Korean Journal of Family Medicine (가정의학회지)

The Korean Academy of Family Medicine (대한가정의학회)
권호 표지
DOI QR코드

DOI QR Code

Association of the Metabolic Syndrome and Bone Mineral Density in Postmenopausal Women

폐경 후 여성에서 대사증후군과 골밀도의 연관성

  • Park, Jong-Chang (Department of Family Medicine, Konkuk University School of Medicine) ;
  • Kweon, Hyuk-Jung (Department of Family Medicine, Konkuk University School of Medicine) ;
  • Oh, Yun-Kyo (Department of Family Medicine, Konkuk University School of Medicine) ;
  • Do, Hyun-Jin (Department of Family Medicine, Konkuk University School of Medicine) ;
  • Oh, Seung-Won (Department of Family Medicine, Konkuk University School of Medicine) ;
  • Lym, Youl-Lee (Department of Family Medicine, Konkuk University School of Medicine) ;
  • Choi, Jae-Kyung (Department of Family Medicine, Konkuk University School of Medicine) ;
  • Joh, Hee-Kyung (Department of Family Medicine, Konkuk University School of Medicine) ;
  • Cho, Dong-Yung (Department of Family Medicine, Konkuk University School of Medicine)
  • 박종창 (건국대학교 의학전문대학원 가정의학교실) ;
  • 권혁중 (건국대학교 의학전문대학원 가정의학교실) ;
  • 오윤교 (건국대학교 의학전문대학원 가정의학교실) ;
  • 도현진 (건국대학교 의학전문대학원 가정의학교실) ;
  • 오승원 (건국대학교 의학전문대학원 가정의학교실) ;
  • 임열리 (건국대학교 의학전문대학원 가정의학교실) ;
  • 최재경 (건국대학교 의학전문대학원 가정의학교실) ;
  • 조희경 (건국대학교 의학전문대학원 가정의학교실) ;
  • 조동영 (건국대학교 의학전문대학원 가정의학교실)
  • Received : 2008.09.19
  • Accepted : 2009.12.22
  • Published : 2010.01.20
⟨ Previous Next ⟩

Abstract

Background: The metabolic syndrome (MS) is a cluster of risk factors of cardiovascular disease. The association between components of the MS and bone mineral density has been researched, but no prior studies have directly evaluated the association with the metabolic syndrome and bone mineral density in Korea. Methods: We evaluated postmenopausal women who had visited a university hospital from November 2006 to October 2007. Data on their lifestyle, current medical diseases and medications were collected from medical records. Height, body weight, waist circumference and serum lipid profiles were measured. Results: The prevalence of metabolic syndrome was 21.8% in this study. In adjusted analysis including age and other factors, only waist circumference had a close correlation with bone mineral density of femur and lumbar vertebral body (P < 0.05). The bone mineral density of femur and lumbar vertebral body had no correlation with the presence of metabolic syndrome. When stratified by body mass index, corrected bone mineral density revealed no significant correlation with the presence of metabolic syndrome. Conclusion: The bone mineral density of postmenopausal women with metabolic syndrome has highly influenced by obesity, especially by abdominal obesity.

연구배경: 대사증후군은 내당능장애, 이상지질혈증, 인슐린 저항성, 고혈압, 복부비만과 같은 심혈관계 질환의 위험 인자 가 군집되어 나타나는 증후군을 말한다. 대사증후군 위험 인자들과 골다공증과의 연관성을 폭넓게 연구되어 왔으나 결과는 논란의 여지가 있다. 국내에서 아직까지 대사증후군 전체 위험인자들의 골밀도에 대한 복합적인 영향을 보고한 연구는 이루어지지 않고 있다. 따라서 본 연구에서는 대사증후 군과 골밀도의 연관성을 규명하고자 한다. 방법: 2006년 11월 1일부터 2007년 10월 31일까지 일개 대학 병원 건강증진센터를 방문한 폐경 후 여성들 중 353명을 대상으로 하였다. 대상자들의 생활습관과 현재병력은 자기 기입식 설문지를 통해 조사하였고, 신장, 체중, 허리둘레, 혈압, 혈당과 혈액지질을 측정하였다. 결과: 대사증후군의 유병률은 21.8%로 나타났다. 나이와 다른 인자를 보정한 결과 대사증후군 위험인자 중 허리둘레만이 대퇴골 및 요추 골밀도와 유의한 연관성을 보였다(P<0.05). 나이와 다른 인자들을 보정하였을 때 대퇴골 골밀도와 요추의 골밀도는 대사증후군 유무와는 관련이 없었다. 체질량지수에 따른 층화분석에서 보정된 골밀도는 대사증후군 유무와 상관없이 의미있는 관련성을 보이지 않았다. 결론: 대사증후군이 있는 폐경 후 여성의 골밀도는 비만, 특히 복부 비만에 의하여 영향을 받는다고 생각된다.

Keywords

Acknowledgement

Supported by : Konkuk University

References

  1. WHO Study Group. Assessment of fracture risk and its application to screening for postmenopausal osteoporosis: report of a WHO Study Group. WHO Technical Report Series 843. Geneva: World Health Organization; 1994.
  2. Yoo TW. Health yearbook. Seoul: Bokuennews; 2000. p. 281- 92.
  3. Vega GL. Results of experts meetings: obesity and cardiovascular disease. Obesity, the metabolic syndrome, and cardiovascular disease. Am Heart J 2001;142:1108-16. https://doi.org/10.1067/mhj.2001.119790
  4. Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive summary of the third report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA 2001;285:2486-97. https://doi.org/10.1001/jama.285.19.2486
  5. Hyldstrup L, Andersen T, McNair P, Breum L, Transbol I. Bone metabolism in obesity: changes related to severe overweight and dietary weight reduction. Acta Endocrinol (Copenh) 1993; 129:393-8.
  6. Ostrowska Z, Zwirska-Korczala K, Buntner B, Pardela M, Drozdz M. Assessment of bone metabolism in obese women. Endocr Regul 1998;32:177-81.
  7. Adami S, Braga V, Zamboni M, Gatt i D, Rossini M, Bakri J, et al. Relationship between lipids and bone mass in 2 cohorts of healthy women and men. Calcif Tissue Int 2004;74:136-42. https://doi.org/10.1007/s00223-003-0050-4
  8. Yamaguchi T, Sugimoto T, Yano S, Yamauchi M, Sowa H, Chen Q, et al. Plasma lipids and osteoporosis in postmenopausal women. Endocr J 2002;49:211-7. https://doi.org/10.1507/endocrj.49.211
  9. Lidfeldt J, Holmdahl L, Samsioe G, Nerbrand C, Nyberg P, Schersten B, et al. Th e infl uence of hormonal status and features of the metabolic syndrome on bone density: a population-based study of Swedish women aged 50 to 59 years. The women's health in the Lund area study. Metabolism 2002;51:267-70. https://doi.org/10.1053/meta.2002.300001
  10. Tsuda K, Nishio I, Masuyama Y. Bone mineral density in women with essential hypertension. Am J Hypertens 2001;14(7 Pt 1):704-7. https://doi.org/10.1016/S0895-7061(01)01303-6
  11. Powers AC. Diabetes mellitus. In: Kasper DL, Braunwald E, Fauci AS, Hauser SL, Longo DL, Jameson JL, editors. Harrison's principles of internal medicine. 16th ed. New York: McGraw- Hill; 2005. p. 2268-78.
  12. Leidig-Bruckner G, Ziegler R. Diabetes mellitus a risk for osteoporosis? Exp Clin Endocrinol Diabetes 2001;109 Suppl 2: S493-514. https://doi.org/10.1055/s-2001-18605
  13. Koh YY, Rhee EJ, Kim SY, Jung CH, Park CY, Lee WY, et al. Th e relationship between lumbar spine bone mineral density and cardiovascular risk factors in Korean female adults. J Korean Soc Endocrinol 2006;21:497-505. https://doi.org/10.3803/jkes.2006.21.6.497
  14. Kim SH, Lee KK. Relationship between hypertension and body composition, bone mineral density, muscular strength in older women. J Korea Sport Res 2007;18:349-58.
  15. Shin JH, Hwang YN, Kim WW, Kim HS, Song SW. The relationship between the level of serum lipids and bone metabolism among pre and postmenopausal women. Korean J Obes 2007;16:162-9.
  16. WHO Western Pacific Region, International Association for the Study of Obesity, International Obesity Task Force. The Asia-Pacific perspective: redefining obesity and its treatment. Sydney: Health Communications Austrailia; 2000.
  17. Ford ES, Giles WH, Dietz WH. Prevalence of the metabolic syndrome among US adults: findings from the third National Health and Nutrition Examination Survey. JAMA 2002;287:356-9. https://doi.org/10.1001/jama.287.3.356
  18. Lym YL, Hwang SW, Shim HJ, Oh EH, Chang YS, Cho BL. Prevalence and risk factors of the metabolic syndrome as defi ned by NCEP-ATP III. J Korean Acad Fam Med 2003;24:135-43.
  19. Kinjo M, Setoguchi S, Solomon DH. Bone mineral density in adults with the metabolic syndrome: analysis in a populationbased U.S. sample. J Clin Endocrinol Metab 2007;92:4161-4. https://doi.org/10.1210/jc.2007-0757
  20. von Muhlen D, Safii S, Jassal SK, Svartberg J, Barrett-Connor E. Associations between the metabolic syndrome and bone health in older men and women: the Rancho Bernardo Study. Osteoporos Int 2007;18:1337-44. https://doi.org/10.1007/s00198-007-0385-1
  21. Lee KC, Yoon CH, Lee JB. Comparison of body weight and body mass index as predictors for osteoporosis among postmenopausal Korean women. J Korean Acad Fam Med 2005; 26:609-13.
  22. Cummings SR, Kelsey JL, Nevitt MC, O'Dowd KJ. Epidemiology of osteoporosis and osteoporotic fractures. Epidemiol Rev 1985; 7:178-208.
  23. Compston JE, Bhambhani M, Laskey MA, Murphy S, Khaw KT. Body composition and bone mass in post-menopausal women. Clin Endocrinol (Oxf) 1992;37:426-31. https://doi.org/10.1111/j.1365-2265.1992.tb02354.x
  24. Steinberg KK, Freni-Titulaer LW, DePuey EG, Miller DT, Sgoutas DS, Coralli CH, et al. Sex steroids and bone density in premenopausal and perimenopausal women. J Clin Endocrinol Metab 1989;69:533-9. https://doi.org/10.1210/jcem-69-3-533
  25. Lau EM, Tasi KS, Woo J, Chan NF, Leung PC, Lim L. Bone mineral density in Hong Kong and Taiwan Chinese women: a comparative study. Hong Kong Med J 1995;1:53-7.
  26. Aloia JF, Cohn SH, Vaswani A, Yeh JK, Yuen K, Ellis K. Risk factors for postmenopausal osteoporosis. Am J Med 1985;78:95- 100.
  27. Jankowska EA, Rogucka E, Medras M. Are general obesity and visceral adiposity in men linked to reduced bone mineral content resulting from normal ageing? A population-based study. Andrologia 2001;33:384-9. https://doi.org/10.1046/j.1439-0272.2001.00469.x
  28. Blaauw R, Albertse EC, Hough S. Body fat distribution as a risk factor for osteoporosis. S Afr Med J 1996;86:1081-4.
  29. Edelstein SL, Barrett-Connor E. Relation between body size and bone mineral density in elderly men and women. Am J Epidemiol 1993;138:160-9.
  30. Ahmed LA, Schirmer H, Berntsen GK, Fonnebo V, Joakimsen RM. Features of the metabolic syndrome and the risk of nonvertebral fractures: the Tromso study. Osteoporos Int 2006; 17:426-32. https://doi.org/10.1007/s00198-005-0003-z

Cited by

  1. 30~50대 여성의 연령별 신체조성분과 식행동, 생활습관 관련 요인 연구 vol.17, pp.4, 2010, https://doi.org/10.5720/kjcn.2012.17.4.440
  2. 한국 중년 여성의 주관적 건강상태에 따른 식사의 질 평가 －2008~2009 국민건강영양조사 자료 활용－ vol.42, pp.9, 2010, https://doi.org/10.3746/jkfn.2013.42.9.1395
  3. 30~70대 여성의 골밀도, 생화학적 특성 및 영양소 섭취 분석 -2011년 국민건강영양조사를 중심으로- vol.19, pp.4, 2010, https://doi.org/10.5720/kjcn.2014.19.4.328
  4. 다중 검출 전산화단층촬영을 이용한 국내 일부 지역 성인의 골밀도 현황 분석: 식습관, 생활습관, 신체적, 사회적 특성과의 상관관계를 중심으로 vol.39, pp.4, 2010, https://doi.org/10.17946/jrst.2016.39.4.05
  5. 성인 남녀를 대상으로 대사증후군이 총 진료비에 미치는 영향분석 vol.27, pp.1, 2010, https://doi.org/10.4332/kjhpa.2017.27.1.47
  6. Association between Metabolic Syndrome and Osteoporosis in Korean Adults Aged Over 50 Years Old Using the Korea National Health and Nutrition Examination Survey, 2016-2017 vol.44, pp.3, 2010, https://doi.org/10.21032/jhis.2019.44.3.245