Background
Previous studies have shown that body composition is associated with chronic kidney disease (CKD), and perimenopause is associated with increased fat mass and decreased lean body mass. Muscle wasting is common among patients with CKD. Sarcopenic obesity (SO) refers to excess adiposity with decreased muscle mass. However, little is known about the relationship between SO and renal function decline. Here, we identified the relationship between SO and decreased estimated glomerular filtration rate (eGFR) in postmenopausal women.
Methods
We conducted a cross-sectional study based on the data from the Korea National Health and Nutrition Examination Survey (2008–2011). We analyzed 4,560 postmenopausal women who underwent dual energy X-ray absorptiometry. Sarcopenia was defined based on weight-adjusted appendicular skeletal muscle mass. Obesity was defined based on body mass index. The eGFR was calculated using the Chronic Kidney Disease Epidemiology Collaboration equation. Subjects were classified into four groups: normal, obese, sarcopenic, and sarcopenic obese. Logistic regression analysis was performed to examine the association between SO and decreased eGFR. The results were adjusted for variable confounders.
Results
In the unadjusted model, the odds ratio (OR) of decreased eGFR for SO was 1.67 (95% confidence interval [CI], 1.23–2.26). The obese and sarcopenic groups had ORs of 0.67 (95% CI, 0.44–1.03) and 0.70 (95% CI, 0.44–1.10), respectively. After controlling for confounding variables, there was also a significant association between SO and decreased eGFR (adjusted OR, 1.48; 95% Cl, 1.05–2.07).
Conclusion
SO was independently associated with decreased eGFR in postmenopausal Korean women.

Citations

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Citations

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Background
: Alendronate is on of the anti-resorptive drugs for the treatment of osteoporosis and results in a decrease of bone turnover. HRT is also known to decrease the bone turnover. Combination therapy with HRT and alendronate has made significant increase of BMD in postmenopausal women. But there were no available long-term results about combination therapy of HRT and alendronate on Korean osteoporotic women.

Methods : Eighty postmenopausal women with osteoporosis who visited the Climacteric Clinic in Samsung Cheil Hospital & Women's Health Care Center from April to July 1999 were subjects. Randomized open labeled case control study was made. We evaluated 37 postmenopausal osteoporotic Korean women who were treated for 2 years after enrollment. Subjects in Group I were treated with HRT only and group II had HRT with alendronate 10 mg daily. Subjects also were measured BMD at lumbar spine and makers of bone turnover before, one and two year after treatment.

Results : Common reasons for dropouts were side effects of HRT such as breast tenderness, irregular vaginal bleeding, economic problems, long distance from clinic etc. BMD in lumbar spine was increased 10.1% in the first year, and 12.0% in the second year in subjects treated with HRT and alendronate. But in HRT only group BMD increased to 6.4% in the first year and 7.8% at second year. Markers of bone turnover were decreased significantly in both groups compared with baseline value, but the percent changes of markers after 1 year and 2 years between the two groups were not significant.

Conclusion : This study demonstrated that, in postmenopausal Korean women with osteoporosis, 2 years of combination therapy with HRT and alendronate resulted in a significant and sustained increase in spinal BMD than HRT and alendronate resulted in a significant and sustained increase in spinal BMD than HRT only group.

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
: Increased bone turnover results in bone loss after menopause. After menopause, the major cause of bone loss is estrogen deficiency. Rate of bone loss seems to increase after menopause and then formation coupled with resorption is also increased. Antiresorptive drugs are known to be helpful in preventing bone loss. Alendronate is one of antiresorptive drugs for the treatment of osteoporosis which results in a decrease in bone turnover. Some papers report about nonresponders to antiresorptive drugs, and screening people early is very important to optimal management. There are no available data of Korean people. Therefore, this study evaluated the effects of alendronate in Korean postmenopausal osteoporosis patients after 3 months of treatment.

Methods : We studied 96 women with postmenopausal osteoporosis (bone mineral density{BMD} T score<2.5) who visited Climacteric Clinic in Samsung Cheil Hospital from Jan. 1999 to Jul. 1999. Subjects were stratified in to 3 group: Group 1 treated with alendronate (Fosamax ; MSD, Rahyway, NJ, USA) 10mg/day and estrogen, Group 2 treated with calcitonin nasal spray 100 IU every other day and estrogen, and Group 3 treated with estrogen alone for 3 months. We measured serum marker of bone formation (osteocalcin [BGP]), and marker of bone resorption (deoxypyridinoline [DPYD] from urine at baseline and 3 months after treatment.

Results : The mean difference in change of markers among the three groups at the end of study that were significant were BGP 25.7±4.8% and DPYD 23.3±2.3%. DPYD known as bone resorption marker showed a significant response in alendronate and estrogen therapy group than estrogen alone group (P<0.05). Also, BGP showed response to estrogen alone, and calcitonin and estrogen group, but its responsiveness was lesser than alendronate therapy.

Conclusion : Our data showed that using alendronate with estrogen in patients of osteoporosis further prevents bone resorption. Therefore, we conclude that alendronate therapy with estrogen is helpful managing osteoporosis patients.

Background
: To determine the relationship between nutrient intake and bone mineral density (BMD), we have investigated this issue by the use of a semiquantitative food-frequency questionnaire.

Methods : A total 312 women aged 33-77 was divided into two groups, 187 premenopausal and 125 postmenopausal women, Dietary intake was assessed with a food-frequency questionnaire. DMD was assessed with dual-energy X-ray absorptiometry at the lumbar spine (lumbar vertebrae 2-4). Pearson correlation and partial correlation coefficients were calculated for each nutrient at the lumbar spine MBD.

Results : The mean age of the 32 participants was 48 years, and their mean body mass index (BMI) was 23.7±2.8 kg/m² . Forty percent of the women were in postmenopausal state. The mean lumbar BMD was 1.117g/cm2. Age was negatively correlated with BMD in postmenopausal women, but smoking and exercise were not correlated with BMD. In premenopausal women, nutrient intakes were not associated with BMD. A significant association was found between intakes of fat, iron, vitamin A, vitamin C and BMD in postmenopausal women, but after adjusting for age, body mass index, energy intake, smoking, exercise, and use of hormone replacement therapy, there was no association.

Conclusion : There was no significant association between nutrient intakes and BMD of the lumbar spine.

Background
: In postmenopausal women, progesterone should be added to protect the endometrium from hyperplasia or carcinoma induced by the unopposed estrogen. However, the effects of progestogen on bone mineral densities and serum lipoproteins have not been precisely evaluated in Korean postmenopausal women.

Methods : To evaluate the effects of progestogen on bone mineral densities and serum lipoprotein in estrogen replacement therapy, we conducted a 2-year trial of long conjugated equine estrogen(conjugated estrogen 0.625mg/day) with or without cyclic progestogen(MPA 5mg/day for 12 days) in 120 postmenopausal women. In all subjects, bone mineral density was measured in lumbar vertebra(L2-L4) and femur neck using dual energy X-ray absorptiometry(DEXA) and serum lipoprotein was measured from the beginning of the treatment, 12 months, and 24 months later, respectively.

Results : BMD of femur neck in both groups increased but not significantly compared to basal level at 12 months and/or 24 months of treatment. As for BMD of lumbar spine, it increased significantly in both groups. Both groups showed a significant decrease in the levels LDL cholesterol, but there was no statistical significance in serum triglycerides. Conjugated estrogen plus MPA group in contrast to conjugated estrogen only group showed a significant decrease in total cholesterol levels.

Conclusion : These results suggest that the addition of MP of the daily of 5mg for 12 days cyclically in estrogen replacement treatment appear to be effective in postmenopausal women with protection on bone mineral density and maintenance of long-term favorable effects on serum lipoprotein.