Female reproductive factors, genetic susceptibility and incident osteoporosis risk.

IF 3.9 4区医学 Q1 OBSTETRICS & GYNECOLOGY

Climacteric Pub Date : 2026-06-01 Epub Date: 2026-02-26 DOI:10.1080/13697137.2026.2627565

Zhong-Qiang Liu, Yu-Jun Xiong, Xiao Yu, Tian Lv, Hang-Yang Xu

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引用次数: 0

Abstract

Objective: Osteoporosis risk is shaped by both reproductive factors and genetic predisposition, yet their combined effects remain insufficiently studied.

Method: A total of 49,885 women from the UK Biobank were analyzed, excluding those with baseline osteoporosis or missing reproductive data. Reproductive factors included age at menarche, menopause time/status, history of stillbirth, hysterectomy, oophorectomy and oral contraceptive (OC) use. Genetic susceptibility was assessed using the polygenic risk score (PRS). Cox models estimated associations, with restricted cubic splines testing non-linear trends. Kaplan-Meier curves and sensitivity analyses were performed.

Results: Late menarche, premature ovarian insufficiency, menopausal status, stillbirth, hysterectomy and oophorectomy were linked to higher osteoporosis risk, while OC use was protective. Women with high PRS combined with adverse reproductive histories had the greatest risk. Additive interactions were evident between genetic risk and menopause, stillbirth, hysterectomy and oophorectomy, whereas other factors acted largely independently. Sensitivity analyses supported robustness.

Conclusion: Both reproductive history and genetic susceptibility contribute to osteoporosis risk in women. Joint assessment of these factors may enhance risk stratification and inform personalized prevention.

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女性生殖因素、遗传易感性与发生骨质疏松的风险。

目的：骨质疏松症的风险是由生殖因素和遗传易感性共同决定的，但它们的共同作用尚未得到充分的研究。方法：对来自UK Biobank的49885名女性进行了分析，排除了基线骨质疏松或缺少生殖数据的女性。生殖因素包括初潮年龄、绝经时间/状态、死产史、子宫切除术、卵巢切除术和口服避孕药（OC）的使用。采用多基因风险评分（PRS）评估遗传易感性。Cox模型估计关联，限制三次样条检验非线性趋势。进行Kaplan-Meier曲线和敏感性分析。结果：月经初潮晚、卵巢功能不全、绝经状态、死产、子宫切除术和卵巢切除术与骨质疏松症风险增加有关，而使用卵巢切除术具有保护作用。PRS高且有不良生育史的女性风险最大。遗传风险与更年期、死产、子宫切除和卵巢切除之间存在明显的相互作用，而其他因素在很大程度上是独立的。敏感性分析支持稳健性。结论：生育史和遗传易感性都与女性骨质疏松风险有关。对这些因素的联合评估可以加强风险分层，为个性化预防提供信息。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Climacteric 医学-妇产科学

CiteScore

1.70

自引率

7.10%

发文量

审稿时长

1 months

期刊介绍： Climacteric is the official journal of the International Menopause Society (IMS). As an international peer-reviewed journal it publishes original research and reviews of all aspects of aging in women. Climacteric was founded by the IMS in 1998 and today has become a leading journal in the publication of peer-reviewed papers on the menopause, climacteric and mid-life health. Topics covered include endocrine changes, symptoms attributed to the menopause and their treatment, hormone replacement and alternative therapies, lifestyles, and the counselling and education of peri- and postmenopausal women. Climacteric, published bimonthly, also features regular invited reviews, editorials and commentaries on recent developments. The editorial review board of Climacteric includes leading scientific and clinical experts in the field of midlife medicine and research and is headed by its Editor-in-Chief, Professor Rod Baber of Australia. He and his team of Associate Editors act independently to set a clear editorial policy, co-ordinate peer review, and ensure a rapid response to submitted papers.