Not Just Skin and Bones: Wrinkles Could Predict Women’s Bone Fracture Risk

Wrinkles are a telltale sign of aging, and they might also be able to predict a woman’s bone fracture risk, according to Yale School of Medicine researchers who report in a new study that the severity and distribution of skin wrinkles and overall skin quality could tell the story of bone mineral density in early menopausal women.

The findings will be presented June 6 at the Endocrine Society Meeting in Boston, Mass., by Lubna Pal, associate professor in the Department of Obstetrics, Gynecology & Reproductive Science at Yale School of Medicine.

“Skin and bones share common building blocks-proteins, and aging is accompanied by changes in skin and deterioration of bone quantity and quality,” said Pal, who, along with the research team, had hypothesized that in postmenopausal women, the quality of an individual woman’s skin-the degree of wrinkling and hardening-will reflect the status of her bones.

Pal and her research team studied this theory in a subgroup of early menopausal women within three years of their last menstrual period who are enrolled in the ongoing clinical trial, the Kronos Early Estrogen Prevention Study (KEEPS). The KEEPS skin and bones ancillary study is being conducted in New Haven and in the Bronx, N.Y., two of the nine participating study sites. The investigators assessed skin wrinkles at 11 locations on the face and neck using a pictoral scale in 114 of the KEEPS enrollees, and assessed skin rigidity at the forehead and the cheek using a device called the durometer. Skeletal mass and density were studied by dual X-ray absorptiometery as well as by a portable heel ultrasound device.

“We found that deepening and worsening skin wrinkles are related to lower bone density among the study participants,” said Pal, who is director of the Reproductive Aging and Bone Health Program at Yale. “The worse the wrinkles, the lesser the bone density, and this relationship was independent of age or of factors known to influence bone mass.”

In contrast to the skin wrinkles, Pal further noted, higher durometer scores-indicating higher skin rigidity-related to better bone density.

“Our findings that the appearance and physical properties of the skin can reflect the quality of the skeleton are noteworthy because this may allow clinicians to identify fracture risk in postmenopausal women ‘at a glance’ without depending on costly tests,” said Pal.

Other authors on the abstract include Neiha Kidwai, Kati Glockenberg, Netta Schneller, Tugba Altun, Alicia Figueroa, Barbara Isaac, Linda McDonald, Lianna Lipton, Erin Wolff, Hugh Taylor, Nanette Santoro and Ruth Freeman.

KEEPS is funded by an Aurora Foundation grant to the Kronos Longevity Research Institute.

By Karen N. Peart

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Karen N. Peart:, 203-980-2222