Background: There have been many studies on osteoporosis, which is one of the most important cause of fracture in adults. However, whether moderate physical activity during youth confers lasting benefits for bone is unclear. Thus, we are here concerned with the relation of teenage physical activity and bone mineral density in Korean premenopausal women. Methods: From March to June 2007, 75 clients who visited a general hospital for medical check-up were enrolled in this study. The subjects reported physical activity for four age periods (12∼18, 19∼34, 35∼49, current) using self reporting questionnaire. And they completed two 3-day food records, had measurements of height and weight, and aBMD assessed using dual-energy X-ray absorptiometry at the lumbar spine (L2-4) and femoral neck. Results: There was a significant relation of teenage physical activity (especially weight bearing physical activity) and aBMD in both sites (lumbar spine r=0.42, P＜ 0.01; femoral neck r=0.33, P＜0.01). But the activity during other age periods was not associated with the current aBMD at both sites. Conclusion: Our results suggest that moderate physical activity during the teen years appears to have lasting benefits for lumbar spine and femoral neck aBMD in Korean premenopausal women. (J Korean Acad Fam Med 2008;29:781-787)
Background : Reduced pulmonary function is a common outcome in pulmonary patients with reduced bone mineral density. But, there are few studies on the relationship in adult females who do not have pulmonary diseases. Thus, this study was to assess the correlation between bone mineral density and pulmonary function in healthy women.
Methods : A total of 193 subjects was selected among adult females who visited a health promotion center. BMD was measured by Dual energy X-ray absorptiometry and T-score of lumbar spine (L1-L4) was used. Pulmonary function was measured by spirometer and questionnaire survey was used to obtain information from the subjects.
Results : Mean T-score of L-spine was -0.284, FEV1 (pred %) was 98.82% and BMI was 23.50 kg/m2. The results showed positive correlation (0.128) between BMD and FEV1 by multiple regression analysis (P＜0.05).
Conclusion : As FEV1 of subjects increased, BMD increased in adult women who did not have pulmonary diseases.
Background : Osteoporosis and hyperlipidemia in postmenopausal women may develop due to a sudden decrease of estrogen. In general, women over 60, about 10 years after menopause, are at risk of continuous bone loss. However, many reports reveal that high body weight may have a preventive effect on bone loss. There are few studies that examine the effect of body mass index on bone loss in aged Korean women. The aim of this study was to show the effect of body mass index on bone loss in aged Korean women.
Methods : We evaluated 510 women aged over 60 who visited a health care center of a university hospital in Seoul from January 1999 to December 2004 to determine the effects of body mass index on bone mineral density in aged Korean women. We measured anthropometrical characteristics, BMD of lumbar spine, markers of bone turnover, and FSH of the subjects.
Results : The higher body mass index, the greater BMD at lumbar spine. But the levels of alkaline phosphatase, osteocalcin and deoxypyridinoline had no significant differences. The FSH level was also low in the high body mass index group. The BMI was positively correlated with BMD (P＜0.01) by Pearson's correlation matrix. The total alkaline phosphatase also had a significant negative correlation with BMD. The levels of FSH had negative correlation (P＜0.01) with BMD.
Conclusion : Higher body mass index groups showed higher BMD with lower FSH levels. Further prospective studies considering the endocrinologic association with body weight, BMD and FSH level will be needed.
Background : There have been bone mass studies for the treatment of osteoporosis, nonetheless, little attention has been paid to the management of osteopenia. This study was to evaluate the effects of estrogen, alendronate and their combination on bone mineral density and bone metabolism in the postmenopausal women with osteopenia.
Methods : A total of 150 healthy regional patients with osteopenia from Busan were enrolled in prospective randomized clinical trial and randomly assigned to receive conjugated equine estrogen (group I), alendronate (group II), or combination of the two (group III). Assessments included BMD of L2-4 spines and femur neck by DEXA and markers of bone turnover including serum osteocalcin, total alkaline phosphatase and urine Deoxypyridnoline (Dpd). BMD and markers of bone turnover were re-evaluated at 6 and 12 months after the treatment.
Results : BMD of the lumbar spines increased significantly at 12 months after treatment in the three groups (P＜0.05). BMD of the femur neck increased at 12 months after treatment in the three groups, but significantly in group III (P＜0.05). Serum osteocalcin decreased at 12 months after treatment in the three groups, but only significantly in group III. Urine Dpd decreased at 12 months after treatment in three groups, but significantly in group, II and III (P＜0.05). Serum total alkaline phosphatase decreased at 12 months after treatment in only group III (P＜0.05). There was more favorable benefit for group III in BMD of the lumbar spines and serum osteocalcin and urine Dpd at 12 months after treatment compared to group, II and III (P＜0.05).
Conclusion : These results indicated a favorable benefit of conjugated equine estrogen, alendronate, or combination of the two in BMD and important markers of bone turnover. The combined treatment with conjugated equine estrogen and alendronate was more effective in postmenopausal women with osteopenia. Long-term studies are required to confirm these results.
Background : Tools such as SCORE (Simple Calculated Osteoporosis Risk Estimation) and ORAI (Osteoporosis Risk Assessment Instrument) have been used for screening test of osteoporosis, These tools include race, age, weight, BMI, previous treatment with HRT and so on, as confounding factors. Among those factors, it has been reported that body weight is more appropriate than BMI. But those study were based on Caucasian women and not based on Korean women. Therefore, comparison among Korean women needed to be assessed.
Methods : A total of 200 postmenopausal women in ages 50 and over were enrolled in health promotion center of one university hospital. BMD was checked by DEXA of lumbar spine (L1-L4) from January 2002 to May, 2003. Women who had previous history of endocrine disease or medications, early onset menopause, previous surgery of uterus and ovary, which all could influence BMD, were excluded.
Results : The average age was 58.01, the average weight 58.36 kg, the average BMI (kg/m2) 24.39, the average BMD (t-score) -1.00. Among the total 26 women (13%) recorded BMD (t-score)≤-2.5 and 50 women (25%) recorded -2.5＜BMD (t-score)≤-1.5. Multiple regression analysis showed body weight was superior to BMI in predicting BMD (t-score). A logistic regression analysis on the likelihood of being osteoporotic (T-score＜-2.5) further confirmed this finding.
Conclusion : Patient body weight was more effective and useful than BMI in explaining BMD T-score as compared to BMI Korean postmenopausal women.
Background : Although lack of exercise is well known to be a risk factor of osteoporosis, it is unclear whether weight-bearing exercise has different effects on bone mineral density compared to non weight-bearing exercise, and the amount of exercise needed to prevent osteoporosis is not clearly defined. This study was performed to clarify the relations between the type and the amount of exercise with BMD.
Methods : This was a cross-sectional study of 3,661 women who had undertaken health screening including BMD measurement at Health Promotion Center of SNUH between May 1997 and March 1999. Information on sociodemographic characteristics, menarche, childbirth andexercise were gathered by means of self-reported questionnaire, and BMD was measured using DEXA.
Results : The number of women with lumbar osteoporosis were 601 (16.4%) and femoral neck osteoporosis 372 (10.2%). Lumbar osteoporosis occurred more frequently with increasing age and age at menarche, and in menopausal women, but less frequently with increasing fat-free mass in multiple logistic regression analysis. When adjusted for age, age at menarche, menopause and fat-free mass, lumbar osteoporosis was less common in women who exercised, but the type and the amount of exercise had no bearing. Especially, lumbar osteoporosis was least common in women engaging in moderate amount of exercise. Femoral neck osteoporosis decreased significantly only in weight-bearing exercise group and in women engaging in high amount of exercise.
Conclusion : The results of this study suggest that lumbar osteoporosis can be prevented through exercise regardless of its type and amount, and high amount or weight- bearing exercise is most effective to prevent femoral neck osteoporosis.
Background : Estrogen deficiency after menopause is a major reason of bone loss in postmenopausal women. YSM (years since menopause) is negatively related with BMD in postmenopausal women. Bone loss after menopause is accelerated in early stage of menopause, and then decreases. There are some evidence that body weight can prevent bone loss in menopausal women. Therefore, we evaluated associations of the general characteristics and lumbar BMD of postmenopausal Korean women, and determined the rate of bone loss after menopause at 5-year interval.
Methods : BMD was measured by DEXA system, and physical, anthropometric data including body fat were obtained in 1006 peri- and postmenopausal women. Pearsons correlation coefficients were made among physical, anthropometric data and lumbar BMD. To determine the contributable factors for lumbar Bmd, multiple regression analysis was done.
Results : 1) In Pearsons correlation analysis among body composition YSM and spinal BMD, YSM was strongly associated negatively with spinal BMD. 2) On the other hand, weight and BMI was associated positively with psinal BMD. 3) The percent difference in spinal BMD between perimenopause and 5-years after menopause was 15.3%. 4) Years since menopause, body weight was revealed as and important factor that predicted spinal BMD by multiple stepwise regression analysis.
Conclusion : We conclude that YSM and body weight were revealed as important factors that can predict spinal BMD in postmenopausal women.
Background : Increased BMD after treatment means that the treatment regimen was effective to prevent fracture associated with osteoporosis. But changes of BMD reflected at least after 1-year. Now we use markers of bone turnover more easily, and they reflects bone metabolism faster than BMD within 3-4 months. Some data showed that changes of bone markers after 3-months could predict the changes of the BMD after 1-year.
Methods : 126 postmenopausal Korean women with osteoporosis were evaluated who visited Samsung Cheil hospital from Aug. 1997 to July 2000, with respect to markers of bone turnover and BMD at lumbar spine. Subjects were classified into 3 groups. HRT only group, HRT with alendronate group and HRT with calcitonin group. To evaluate the effectiveness of treatment regimen, we compared changes of markers after 3 months and changes of spinal BMD after 1 year treatment among 3 groups. And also evaluate the predictability of the changes of markers of bone turnover after 3 months about the changes of spinal BMD, multiple regression analysis were made.
Results : Our results showed those findings. 1. Percent changes of markers of bone turnover decreased significantly compared with baseline(osteocalcin 30.4 53.4%, total alkaline phosphtase 26.7 20.0%, deoxypyridinoline 19.0 30.1%, and mean percent changes of markers among three groups showed no significant differences. 2. No significant relationships were noted between percent changes of spinal BMD and percent changes of markers of bone turnover. 3. Percent changes of BMD at lumbar spine were increased significantly after 1 year treatment(HRT only 5.6 3.6%, HRT with calcitonin 7.8 4.5%, HRT with alendronate 9.8%, 4.7%).
Conclusion : These results made conclusion that changes of markers of bone trunover after 3 months couldn't predict the changes of spinal BMD after 1-year treatment. But, HRT with antiresorptive agent may be effective in treating postmenopausal osteoporotic Korean women.
Background : As the mean life span is prolonged, the concern about health care in postmenopausal women is now promoted. Especially, osteoporosis is the serious health problem in postmenopausal women. Bone mineral density in postmenopause is controlled by that in premenopause. Therefore, we searched for the factors which contribute to bone mineral density in premenopause.
Methods : The study subjects who visited the Health Screening and Diagnosis Center in Yeungnam University Hospital from March 1998 to July 1999 was measured BMD at the lumbar spine using dual Energy X-ray Absorptiometry. Subjects were checked past medical history, life style (smoking, drinking, physical activity, exercise etc.), birth history, breast feeding, oral pill intake. The subjects who had disorders known to interfere with bone metabolism and premature menopausal and surgical menopausal women were excluded from the study. And we reviewed the results of the laboratory and radiologic findings which had done in Health Screening and Diagnosis Center.
Results : 352 women were included in this study. The number of normal BMD was 228 and the number of osteopenia was 124. Weight, height, BMI, exercise was significant positively correlated with bone mineral density(P<0.05). Previous operation history was significant negatively correlation with bone mineral density (P<0.05). Multiple logistic regression result showed that weight was the most significant factor affecting to BMD and the history of operation and exercise were significant factors affecting BMD(P<0.05).
Conclusion : In postmenopaual women, who has low weight, past operation history and lack of exercise, evaluation of BMD and education for prevention of osteoporosis are needed.
Background : Osteoporosis has been a rising problem as growth of older age population increased caused by elongation of life. The purpose of this research was to find out about the mean values and differences of BMD by age, relationships between body weight and bone mineral density (BMD) and differences of BMD between pre-and post-menopausal status based on data of lumbar spines and left hip joint performed by dual energy X-ray absorptiometry(DEXA).
Methods : We evaluated 502 female patients who visited Namwon Medical Center from Jan. 1998 to Dec. 1999. The bone mineral density (gm/cm2) of lumbar spines (L2-L4) and left hip joint were evaluated by DEXA machine.
Results : The BMD of lumbar spines was highest at fourth decades, rapidly declined at fifth to sixth decades ad slowly declined at eighth decades. The density of left hip joint was highest at fourth decades, but progressively declined to eighth decades. The relationship between body weight and BMD showed positive correlation (p<0.05). The BMD of pre- & postmenauposal women showed significant difference (p<0.001).
Conclusion : The BMD of Korean women is rapidly declining after menopause. Thus enthusiastic treatment of osteoporosis is needed at this period.
Background : In general, increased body weight may be a risk factor for hypertension, diabetes, hyperlipidemia, and coronary heart disease. It is very difficult to lose weight especially in aged people. Osteoporosis is commonly developed in aged. Many reports revealed that obesity may prevent bone loss. The protective effect of obesity on bone has been ascribed to a high body fat content. Obese aged people can be very confused whether to decide to lose weight or not.
Methods : We evaluated 137 women aged over 60 who visited a health care center of a university hospital in Seoul from Jan.1999 to Oct. 1999 to determine the effects of obesity on bone mineral density in aged Korean women. We measured anthropometrical charactersitics, BMD of lumbar spine, markers of bone turnover, and FSH of the subjects.
Results : The results revealed that obese group had a greater BMD at lumbar spine, but the levels of FSH were noted to be lower than the non-obese group. But, none of the markers of bone turnover showed significant differences between the two groups. BMI was positively correlated with BMD (r=0.455, P<0.001) by Pearson's correlation matrix. Also, the level of total alkaline phosphatase significantly had negative association with BMD. The level of FSH revealed that it had a negative correlation (r=-0.290, P<0.01) with BMI.
Conclusion : We concluded that obesity might have a protective effect related with FSH. Prospective studies on endocrinologic association with BMD, bone markers, FSH and estradiol will be needed.
Background : The positive effects of hormone replacement therapy (HRT) on the skeleton in postmenopausal women are well defined. However, the effects of vitamin D supplementation on BMD in postmenopausal women are controversial. But many women, who are contraindicated to HRT or afraid of side effects of HRT or are already on HRT regimen, take calcium plus vitamin D supplement for prevention of osteoporosis. Therefore, this study was designed to examine the effect of vitamin D supplementation on BMD in postmenopausal women and to determine whether vitamin D supplementation can give additional benefit to HRP.
Methods : Subjects were 109 postmenopausal women out of total 213, who visited the Sacred Heart Hostpital, Chuncheon and had followed up BMD study one year after during January, 1996 to May, 1999. The study group was as follows : No treatment (n=31) ; Vit D (n=11) ; HRT (n=50) ; HRT+Vit D (n=17). We compared and analyzed the changes of BMD in the region of lumbar spine (L2-4) and femur (femoral neck, trochanter, Ward's triangle). SPSSWIN 7.5 was used for statistical procedure.
Results : Subject had a mean age of 54.4±5.7 years, mean menopausal age of 48.4±2.4 years, mean postmenopausal duration of 6.1±4.1 years, and mean body mass index of 24.1±2.8 kg/m2. No correlation was observed between general characteristics (age, menopausal age, postmenopausal duration, and body mass index) and changing rate of BMD. Lumbar BMD had increased by 1.83% in the Vit D group, by 1.95% in the HRT group and by 3.15% in the HRT+Vit D group, whereas it had decreased by 1.99% in the no treatment group. The increase of femoral neck BMD in the Vit D group was 1.5%, in the HRT group 0.66%, and in the HRT+Vit D group 2.09%, but the loss in the no treatment group was 1.65%. The changes of trochanteric BMD were as follows: No treatment group(-2.49%), Vit D group (0.04%), HRT group (1.48%), and HRT+Vit D group (-4.09%), Vit D group (1.17%), HRT group (-0.01%), HRT+Vit D group (0.16%). In the Vit D group, except for the trochanteric area (P<0.05), there was a significant increase in BMD of L2-4, femoral neck, and Ward's triangle (P<0.05) whereas in the HRT group and HRT+Vit D group significant increases were observed in all areas (P<0.05). But there was no significance among Vit D group, HTR group and HRT+Vit D group.
Conclusion : This study confirmed the beneficail effect of HRT on lumbar and femoral BMD. It also showed that low dose Vitamin D supplementation had effect in the prevention of osteoporosis in postmenopausal women, In the HRT+Vit D group. BMD had increaed more than HRT alone, but does not give benefit additional to that of HRT alone.
Background : The study was done to examine the role of long-term diving(5-20m depth) on regional bone mineral density(BMD) in women.
Methods : We compared woman divers(n=38) with matched non-diver controls(n=38) according to age, weight, and duration of menopause. BMD(g/cm2)of the proximal femur (femoral neck, trochanter, Wards’s triangle) was assessed by dual-energy X-ray absorptiometry (DEXA, Hologic QDR-1500).
Results : There was no significant difference between groups for proximal femur BMD. But in premenopausal group, BMD of divers was higher than controls in femur neck and trochanter (P<0.05). Correlations analysis revealed that body weight of divers was significantly correlated to femoral neck BMD (P<0.05). In multiple regression analysis, menopause and age of postmenopausal divers was a predictors of femoral neck BMD in divers.
Conclusion : These result suggest that diving is has osteogenic effect on women.
Background : It is widely accepted the Tai Chi has been suited for whole aged people, especially old aged women and improves bone mineral density and physical fitness levels. To investigate the efficacy of Tai Chi in postmenopausal women, we compared the bone mineral density and physical fitness levels between Tai Chi and control groups.
Methods : The study subjects were 10 Tai Chi and 18 control group who were postmenopausal women aged 40 years and older. Bone mineral density(BMD) was measured at the lumbar spine and femoral area using dual energy x-ray absorptiometry and maximal O2 intake, flexibility, grip strength, sit up, broad jump, balance, side-to-side step were checked for assessment of fitness levels. Other data was gathered from the questionnaire.
Results : The BMD of lumbar spine and Ward's triangle was significantly higher in control group(P<0.05) and the results of maximal O2 intake(P<0.05), grip strength(P<0.05), sit up(P<0.05), balance(P<0.01) were significantly higher in the control group. Logistic regression analysis showed that the results of grip strength, sit up, balance were significantly higher in the control group(P<0.05).
Conclusion : Tai Chi improve physical finess levels and bone mineral density and can be a useful ex-physical type for menopausal women.
BACKGROUND Physical activity and calcium nutriture with reproductive endocrine status are primary controller of bone remodelling activity. There are differences in impact of exercise on early menopausal bone ; late menopausal bone.
There are possibility of different effect of calcium intake on bone mass among different life stage. The aim of this study was to elucidate whether the relation between lifestyle and bone mineral density varied with life stages. METHODS We examined bone mineral density and took questionnaires related to lifestyle of 1,698 women aged 49~54 years old who lived in ulsan from July 1999 to Dec.
1999. We selected 731 healthy subjects without medical conditions or lifestyle factors known to affect bone metabolism. RESULTS In 6~10 years postmenopausal women, those with calcium intake of more than 600 or 800mg /day showed significantly greater BMD. In postmenopausal women , those daily consumption of milk showed greater BMD. But it is not significantly. In premenopausal women with regular menstruation, those who took regular exercise showed significantly greater BMD than those who did not. Working hours is not related with BMD. CONCLUSIONS Our study showed that the relation between calcium intake or physical activity and BMD differed with life stages. It was suggested that life stages should be taken into consideration to perform lifestyle modifications for the prevention and management of osteoporosis.
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