Skip to main content

Advertisement

SpringerLink
Log in

Cigarette smoking, steroid hormones, and bone mineral density in young women

  • Clinical Investigation
  • Published:
Calcified Tissue International Aims and scope Submit manuscript

Summary

There are few studies of the effect of smoking on bone density in young women. The reported antiestrogenic effect of smoking could be a mechanism for a possible effect of smoking on bone. We measured bone mineral density (BMD) by dual-energy X-ray absorptiometry (whole body, proximal femur, lumbar spine), and serum levels (midfollicular phase) of testosterone (T), estradiol (E2), sex hormone-binding globulin (SHBG), and cortisol in 52 women (25 smokers, 27 nonsmokers) aged 20–35 years. The two groups did not differ significantly in age, height, weight, or the sum of eight skinfold thicknesses. The mean number of cigarettes smoked per day and the number of years of smoking were 16.9 and 12.9, respectively. There were no significant differences in BMD between smokers and nonsmokers at any site. For both smokers and nonsmokers, SHBG and the free androgen index (T/SHBG) made significant contributions (P<0.005) to the variance in BMD at all sitesexcept the lumbar spine. The free estradiol index (E2/SHBG) contributed to whole body BMD (P<0.05). For all subjects, there were significant inverse relationships between SHBG and BMD (P<0.002), and positive relationships between T/SHBG and BMD (P<0.02) for all sites except the lumbar spine. These data suggest that moderate smoking in young women is not associated with low BMD at any site. However, smokers had lower free estradiol and higher SHBG, both of which have been related to increased bone loss in older women.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Kelsey JL (1989) Risk factors for osteoporosis and associated fractures. Public Health Rep 104(suppl):14–20

    Google Scholar 

  2. Daniell HW (1976) Osteoporosis of the slender smoker: vertebral compression fractures and loss of metacarpal cortex in relation to postmenopausal cigarette smoking and lack of obesity. Arch Int Med 136:298–304

    Google Scholar 

  3. Williams AR, Weiss NS, Ure CL, Ballard J, Daling JR (1982) Effect of weight, smoking, and estrogen use on the risk of hip and forearm fractures in postmenopausal women. Obstet Gynecol 60:695–699

    Google Scholar 

  4. Aloia JF, Cohn SH, Vaswani A, Yeh JK, Yuen K, Ellis K (1985) Risk factors for postmenopausal osteoporosis. Am J Med 78:95–100

    Google Scholar 

  5. Wickham CA, Walsh K, Cooper C, Barker DJ, Margetts BM, Morris J, Bruce SA (1989) Dietary calcium, physical activity, and risk of hip fracture: a prospective study. BMJ 299:889–892

    Google Scholar 

  6. Slemenda CW, Hui S, Longcope C, Wellman H, Johnston CC (1990) Predictors of bone mass in perimenopausal women: a prospective study of clinical data using photon absorptiometry. Ann Int Med 112:96–101

    Google Scholar 

  7. Mazess RB, Barden HS (1991) Bone density in premenopausal women: effects of age, dietary intake, physical activity, smoking, and birth control pills. Am J Clin Nutr 53:132–142

    Google Scholar 

  8. Hooper JL, Seeman E (1990) Tobacco use and reduced bone density: a co-twin control study. In: Christiansen C, Overgaard K (eds) Osteoporosis 1990, Vol 2. Osteopress ApS, Copenhagen, pp 1117–1118

    Google Scholar 

  9. Jensen GF (1986) Osteoporosis of the slender smoker revisited by epidemiologic approach. Eur J Clin Invest 16:239–242

    Google Scholar 

  10. Holbrook TL, Barrett-Connor E, Wingard DL (1988) Dietary calcium and risk of hip fracture: 14-year prospective population study. Lancet 2:1046–1049

    Google Scholar 

  11. Bilbrey GH, Weix J, Kaplan GK (1988) Value of single photon absorptiometry in osteoporosis screening. Clin Nucl Med 13:7–12

    Google Scholar 

  12. McDermott MT, Witte MC (1988) Bone mineral content in smokers. South J Med 81:477–480

    Google Scholar 

  13. Hall ML, Heavens J, Cullum ID, Ell PJ (1990) The range of bone density in normal British women. Br J Radiol 63:266–269

    Google Scholar 

  14. Garvey AJ, Bosse R, Seltzer CC (1974) Smoking, weight change, and age: a longitudinal analysis. Arch Environ Health 28:327–329

    Google Scholar 

  15. Slemenda CW, Hui SL, Longcope C, Johnston CC (1989) Cigarette smoking, obesity, and bone mass. J Bone Miner Res 4:737–741

    Google Scholar 

  16. Stevenson JC, Lees B, Devenport M, Cust MP, Ganger KF (1989) Determinants of bone density in normal women: risk factors for future osteoporosis? Br Med J 298:924–928

    Google Scholar 

  17. McCulloch RG, Bailey DA, Houston CS, Dodd BL (1990) Effects of physical activity, dietary calcium intake and selected lifestyle factors on bone density in young women. Can Med Assoc J 142:221–227

    Google Scholar 

  18. Whiting SJ, McCulloch RG, Bailey DA, Houston CS (1990) The effect of cigarette smoking on trabecular bone density in premenopausal women aged 20–35 years (abstract). J Bone Miner Res 5(suppl):S249

    Google Scholar 

  19. Cauley JA, Gutai JP, Sandler RB, LaPorte RE, Kuller LH, Sashin D (1986) The relationship of endogenous estrogen to bone density and bone area in normal postmenopausal women. Am J Epidemiol 124:752–761

    Google Scholar 

  20. Slemenda C, Hui SL, Longcope C, Johnston CC (1987) Sex steroids and bone mass. A study of changes about the time of menopause. J Clin Invest 80:1261–1269

    Google Scholar 

  21. Horsman A, Jones M, Francis R, Nordin C (1983) The effect of estrogen dose on postmenopausal bone loss. N Engl J Med 309:1404–1407

    Google Scholar 

  22. Lindsay R, Tohme JF (1990) Estrogen treatment of patients with established postmenopausal osteoporosis. Obstet Gynecol 76:290–295

    Google Scholar 

  23. Jensen J, Christiansen C, Rodbro P (1985) Cigarette smoking, serum estrogens, and bone loss during hormone-replacement therapy early after menopause. N Engl J Med 313:973–975

    Google Scholar 

  24. Kaufman DW, Slone D, Rosenberg L, Meittinen OS, Shapiro S (1980) Cigarette smoking and age at natural menopause. Am J Public Health 70:420–422

    Google Scholar 

  25. Hartz AJ, Kelber S, Borkowf H, Wild R, Gillis BL, Rimm AA (1987) The association of smoking with clinical indicators of altered sex steroids—a study of 50,145 women. Pub Health Rep 102:254–259

    Google Scholar 

  26. Lesko SM, Rosenberg L, Kaufman DW, Helmrich SP, Miller DR, Strom B, Schottenfeld D, Rosenshein NB, Knapp RC, Lewis J, Shapiro S (1985) Cigarette smoking and the risk of endometrial cancer. N Engl J Med 313:593–596

    Google Scholar 

  27. Vessey M, Baron J, Doll R, McPherson K, Yates D (1983) Oral contraceptives and breast cancer: final report of an epidemiological study. Br J Cancer 47:455–462

    Google Scholar 

  28. Tokuhata G (1968) Smoking in relation to infertility and fetal loss. Arch Environ Health 17:353–359

    Google Scholar 

  29. Garn SM (1968) Smoking and human biology. Hum Biol 57:505–523

    Google Scholar 

  30. Mochizuki M, Maruo T, Masuko K, Ohtsu T (1984) Effects of smoking on fetoplacental-maternal system during pregnancy. Am J Obstet Gynecol 149:413–420

    Google Scholar 

  31. Barbieri RL, McShane RM, Ryan KJ (1986) Constituents of cigarette smoke inhibit human granulosa cell aromatase. Fertil Steril 46:232–236

    Google Scholar 

  32. Michnovicz JJ, Herschcopf RJ, Naganuma H, Bradlow HL, Fishman J (1986) Increased 2-hydroxylation of estradiol as a possible mechanism for the anti-estrogenic effect of cigarette smoking. N Engl J Med 315:1305–1309

    Google Scholar 

  33. Albanes D, Jones Y, Micozzi MS, Mattson ME (1987) Associations between smoking and bodyweight in the US population: analysis on NHANES II. Am J Pub Health 77:439–444

    Google Scholar 

  34. Ross WD, Marfell-Jones MJ (1982) Kinanthropometry. In: McDougall SD, Wenger HA, Green HA (eds) Physiological testing of the elite athelete. Mutual, Ottawa, pp 75–115

    Google Scholar 

  35. Mazess RB, Trempe JA, Bisek JP, Hanson JA, Hans D (1991) Calibration of dual-energy X-ray absorptiometry for bone density. J Bone Miner Res 6:799–806

    Google Scholar 

  36. Mazess RB, Collick B, Trempe JA, Barden HS, Hanson JA (1989) Performance evaluation of a dual energy X-ray bone densitometer. Calibration of dual-energy X-ray absorptiometry for bone density. Calcif Tissue Int 44:228–232

    Google Scholar 

  37. Mazess RB, Barden HS, Drinka PJ, Bauwens SF, Orwoll ES, Bell NH (1990) Influence of age and body weight on spine and femur bone mineral density in U.S. white men. J Bone Miner Res 5:645–652

    Google Scholar 

  38. Perel E, Killinger DW (1979) The interconversion and aromatization of androgens by human adipose tissue. J Steroid Bioch 10:623–627

    Google Scholar 

  39. Vermeulen A, Verdonck L (1979) Factors affecting sex hormone levels in postmenopausal women. J Steroid Bioch 11:899–904

    Google Scholar 

  40. Mlynaryk P, Gillies RR, Murphy B, Pattee CJ (1962) Cortisol production rates in obesity. J Clin Endocrinol Metab 22:587–591

    Google Scholar 

  41. Garn SM, Leonard WR, Hawthorne VM (1986) Three limitations of the body mass index (lette). Am J Clin Nutr 44:996–997

    Google Scholar 

  42. Daniel M, Martin AD, Faiman C (1992) Sex hormones and adipose tissue distribution in pre-menopausal cigarette smokers. Int J Obesity (in press)

  43. Vermeulen A, Verdonck L, Van Der Staten M, Orie N (1969) Capacity of the testosterone-binding globulin in human plasma and influence of specific binding of testosterone on its metabolic clearance rate. J Clin Endocrinol Metab 29:1470–1477

    Google Scholar 

  44. Friedman AJ, Ravnikar VA, Barbieri RL (1987) Serum steroid hormone profiles in postmenopausal smokers and nonsmokers. Fertil Steril 47:398–401

    Google Scholar 

  45. Khaw K-T, Tazuke S, Barret-Connor E (1988) Cigarette smoking and levels of adrenal androgens in postmenopausal women. N Engl J Med 318:1705–1709

    Google Scholar 

  46. Longcope C, Johnston CC (1988) Androgen and estrogen dynamics in pre- and postmenopausal women: a comparison between smokers and nonsmokers. J Clin Endocrinol Metab 67:379–383

    Google Scholar 

  47. Cauley JA, Gutai JP, Kuller LH, LeDonne D, Powell JG (1989) The epidemiology of serum sex hormones in postmenopausal women. Am J Epidemiol 129:1120–1131

    Google Scholar 

  48. Bernstein L, Pike MC, Lobo RA, Depue RH, Ross RK, Henderson BE (1989) Cigarette smoking in pregnancy results in marked decrease in maternal hCG and oestradiol levels. Br J Obstet Gynecol 96:92–96

    Google Scholar 

  49. Moore JW, Key TJA, Bulbrook RD, Clark GMG, Allen DS, Wang DY, Pike MC (1987) Sex hormone binding globulin and risk factors for breast cancer in a population of normal women who had never used exogenous sex hormones. Br J Cancer 56:661–666

    Google Scholar 

  50. Lapidus L, Lindstedt G, Lundberg P-A (1986) Concentrations of sex-hormone binding globulin and corticosteroid binding globulin in serum in relation to cardiovascular risk factors and to 12-year incidence of cardiovascular disease and overall mortality in postmenopausal women. Clin Chem 32:146–152

    Google Scholar 

  51. Baron JA (1984) Smoking and estrogen-related disease. Am J Epidemiol 119:9–22

    Google Scholar 

  52. Seyler LEJ, Pomerleau OF, Fertig JB, Hunt D, Parker K (1986) Pituitary hormone response to cigarette smoking. Pharmacol Biochem Behav 24:159–162

    Google Scholar 

  53. Gossain VV, Sherma NK, Srivastava L, Michelakis AM, Rovner DR (1986) Hormonal effects of smoking—II: effects on plasma cortisol, growth hormone, and prolactin. Am J Med Sci 291:325–327

    Google Scholar 

  54. Wild RA, Buchanan JR, Myers C, Lloyd T, Demers LM (1987) Adrenal androgens, sex hormone binding globulin and bone density in osteoporotic menopausal women. Maturitas 9:55–61

    Google Scholar 

  55. Van Hemert AM, Birkenhäger JC, De Jong FH, Vandenbroucke JP, Valkenburg HA (1989) Sex hormone binding globulin in postmenopausal women: a predictor of osteoporosis superior to endogenous oestrogens. Clin Endocrinol 31:499–509

    Google Scholar 

  56. Horsman A, Marshall DH, Nordin BEC (1981) The relation between bone loss and calcium balance in women. Clin Sci 59:137–142

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. The Sport & Exercise Sciences Research Institute, The University of Manitoba, Winnipeg, Manitoba, Canada

    Mark Daniel

  2. The School of Physical Education, The University of British Columbia, 6081 University Boulevard, V6T 1Z1, Vancouver, B.C., Canada

    Alan D. Martin

  3. The College of Physical Education, The University of Saskatchewan, Saskatoon, Canada

    Donald T. Drinkwater

Authors
  1. Mark Daniel
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Alan D. Martin
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Donald T. Drinkwater
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Daniel, M., Martin, A.D. & Drinkwater, D.T. Cigarette smoking, steroid hormones, and bone mineral density in young women. Calcif Tissue Int 50, 300–305 (1992). https://doi.org/10.1007/BF00301626

Download citation

  • Received:

  • Revised:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00301626

Key words

Search

Navigation