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We investigated the association between body composition, especially truncal or non-truncal fat mass (FM), and bone mineral density (BMD) in premenopausal women in Korea.
A cross-sectional study was performed using data from the Korea National Health and Nutrition Examination Survey IV and V (2008–2011). Total lean mass (LM), total FM (TFM), truncal FM, and non-truncal FM, and BMD of the total femur, femoral neck (FN), and lumbar spine were measured using dual-energy X-ray absorptiometry. The association between body composition and BMD was analyzed using multiple linear regression. The risk of low BMD according to quartiles of TFM, truncal FM, and non-truncal FM was calculated using logistic regression. Subgroup analysis according to body mass index was also performed.
In 4,343 premenopausal women, total LM was positively associated with BMD regardless of weight adjustment. TFM, truncal FM, and non-truncal FM were inversely associated with BMD after adjusting for weight. Odds ratios (ORs) for low BMD and 95% confidence intervals (CIs) of the highest quartile of TFM, truncal FM, and non-truncal FM compared with the lowest quartile were calculated. The risk of low BMD of the FN was higher in the highest quartile of TFM (OR, 4.48; 95% CI, 1.11–18.01) and truncal FM (OR, 5.48; 95% CI, 1.75–17.20). Truncal FM and not-truncal FM had an inverse association with BMD in the non-obese and obese subgroups of women.
Total LM has a protective effect on BMD and FM can have a detrimental effect on BMD besides its skeletal loading effect.
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We previously proposed the Predictive Index for Osteoporosis as a new index to identify men who require bone mineral density measurement. However, the previous study had limitations such as a single-center design and small sample size. Here, we evaluated the usefulness of the Predictive Index for Osteoporosis using the nationally representative data of the Korea National Health and Nutrition Examination Survey.
Participants underwent bone mineral density measurements via dual energy X-ray absorptiometry, and the Predictive Index for Osteoporosis and Osteoporosis Self-Assessment Tool for Asians were assessed. Receiver operating characteristic analysis was used to obtain optimal cut-off points for the Predictive Index for Osteoporosis and Osteoporosis Self-Assessment Tool for Asians, and the predictability of osteoporosis for the 2 indices was compared.
Both indices were useful clinical tools for identifying osteoporosis risk in Korean men. The optimal cut-off value for the Predictive Index for Osteoporosis was 1.07 (sensitivity, 67.6%; specificity, 72.7%; area under the curve, 0.743). When using a cut-off point of 0.5 for the Osteoporosis Self-Assessment Tool for Asians, the sensitivity and specificity were 71.9% and 64.0%, respectively, and the area under the curve was 0.737.
The Predictive Index for Osteoporosis was as useful as the Osteoporosis Self-Assessment Tool for Asians as a screening index to identify candidates for dual energy X-ray absorptiometry among men aged 50–69 years.
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The results of previous studies on the association between blood mercury (Hg) and bone mineral density (BMD) are inconsistent. We therefore used a large-scale nationwide representative sample of Korean men to investigate the relationship between these two parameters.
A nationwide cross-sectional study was conducted using data from the 2008 to 2010 Korean National Health and Nutrition Examination Survey to evaluate the relationship between blood Hg and BMD and the prevalence of osteopenia or osteoporosis in 1,190 men over 50 years of age. BMD was measured by dual-energy X-ray absorptiometry. Osteopenia and osteoporosis were diagnosed for each body site according to World Health Organization T-score criteria.
After adjusting for age, body mass index, caloric energy and calcium intake, vitamin D levels, fish consumption, alcohol consumption, smoking, and exercise, quartiles of blood Hg were positively associated with femur neck T-scores in multiple linear regression analysis (β=0.06, P-value=0.03). Compared with the lowest blood Hg quartile, the odds ratios and 95% confidence intervals for diagnosis of osteopenia or osteoporosis in the second and fourth quartiles were 0.63 (0.41–0.99) and 0.57 (0.36–0.91), respectively, in the femur neck after adjusting for the same co-variables.
High blood Hg levels were associated with reduced odds of decreased femur neck BMD in Korean men. However, subgroup analysis did not show a significant protective effect of blood Hg on osteoporotic fractures. Further research is necessary to clarify the association between blood Hg and BMD.
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An association between arterial stiffness and osteoporosis has previously been reported. Therefore, we investigated the relationship between arterial stiffness, measured by brachial-ankle pulse wave velocity, and bone mineral density in a sample of healthy women undergoing routine medical checkup.
We retrospectively reviewed the medical charts of 135 women who had visited the Health Promotion Center (between May 2009 and December 2012). Brachial-ankle pulse wave velocity was measured using an automatic wave analyzer. Bone mineral density of the lumbar spine (L1-L4) and femur was measured by dual-energy X-ray absorptiometry. Metabolic syndrome was defined according to National Cholesterol Education Program-Adult Treatment Panel III criteria, using body mass index >25 kg/m2 instead of waist circumference >88.9 cm.
Pearson's correlation analysis revealed significant inverse relationships between pulse wave velocity and bone mineral density of the lumbar spine (r=-0.335, P<0.001), femur neck (r=-0.335, P<0.001), and total femur (r=-0.181, P=0.04). Pulse wave velocity showed the strongest association with age (r=0.586, P<0.001). Multiple regression analysis identified an independent relationship between pulse wave velocity and lumbar spine bone mineral density in women after adjusting for age, metabolic syndrome, body mass index, smoking status, alcohol intake, and exercise (r=-0.229, P=0.01).
This study confirmed an association between arterial stiffness and bone mineral density in women.
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A cross-sectional study evaluated 1,126 men undergoing a comprehensive health screening in a private Korean screening center. Subjects' sera were tested for
In men,
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An association between sleep duration and a wide spectrum of diseases has been reported, but little is known about its relationship with bone mineral density (BMD). Previously conducted studies in Korea and abroad have reported results that are controversial. The present study sought to assess whether sleep duration can be considered an independent risk factor of osteoporosis.
We included participants over the age of 60 years with data on self-reported habitual sleep duration and BMD measured with dual X-ray absorptiometry. Comprehensive data on the study sample was obtained from the Korea National Health and Nutritional Survey performed from 2008 to 2010. Sex-stratified multiple regression analyses were conducted with adjustments for possible confounding factors.
There was a significant inverse dose-dependent association between sleep duration and BMD measured at total hip, femur neck, and lumbar spine for women and total hip and femur neck for men. Sex-stratified regression analyses adjusted for age and body mass index revealed that sleep duration had a negative correlation with BMD at total hip and femoral neck for both women (β = -0.0048; P = 0.0172 for total hip, β = -0.0037; P = 0.0303 for femur neck) and men (β = -0.0057; P = 0.0218 for total hip, β = -0.0057; P = 0.0143 for femur neck). For women, the significance remained after further adjustment of confounding variables.
Prolonged sleep duration appears to have a significant association with lower total hip and femur neck BMD in elderly women but not in elderly men.
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Sarcopenia is the loss of muscle mass leading to decreased muscle strength, physical disability, and increased mortality. The genesis of both sarcopenia and osteoporosis is multifactorial, and several factors that play a role in osteoporosis are thought to contribute to sarcopenia. This study evaluated the association between sarcopenia and bone density and health-related quality of life in Korean men.
We used the data of 1,397 men over 50 years of age from the 2009 Korean National Health and Nutrition Examination Survey. Sarcopenia was defined as the appendicular skeletal muscle mass divided by height2 (kg/m2) < 2 standard deviations below the sex-specific mean for young adults. Health-related quality of life was measured by the EuroQol-5 dimension (EQ-5D) instrument. Logistic regression analysis was performed to evaluate the relationship between sarcopenia, bone density, and health-related quality of life.
The T-score of the lumbar spine, total femur, and femur neck in bone mineral density in subjects with sarcopenia were lower than those in subjects without sarcopenia. The score of the EQ-5D index was significantly lower and the rate of having problems with individual components of health-related quality of life was higher in the sarcopenic group. After adjustment for age and body mass index, the odds ratios (ORs) (95% confidence interval [CI]) for sarcopenia were 2.06 (1.07-3.96) in osteopenic subjects and 3.49 (1.52-8.02) in osteoporotic subjects, respectively. After adjustment, the total score of the EQ-5D index was significantly lower in the sarcopenic subjects. The ORs (95% CI) for having problems of mobility and usual activity of the EQ-5D descriptive system were 1.70 (1.02-2.84) and 1.90 (1.09-3.31), respectively.
Sarcopenia was associated with decreased bone mineral density in Korean men. In addition, sarcopenia was related to poor quality of life, especially with regard to mobility and usual activity. Greater attention to and evaluation for sarcopenia are needed in subjects showing low bone mineral density to prevent and manage poor quality of life.
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The association between daily protein intake and osteoporosis is still controversial and only a few studies have explored the issue in Korea. This study investigated the relationship between daily protein intake and the prevalence of osteoporosis in Korean adults.
This study analyzed data extracted from the Korean National Health and Nutrition Examination Survey 4. Participants were aged 19 years or older and had never been treated for osteoporosis. The percentage of calories coming from protein intake was assessed by 24-hour recall method, and participants were divided into three groups according to recommended daily dietary protein intake as a proportion of total daily calories (i.e., <10%, 10%-20%, and >20%). A lumbar or femur neck bone mineral density T-score less than -2.5 was indicative of the presence osteoporosis. The influence of daily protein intake on the prevalence of osteoporosis was analyzed.
In both sexes, the group with the highest protein intake had significantly lower odds of developing lumber osteoporosis when compared to the group with the lowest protein intake, after adjusting for associated factors (females: odds ratio [OR], 0.618; 95% confidence interval [CI], 0.610 to 0.626; P for trend <0.001; males: OR, 0.695; 95% CI, 0.685 to 0.705; P for trend <0.001).
Sufficient daily protein intake lowered the prevalence of osteoporosis in Korean adults. Further prospective studies are necessary to verify the preventive effect of adequate protein intake on osteoporosis.
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Combined therapy with alendronate and calcitriol may have additive effects on bone density. An observational study was performed to evaluate the efficacy and safety of Maxmarvil, a combinative agent of alendronate (5 mg) and calcitriol (0.5 µg), and to identify factors associated with efficacy.
A total of 568 postmenopausal women with osteoporosis were enrolled by family physicians in 12 hospitals. The study subjects took Maxmarvil daily for 12 months. Questionnaires about baseline characteristics, socioeconomic status, and daily calcium intake were completed at the first visit. Adverse events were recorded every 3 months and bone mineral density (BMD) in the lumbar spine was measured using dual-energy X-ray absorptiometry at baseline and after 12 months. We evaluated the efficacy and safety of Maxmarvil, and the factors related to BMD improvement.
A total of 370 patients were included in final analysis. The median BMD was 0.81 ± 0.12 g/cm2 at pre-treatment and 0.84 ± 0.13 g/cm2 after one year. The average BMD improvement was 3.4% ± 6.4% (P < 0.05), and 167 (45.1%) patients showed improvement. Factors associated with improved BMD were continuation of treatment (odds ratio [OR], 2.41; 95% confidence interval [CI], 1.15 to 5.07) and good compliance (OR, 2.54; 95% CI, 1.29 to 5.00). Adverse events were reported by 35 of the 568 patients, with the most common being abdominal pain and dyspepsia.
Maxmarvil was found to be safe, well tolerated and effective in osteoporosis treatment. Continuation of treatment and good compliance were the factors associated with efficacy.
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Blood lipid profiles have been suggested to be a risk factor for osteoporosis. However, the association between lipid profiles and bone mineral density (BMD) is still unclear. This study aimed to evaluate an association between blood lipid profiles and BMD through both a cross-sectional and a longitudinal study.
Study subjects were 958 postmenopausal Korean women who have repeatedly undertaken laboratory tests and BMD measurements at lumbar spine and femur neck with an interval of 7.1 years. The associations between lipid profiles and BMD were examined using Spearman correlation analysis with an adjustment for age, smoking, alcohol drinking, physical activity, body mass index, and follow-up duration.
Lumbar spine BMD was not associated with total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), and high density lipoprotein cholesterol (HLD-C) regardless of when the measurement was performed. In an analysis using data measured at the beginning of the study, femur neck BMD was not associated with TC and LDL-C. However, femur neck BMD showed weak but significantly positive correlation with HDL-C (correlation coefficient, 0.077; 95% confidence interval, 0.005 to 0.149). When the analysis was repeated with data measured at the end of the follow-up, there was no significant correlation between femur neck BMD and any lipid profile. In addition, change in femur neck BMD during follow-up was not associated with the change in lipid profiles.
Although further study with a consideration of calcium intake and osteoporosis medication seems necessary, this study found no association between serum lipid profiles and BMD in postmenopausal Korean women.
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Metabolite Profiling of Osteoporosis and Atherosclerosis in Postmenopausal Women: A Cross-Sectional Study
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