Association of follicle‐stimulating hormone with bone turnover markers and bone mineral density in Chinese women across the menopausal transition

BACKGROUND: Elevated follicle‐stimulating hormone (FSH) is associated with an increased risk of postmenopausal osteoporosis. This study investigated the association of serum FSH with bone turnover markers (BTMs) and bone mineral density (BMD) in healthy women undergoing menopausal transition. METHODS: A total of 487 healthy women (age 35–65 years, 50 ± 8.5 years) were enrolled in this study. Serum FSH, BTMs, and BMD at lumbar spine and total hip were measured in these subjects. RESULTS: Follicle‐stimulating hormone was positively correlated with various BTMs (r = 0.339–0.583, all p < 0.001) and negatively correlated with lumbar spine and total hip BMD (r = −0.629 and −0.514, all p < 0.001). After adjusting for age and body mass index, the partial correlation coefficients of FSH with BTMs and BMD remained significant. Estimating from the regression equation, for every 10 IU/L increase in serum FSH, BTMs increased by 0.38–3.6 units, and BMD decreased by 0.03–0.05 g/cm(2), respectively. Multiple linear regression analysis showed that FSH was a positive factor for serum bone‐specific alkaline phosphatase, osteocalcin, and N‐telopeptide of collagen type 1 (β = 0.188–0.403, all p < 0.001), and a negative factor for lumbar spine BMD and serum C‐telopeptide of collagen type 1 (β = −0.629 and –0.183, all p < 0.001). CONCLUSIONS: This study suggests that serum FSH levels are an independent risk factor for BTMs and BMD in menopause‐transitioning women, particularly for serum BAP and lumbar spine BMD.