Osteoporosis Prevalence of Radius and Tibia and Related Factors Using Multiple Bone Sites Quantitative Ultrasound Measurement of the Korean Health and Genome Study Cohort Women

지역사회 코호트 여성의 요골과 경골에서의 골다공증 유병률과 관련 요인 분석

  • Park Seon-Joo (National Genome Research Institute, National Institute of Health) ;
  • Abn Younjhin (National Genome Research Institute, National Institute of Health) ;
  • Min Hae Sook (National Genome Research Institute, National Institute of Health) ;
  • Oh Kyoung Soo (National Genome Research Institute, National Institute of Health) ;
  • Park Chan (National Genome Research Institute, National Institute of Health) ;
  • Cho Nam Han (Department of Preventive Medicine, Ajou University School of Medicine & Hospital) ;
  • Kim Kuchan (National Genome Research Institute, National Institute of Health)
  • 박선주 (국립보건연구원 유전체연구부) ;
  • 안윤진 (국립보건연구원 유전체연구부) ;
  • 민해숙 (국립보건연구원 유전체연구부) ;
  • 오경수 (국립보건연구원 유전체연구부) ;
  • 박찬 (국립보건연구원 유전체연구부) ;
  • 조남한 (아주대학교 의과대학 예방의학교실) ;
  • 김규찬 (국립보건연구원 유전체연구부)
  • Published : 2005.08.01

Abstract

This study was conducted to investigate osteopenia and osteoporosis prevalence of radius and tibia using Quantitative Ultrasound (QUS) and to identify affecting factors of osteoporosis. A total of 4,340 women aged 40 - 69 years, living in Ansung (rural) and Ansan (mid-sized) area, and free of illnesses affecting bone metabolism participated in the community-based cohort study. Among them 4,059 subjects measured radius bone density and 4,089 measured tibia. The T-score threshold, defined as < -1.0 and $\le$-2.5, was used to identify subjects with osteopenia and osteoporosis by WHO criteria. The crude prevalence of osteoporosis in radius and tibia was $8.4\%$ and $23.3\%$ respectively; after adjustment for age, it changed $6.3\%$ and $18.8\%$. In simple logistic regression analysis, the prevalence of osteoporosis increased by aging, non-marital status, low education, low income. Otherwise, high intakes of Ca/P, thiamin, riboflavin, vitamin B6, and vitamin E were decreased osteoporosis prevalence. Compared to the normal BMI (body mass index) group 08.5 $\le$ BMI < 23), the odds ratio (ORs) of the low BMI group (BMI < 18.5), and high BMI groups (BMl25-30, BMI $\ge$ 30) were significantly increased. The OR of osteoporosis decreased across increasing quartiles of intakes of Ca, P and Ca/P. Therefore, maintaining normal BMI and increasing Ca intake and Ca/P ratio may have a beneficial effect on bone health of Korean women.

Keywords

References

  1. 통계청(2000): 인구주택총조사
  2. Ahn Y, Lee JE, Cho NH, Shin C, Park C, Oh BS, Kimm K (2004): Validation and calibration of semi-quantitative food frequency questionnaire- with participants of the Korean Health and Genome Study-. Korean J Community Nutrition 9(2): 173-182
  3. Braunwald E. Fauci AS, Kasper DL, Hauser SL, Longo DL, Jameson JL. (2001): Harrison's 15th edition Principles of internal medicine, pp.2226-2227, The McGraw-Hill Companies, Inc., USA
  4. Bryant RJ, Cadogan J, Weaver CM (1999): The New Dietary Reference Intakes for Calcium: Implication for Osteoporosis. Journal of the American College of Nutrition 18(5): 406s-412s
  5. Cho EM, Kim JY, Bai SW, Park KH (1997): Analysis of correlation between parameters by QUS (Quantitative Ultrasound) and bone mineral density by DEXA (Dual-energy X-ray absorptiometry). The Journal of the Korean Society of Menopause 3(2): 171-177
  6. Choi MJ (2002): Effects of nutrients intake and exercise on bone mineral density and bone mineral density in premenopausal women. Korean J Nutrition 35(4): 473-479
  7. Choi MJ, Jung YJ (1998): The relationship between food habit, nutrient intakes and bone mineral density and bone mineral content in adult women. Korean J Nutr 31(9): 1446-1456
  8. Damilakis J, Papadokostakis G, Perisinakis K, Maris T, Dimitriou P, Hadjipavlou A, Gourtsoyiannis N (2004): Discrimination of hip fractures by quantitative ultrasound of the phalanges and the calcaneus and dual X-ray absorptiometry. European Journal of Radiology 50: 268-272 https://doi.org/10.1016/j.ejrad.2004.01.023
  9. Feskanich D, Willett WC, Colditz GA (2003): Calcium, vitamin D, milk consumption, and hip fractures: a prospective study among postmenopausal women. Am J Clin Nutr 77: 504-511
  10. Folders AJ, Rimon A, Keinan DD, Popovtzer MM (1995): Quantitative ultrasound of the tibia: a novel approach for assessment of bone status. Bone 17(4): 363-367 https://doi.org/10.1016/S8756-3282(95)00244-8
  11. Han IK, Lee DJ, Kim YS, Kim KM (1998): Clinical applicability of ultrasonometric skin thickness measurement in the diagnosis of postmenopausal osteoporosis. J Kor Soc Endocrinol 13(1): 60-66
  12. Ho SC, Chen Y, Woo JLF (2005): Education level and osteoporosis risk in postmenopausal Chinese women. Am J Epidemiol 161(7): 680-690 https://doi.org/10.1093/aje/kwi047
  13. Hong HO, Yu CH (1994): The effect of Ca and Vitamin D supplementation on bone metabolism in postmenopausal women. Korean J Nutr 27(10): 1025-1036
  14. Jeon KY, Choi YS (1996): The occurrence of osteoporosis and osteopenia between two groups with different socioeconomic conditions. Korean Journal of Medicine 50(4): 522-529
  15. Kim CH, Kim YI, Choi CS, Park JY, Lee MS, Lee SI, Kim GS (2000): Prevalence and risk factors of low quantitative ultrasound values of calcaneus in Korean elderly women. Ultrasound in Med & Biol 26 (1): 35-40 https://doi.org/10.1016/S0301-5629(99)00126-X
  16. Kim HJ (2003): Research on relation of nutrients intake, health status, and bone mineral density in middle-aged women. Journal of the Korean Dietetic Association 9(4): 307-315
  17. Kim WY (1994): Osteoporosis and dietary factors. Korean J Nutrition 27(6): 636-645
  18. Lau EMC (2001): Epidemiology of osteoporosis. Best Practice & Research Clinical Rheumatology 15(3): 335-344 https://doi.org/10.1053/berh.2001.0153
  19. Lee BK, Chang YK, Choi KS (1992): Effect of nutrient intake on bone mineral density in postemenopausal women. Korean J Nutrition 25 (7): 642-655
  20. Lee HJ, Choi MJ (1996): The effect of nutrient intake and energy expenditure on bone mineral density of Korean women in Taegu. Korean J Nutrition 29(6): 622-633
  21. Lee HJ, Lee HO (1999): A study on the bone mineral density and related factors in Korean postmenopausal women. Korean J Nutrition 32 (2): 197-203
  22. Lee HS, Lee DH, Sung CJ (2001): Relationship between nutrient intake and biochemical markers of bone metabolism in Korean postmenopausal women. Korean J Community Nutrition 6(5): 765-772
  23. Lee RD, Nieman DC (2003): Nutritional Assessment, pp.285-286, McGrawHill, USA
  24. Lee SM, Kim Y, Youn KE, Park BJ (2002): Reproductive history and hip fracture in the elderly women in Korea: A cohort study. Korean J Prev Med 35(4): 305-312
  25. Lewiecki EM (2004): Management of osteoporosis. Clinical and Molecular Allergy. http://www.clinicalmolecularallergy.com/content/2/ 1/9
  26. Macdonald HM, New SA, Golden MHN, Campbell MK, Reid DM. (2004): Nutritional associations with bone loss during the menopausal transition: evidence of a beneficial effect of calcium, alcohol, and fruit and vegetable nutrients and of a detrimental effect of fatty acids. Am J Clin Nutr 79: 155-165
  27. Ministry of Health & Welfare (2002): Report on 2001 National Health and Nutrition survey - Nutrition survey
  28. Moyad MA (2003): Osteoporosis: a rapid review of risk factors and screening methods. Urologic Oncology 21: 375-379 https://doi.org/10.1016/S1078-1439(03)00140-6
  29. Munger RG, Cerhan JR, Chiu BCH (1999): Prospective study of dietary protein intake and risk of hip fracture in postmenopausal women. Am J Clin Nutr 69: 147-152
  30. Murphy S. Khaw KT, May H, Compston JE (1994): Milk consumption and bone mineral density in middle aged and elderly women. BMJ 308: 939-941 https://doi.org/10.1136/bmj.308.6934.939
  31. Na HB (2004): Factors affecting bone mineral density in Korean women by menopause. Korean J Community Nutrition 9(1): 73-80
  32. Oh JJ, Hong ES, Baik IK, Lee HS, Lim HS (1996): Effects of dietary calcium, protein, and phosphorus intakes on bone mineral density in Korean premenopausal women. Korean J Nutr 29(1): 59-69
  33. Oh SI, Lee HS, Lee MS, Kim CI, Kwon IS, Park SC (2002): Some Factors affecting bone mineral status of postmenopausal women. Korean J Community Nutrition 7(1): 121-129
  34. Oh SI, Lee HS, Lee MS, Kim CI, Kwon IS, Park SC (2003): Factors affecting bone mineral status of premenopausal women. Korean J Community Nutrition 8(6): 927-937
  35. Oliveri B, Di Gregorio S, Parisi MS, Solis F, Mautalen C (2002): Is ultrasound of bone relevant for corticosteroid-treated patients? A comparative study with bone densitometry measured by DEXA. Joint Bone Spine 70: 46-51 https://doi.org/10.1016/S1297-319X(02)00010-6
  36. Pafumi C, Chiarenza M, Zizza G, Roccasalva L, Ciotta L, Farina M, Pernicone G, Russo A, Maggi I, Bandiera S, Giardina P, Cavallaro A, Cianci A (2002): Role of DEXA and ultrasonometry in the evaluation of osteoporotic risk in postmenopausal women. Maturitas 42: 113-117 https://doi.org/10.1016/S0378-5122(02)00036-1
  37. Shin GO, Park KW, Lee DW, Park TJ, Lee K (2002): Comparison of body components and mineral mass between women with osteoporosis and non-osteoporosis postmenopausal women. J Korean Acad Fam Med 23(7): 934-941
  38. Sung CJ, Choi YH, Kim MH, Choi SH, Cho KO (2002): A study of nutrient intake and serum levels of osteocalcin, Ca, P, and Mg and their correlation to bone mineral density in Korean postmenopausal women residing in rural areas. Korean J Community Nutrition 7 (1): 111-120
  39. The Korean Nutrition Society (2000): Food Composition table in Recommended dietary allowances for Koreans 7th revision. Seoul
  40. Valtora A, Konkanen R, Kroger H, Tuppurainen M, Saarikoski S, Alhava E (2002): Lifestyle and other factors predict ankle fractures in perimenopausal women: A population-based prospective cohort study. Bone 30(1): 238-242 https://doi.org/10.1016/S8756-3282(01)00649-4
  41. Weiss M, Ben Shlomo A, Hagag P, Rapoport M, Ish-Shalom S (2000): Effect of estrogen replacement therapy on speed of sound at multiple skeletal sites. Maturitas 35: 237-243 https://doi.org/10.1016/S0378-5122(00)00124-9
  42. Woo SO, Bae S, Kim DH (1995): A case-control study of risk factors of osteoporosis in some Korean outpatient women of one general hospital of Seoul. Korean J of Preventive Medicine 28(3): 609-622
  43. Woodward M (1999): Epidemiology study design and data analysis, pp.158-161, Chapman & Hall/CRC
  44. World Health Organization (1994): Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. WHO Technical Report Series, 843. Geneva, WHO
  45. Yu CH, Lee JS, Lee L, Kim SH, Lee SS, Kang SA (2004): Nutritional factors related to bone mineral density in the different age groups of Korean men. Korean J Nutr 37(2): 132-142