Journal of Nutrition and Health

The Korean Nutrition Society (한국영양학회)
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A Comparative Study of Bone Mineral Density and Urinary Bone Metabolic Makers according to the Nutrients Intake Levels in Postmenopausal Women

일부 폐경 후 여성의 영양소 섭취수준에 따른 골밀도와 소변 중 골대사 지표 비교연구

  • Kim, Mi-Hyun (Department of Food and Nutrition, Kangwon National University) ;
  • Lee, Da-Hong (Department of Food and Nutrition, Wonkwang University)
  • 김미현 (강원대학교 식품영양학과) ;
  • 이다홍 (원광대학교 식품영양학과)
  • Published : 2007.12.30
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Abstract

To elucidate the relationship among the levels of nutrients intake, bone mineral density(BMD) and the urinary biochemical markers of bone metabolism, this survey is conducted with 225 postmenopausal women over 50 years of age. The urinary biochemical markers including deoxypyridinoline(DPD) and Ca excretion were measured. Bone mineral densities of lumbar spine(L2-L4), femoral neck, ward's triangle and trochanter were measured with dual-energy X-ray absorptiometry and the nutrient intake data obtained by 24 hr recall method. Mean age of all subjects was 64.8 years old, and the BMDs of the subjects were $0.86g/cm^2$(lumbar spine), $0.60g/cm^2$(femoral neck), $0.49g/cm^2$(trochanter), and $0.41g/cm^2$(ward's triangle). The results were compared among 3 groups with different nutrient intake levels classified by the percentage of Dietary Reference Intakes(DRIs) for Koreans as follows: low < 75% DRIs, 75% DRI $\leq$ adequate < 125% DRIs, high $\geq$ 125% DRIs. Bone mineral density of adequate protein intake group was significantly higher than those of low and high protein intake groups(p<0.05). Urinary DPD excretion was lowest in protein and calcium adequate intake groups(p<0.05, p<0.05), respectively. In relation to urinary Ca excretion, it is revealed to be considerably lower in the groups taking protein and vitamin C adequate intake(p<0.05, p<0.05). The percent DRI of protein and calcium were positively correlated with the BMD of the femoral neck after adjusted age(p<0.05, p<0.05). These results showed that there are probably some relationships between nutrient intake levels and urinary biochemical markers. For postmenopausal women with adequate nutrition expecially protein, calcium and vitamin C, has an important role to postpone bone resorption and to prevent the decrease of bone density.

영양소 섭취수준과 골밀도 및 골대사 지표와의 관련성을 알아보고자 폐경 후 여성 225명을 대상으로 이들의 영양소 섭취량을 한국영양섭취기준의 권장섭취량 대비 75% 미만을 섭취하는 군과 $75{\sim}125%$ 섭취군, 125% 이상을 섭취하는 군으로 구분하여 영양소 섭취수준에 따른 골밀도, 골대사 지표물질인 소변의 디옥시피리디놀린, 칼슘의 배설량을 비교분석한 결과를 요약하면 다음과 같다. 1) 본 연구대상자의 골밀도 측정결과, 요추($L2{\sim}L4$)는 $0.86g/cm^2$이었으며, 대퇴경부가 $0.61g/cm^2$, 대퇴전자부는 $0.48g/cm^2$, 와드삼각부는 $0.42g/cm^2$를 나타났다. 본 연구대상자를 정상군(T값${\geq}-1$), 골감소증(-2.5${\leq}-2.5$)으로 구분한 결과, 와드삼각부는 전체 대상자중 79.1%, 대퇴경부는 전체의 67.6%가 골다공증인 것으로 나타났다. 2) 영양소섭취수준에 따른 골밀도를 비교한 결과, 단백질을 권장섭취량의 75% 미만 섭취하는 연구대상자의 대퇴경부 골밀도가 권장섭취량의 $75{\sim}125%$와 125% 이상을 섭취하는 군에 비해 유의적으로 낮았다(p<0.05). 3) 소변 디옥시피리디놀린 배설량은 단백질을 권장섭취량의 $75{\sim}125%$ 섭취하는 군에서 75% 미만과 125% 이상 섭취하는 군 보다 유의적으로 낮게 배설하는 것으로 나타났으며(p<0.05), 또한 칼슘을 75% 미만 섭취한 군과 125% 이상 섭취한 군보다 $75{\sim}125%$ 섭취한 군에서 소변의 디옥시피리디놀린의 배설이 유의적으로 낮게 나타났다(p<0.05). 4) 소변 칼슘배설량은 단백질 섭취수준이 권장섭취량의 75% 미만 섭취 군과 125% 이상 섭취 군보다 $75{\sim}125%$ 섭취 군에서 유의적으로 낮았고(p<0.05), 비타민 C의 경우도 권장섭취량의 75% 미만과 125% 이상 섭취군보다 $75{\sim}125%$ 섭취 군에서 유의적으로 낮았다(p<0.05). 5) 연령 보정 후 단백질, 칼슘의 권장섭취량에 대한 비율은 대퇴경부 골밀도(각 p<0.05, p<0.01)와 유의적인 양의 상관관계를 보였다. 또한 단백질(p<0.01)과 비타민 C(p<0.01), 나이아신(p<0.05)의 섭취량은 소변 중 칼슘 배설량과 유의적인 양의 상관관계를 나타내었다. 이와 같이 폐경 후 여성에게서 영양소 섭취수준에 따라 골대사 지표물질의 농도에도 차이를 보였으며, 특히 단백질의 섭취수준과 칼슘, 비타민 C의 섭취량이 유의적으로 영향을 미쳐 부족하거나, 과잉되지 않는 적정 섭취 범위 내에서 골용출이 감소하는 것으로 나타났다. 따라서 폐경 이후 여성의 골격건강을 위하여 영양소의 적정섭취가 중요하며 부족뿐만 아니라 건강을 염려한 특정영양소의 과잉 섭취도 바람직하지 않은 요인임을 확인할 수 있었다.

Keywords

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