{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T02:09:17Z","timestamp":1793066957786,"version":"4.5.0"},"reference-count":48,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,5,19]],"date-time":"2022-05-19T00:00:00Z","timestamp":1652918400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000991","name":"Faculty of Medicine, Nursing and Health Sciences, Monash University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000991","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Low bone density (BMD) and fractures commonly affect women with premature ovarian insufficiency (POI). However, bone microarchitecture and body composition data are lacking.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To assess and characterise musculoskeletal phenotype and effects of oestrogen replacement therapy (ERT) in women with POI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Cross-sectional and longitudinal studies of 60 normal karyotype women with POI, aged 20-40 years, from 2005-2018. Dual x-ray absorptiometry (DXA)-derived spinal (LS) and femoral neck (FN) BMD, trabecular bone score (TBS), appendicular lean mass (ALM), total fat mass (TFM), and fracture prevalence were compared with 60 age-, and BMI-matched population-based controls. Longitudinal changes in bone and body composition variables and ERT effects were analysed using linear mixed models over a median duration of 6 years.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Women with POI were subdivided into spontaneous (s)-POI (n=25) and iatrogenic (i)-POI (n=35). Median(range) age of POI diagnosis was 34 (10-40) years with baseline DXA performed at median 1(0-13) year post-diagnosis. ERT was used by 82% women (similar for both POI groups). FN-BMD were lowest in s-POI (p&amp;lt;0.002). Low TBS was more common in s-POI [(44%), p=0.03], versus other groups. LS-BMD and ALM were lower in both s-POI and i-POI groups than controls (p&amp;lt;0.05). Fracture prevalence was not significantly different: 20% (s-POI), 17% (i-POI), and 8% (controls) (p=0.26). Longitudinal analysis of 23 POI women showed regular ERT was associated with ALM increment of 127.05 g\/year (p&amp;lt;0.001) and protected against bone loss. However, ERT interruption was associated with annual reductions in FN BMD and TBS of 0.020g\/cm<jats:sup>2<\/jats:sup> and 0.0070 (p&amp;lt;0.05), respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Deficits in BMD, trabecular microarchitecture, and lean mass were present in women with POI. However, regular ERT protected against declines in bone variables, with an increase in ALM. Assessment of skeletal and muscle health, and advocating ERT adherence, is essential in POI to optimise musculoskeletal outcomes.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fendo.2022.860853","type":"journal-article","created":{"date-parts":[[2022,5,19]],"date-time":"2022-05-19T15:14:53Z","timestamp":1652973293000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":17,"title":["Abnormal Trabecular Bone Score, Lower Bone Mineral Density and Lean Mass in Young Women With Premature Ovarian Insufficiency Are Prevented by Oestrogen Replacement"],"prefix":"10.3389","volume":"13","author":[{"given":"Navira","family":"Samad","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanh H.","family":"Nguyen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hikaru","family":"Hashimura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Pasco","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Kotowicz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Boyd J.","family":"Strauss","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter R.","family":"Ebeling","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frances","family":"Milat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda J.","family":"Vincent","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,5,19]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1080\/13697137.2019.1574738","article-title":"The Global Prevalence of Primary Ovarian Insufficiency and Early Menopause: A Meta-Analysis","volume":"22","author":"Golezar","year":"2019","journal-title":"Climacteric"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/dew027","article-title":"ESHRE Guideline: Management of Women With Premature Ovarian Insufficiency","volume":"31","author":"Webber","year":"2016","journal-title":"Hum Reprod"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1080\/13697137.2020.1804547","article-title":"Premature Ovarian Insufficiency: An International Menopause Society White Paper","volume":"23","author":"Panay","year":"2020","journal-title":"Climacteric"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-09-0231","article-title":"Phenotyping and Genetic Studies of 357 Consecutive Patients Presenting With Premature Ovarian Failure","volume":"161","author":"Bachelot","year":"2009","journal-title":"Eur J Endocrinol"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2008-1878","article-title":"Bone Mineral Density in Estrogen-Deficient Young Women","volume":"94","author":"Popat","year":"2009","journal-title":"J Clin Endocrinol Metab"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1016\/S0015-0282(16)58095-9","article-title":"Characterization of Idiopathic Premature Ovarian Failure","volume":"65","author":"Conway","year":"1996","journal-title":"Fertil Steril"},{"key":"B7","doi-asserted-by":"publisher","first-page":"289","DOI":"10.1055\/s-0041-1722849","article-title":"Musculoskeletal Health in Premature Ovarian Insufficiency. 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