Are women’s wrinkles indicator of fracture risk?

An intriguing new study suggests a link between intense skin wrinkling and reduction in bone mineral density (BMD).

According to researchers, severe skin wrinkles during the first few years of menopause could be a sign of skeletal health that may predict a women’s risk of bone fractures from osteoporosis.

Lead author of the study, Dr Lubna Pal, a reproductive endocrinologist and associate professor at Yale School of Medicine, New Haven, Connecticut stated, “In postmenopausal women, the appearance of the skin may offer a glimpse of the skeletal well-being, a relationship not previously described.

“This information may allow for the possibility of identifying postmenopausal women at fracture risk at a glance, without dependence on costly tests.”

An analysis revealed a direct link between severe wrinkles and lower bone density. The results were consistent at all skeletal sites, including the hip, heel and lumbar spine and held true even after taking into account other risk factors known to impact bone density such as a woman’s body composition and age.

Details of the KEEPS study
In a bid to explore the co-relation between BMD, skin wrinkles and skin rigidity, the researchers conducted a study.

They focused on 114 women in their late 40s and early 50s who were part of the Kronos Early Estrogen Prevention Study (KEEPS).

All the participants had entered menopause 3 years prior to the onset of the study but had not yet started hormone therapy. Women who had undergone cosmetic surgery were excluded from the trial.

For the purpose of the study, creases and lines at 11 sites on the face and neck were assessed using the Lemperle wrinkle scale while firmness of the skin at the forehead and cheeks was measured by device called the durometer.

In addition, with the help of the DXA scan the BMD and breakdown of bone was determined.

The investigators compared the number of wrinkles, depth of the creases and skin rigidity of a woman with the bone density in her hip, lumbar spine and total body.

Revelations of the study
An analysis revealed a direct link between severe wrinkles and lower bone density.

The results were consistent at all skeletal sites, including the hip, heel and lumbar spine. The findings held true even after taking into account other risk factors known to impact bone density such as a woman’s body composition and age.

However, women with firm skin at the face and forehead exhibited a greater bone density.

Need for further research
Though the link between wrinkles and bone density is ambiguous, experts theorize that both the sagging of skin and the simultaneous deterioration of bone health as we age could be a result of the gradual decrease in the skin's collagen levels which causes it to lose its elasticity.

However, they feel the study is preliminary and there is need for further research to substantiate the link between wrinkles and the risk of bone fracture.

Pal stated, "Ultimately, we want to know if intensity of skin wrinkles can allow identification of women who are more likely to fracture a bone, especially the femoral neck or the hip, an often fatal injury in older people.

"If this is the case, then including the study of skin wrinkles to other clinical risk factors may allow identification of fracture risk in populations that do not have access to more costly technology."

The results will be presented Monday at The Endocrine Society's 93rd Annual Meeting in Boston.