WebMD Medical News
Laura J. Martin, MD
June 7, 2011 -- Women with deeply furrowed brows in early menopause may also have troubled bones, an early report of a new study shows.
Researchers measured the number and depth of facial wrinkles and the skin firmness of 114 women who were within three years of their last menstrual period.
Bone density at the hip, spine, and heel was measured by dual-energy X-ray absorptiometry (DEXA) scans and ultrasound.
"Women who had worse wrinkles also had lesser bone density," says study researcher Lubna Pal, MD, director of the reproductive aging and bone health program at the Yale University School of Medicine in New Haven, Conn. "Women who had tougher skin had better bones."
That relationship persisted even after researchers accounted for the effects of other things known to influence bone density, including age, body mass, race, smoking, and multivitamin intake.
Pal thinks the connection may be a protein called type 1 collagen, a building block of skin and bone tissue, which is lost with age. It is thought that this loss may be accelerated during menopause, when hormone levels drop.
"There's a global aging process that's going on," Pal says. "The skin reflects what's happening at the level of the bone."
Certain wrinkles were more predictive of lower bone density than others.
"The strongest association of the facial wrinkles with the bone was between the eyebrows," says Pal, speaking of the vertical glabellar lines that form above the bridge of the nose.
The study was presented at the 2011 annual meeting of the American Society of Endocrinology in Boston.
Experts who reviewed the report stress that the study has not been published in a medical journal, which means the data hasn't yet been scrutinized by independent scientists.
And they noted that the observation, in some ways, seems contrary to conventional wisdom.
For example, sun exposure is thought to damage skin and cause greater skin wrinkling. But sun exposure also increases vitamin D, a nutrient that's been shown to be important for strong bones.
So women with more wrinkles, it seems, should have stronger bones.
"When we looked at the effects of sun exposure on skin, we did not see that women who had more sun exposure had worse skin wrinkles," Pal says.
Laure Rittie, PhD, a research investigator in the department of dermatology photoaging and aging research program at the University of Michigan in Ann Arbor, thinks the researchers could have better controlled for sun exposure by testing skin in other areas.
"It seems like the authors have only assessed wrinkle severity on the face and neck, as opposed to sun-protected skin that would more reflect internal and systemic changes and rule out potential extrinsic confounding factors," she writes in an email to WebMD.
Other experts say that while it was a new idea to connect wrinkles and bone health, the finding was worth further investigation.
"I think it's interesting, actually," says Linda A. Russell, MD, a bone health specialist in the department of rheumatology at the Hospital for Special Surgery in New York City.
"We don't do a good job in screening everybody for osteoporosis because you have to get a test called the bone density scan. If we had a cheaper, easier way to at least screen people who should get the bone density, that would be great," Russell says. "If someone walked into your office and they had lots of wrinkles you'd say 'Aha! That's a great person for me to target to get the bone density.'"
The study is scheduled to continue for another year, Pal says, at which time, the study participants will have their skin and bone health assessed again. She hopes further findings will help to confirm this initial observation.
"We have just scratched the surface of this question," she says.
SOURCES:American Society of Endocrinology 2011 annual meeting, Boston.Lubna Pal, MD, director, reproductive aging and bone health program, Yale University School of Medicine, New Haven, Conn.Laure Rittie, PhD, research investigator, department of dermatology photoaging and aging research program, University of Michigan, Ann Arbor.Linda A. Russell, MD, bone health specialist, department of rheumatology, Hospital for Special Surgery, New York City.
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