Skin Wrinkles May Provide a Glimpse Into Bone Health

Medscape Medical News, June 6, 2011

A close look at the skin of early postmenopausal women might provide a glimpse into their skeletal health, according to a study presented here at ENDO 2011: The Endocrine Society 93rd Annual Meeting, Boston, MA, USA.

The study found a significant inverse association between skin wrinkles and bone mineral density(BMD) in a population of women within 3 years of menopause who were not on any hormone therapy and who had not had any cosmetic skin procedures.

“it’s a unique population when changes are happening in a dynamic fashion.” This is a relation “not previously described,” said study presenter Lubna Pal, associate professor at Yale School of Medicine in New Haven Connecticut.

The architecture of the skeleton and the skin share a common building block: Collagen. Age related changes in collagen contribute to age-related skin changes like wrinkles and sagging and might also contribute to reduced BMD.

“When I am seeing an older patient, her bigger concern is what is happening to her skin; the clinician’s concern is what is happening to her bones,” Dr. Pal said. “ So part of the question was: Can I fine tune to the patient’s concern and get a sense of the bone health?”

Dr. Pal and colleagues performed a cross sectional analysis of baseline data on 114 early postmenopausal women (70% white) enrolled in the longitudinal Kronos Early Estrogen Prevention Study (KEEPS).

As part of an ancillary study of the skin, the distribution and depth of skin wrinkles were assessed at 11 sites on the face and neck using the Lemperle wrinkle scale. Skin firmness was assessed at the forehead and cheek using a durometer, which has been validated in patients with scleroderma, and bone density was assessed with dual x-ray absorptiometry at the lumbar spine, hip and total body.

The researchers observed a clear inverse correlation between skin wrinkling and Bone mass density at the spine (r,-0.27; P<0.01), femoral neck (r, –0.29; P< 0.01) and total body (r, –0.26; P=0.01), independent of age, body composition, other factors known to influence Bone mass density.

“Basically, what we found was that the higher the wrinkle score, the worse the bone mineral density,” Dr. Pal said, “so our hypothesis was substantiated by these associations.”

Firmer skin of the face and forehead was associated with higher BMD.