abstract

Background/Aims

Vasomotor symptoms (VMS) adversely affect postmenopausal quality of life. However, their association with bone health has not been elucidated. This study aimed to systematically review and meta-analyze the evidence regarding the association of VMS with fracture risk and bone mineral density (BMD) in peri- and postmenopausal women.

Methods

A literature search was conducted in PubMed, Scopus and Cochrane databases until 31 August 2023. Fracture, low BMD (osteoporosis/osteopenia) and mean change in lumbar spine (LS) and femoral neck (FN) BMD were assessed. The results are presented as odds ratio (OR) and mean difference (MD), respectively, with a 95% confidence interval (95% CI). The I2 index quantified heterogeneity.

Results

Twenty studies were included in the qualitative and 12 in the quantitative analysis (n=49,659). No difference in fractures between women with and without VMS was found (n=5, OR 1.04, 95% CI 0.93–1.16, I2 16%). However, VMS were associated with low BMD (n=5, OR 1.54, 95% CI 1.42–1.67, I2 0%). This difference was evident for LS (MD -0.019 g/cm2, 95% CI -0.03 to -0.008, I2 85.2%), but not for FN BMD (MD -0.010 g/cm2, 95% CI -0.021 to 0.001, I2 78.2%). These results were independent of VMS severity, age and study design. When the analysis was confined to studies that excluded menopausal hormone therapy use, the association with BMD remained significant.

Conclusions

The presence of VMS is associated with low BMD in postmenopausal women, although it does not seem to increase fracture risk.
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Metadata
Title
The association of vasomotor symptoms with fracture risk and bone mineral density in postmenopausal women: a systematic review and meta-analysis of observational studies
Authors
Panagiotis Anagnostis
Konstantinos Lallas
Anna Pappa
Georgios Avgeris
Kristina Beta
Dimitrios Damakis
Eirini Fountoukidou
Maria Zidrou
Irene Lambrinoudaki
Dimitrios G. Goulis
Publication date
02-04-2024
Publisher
Springer London
Published in
Osteoporosis International
Print ISSN: 0937-941X
Electronic ISSN: 1433-2965
DOI
https://doi.org/10.1007/s00198-024-07075-8