Journal of agricultural medicine and community health (농촌의학ㆍ지역보건)

Korean Society for Rural Medicine and Community Health (한국농촌의학지역보건학회)
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Factors associated with the bone mineral density in Korean adults: Data from the 2010-2011 Korean National Health and Nutrition Examination Survey (KNHANES) V

우리나라 성인남녀의 골밀도 관련요인: 국민건강영양조사 제 5기 1, 2차 년도(2010년, 2011년)

  • Received : 2014.11.10
  • Accepted : 2014.12.15
  • Published : 2014.12.31
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Abstract

Objective: The purpose of this study was to identify the correlates of bone mineral density of Korean adults. Methods: This study was based on the data from the 2010-2011 Korean National Health and Nutrition Examination Survey (KNHANES, 2010~2011) V. Among 8,473 subjects of the survey, who were adults 19 years old or over with bone mineral density data, the current study excluded those whose data include a missing study variable or the response of 'I don't know', and finally analyzed the data of 5,986 subjects (2,692 males and 3,294 females). This study employed the following statistical methods of analysis: t-test, analysis of variance (ANOVA), and hierarchical multivariate linear regression analysis. Results: In multivariate analysis, in the case of men, the significant associated factors in bone mineral density were age, education level, body mass index (BMI), waist circumference, total muscle mass, exercise, and weight control; in the case of women, the significant associated factors in bone mineral density were age, education level, economic activity, BMI, total muscle mass, exercise, weight control. fat intake, uptake female hormone, menopause, and age of menarche. Conclusion: For both sexes, the strongest modifiable factor in influencing bone mineral density was total muscle mass. Therefore, to prevent osteoporosis and promote health, active health education and interventions such as regular exercise for total muscle mass increase should be implemented from an early growth period.

본 연구는 국민건강영양조사 제5기 골밀도 검진자 남자 2,692명, 여자 3,294명을 최종분석대상으로 골밀도와 그 관련요인을 분석하였으며 주요 결과는 다음과 같다. 단변량 분석에서 골밀도에 유의한 차이를 보인 사회인구학적 특성은 성인 남자와 여자 모두 연령, 교육수준, 경제활동상태, 소득사분위수, 거주지였으며, 건강행위 및 건강관련 특성으로는 남자는 흡연, 음주, 비만, 총근육량, 격렬한 신체활동, 중등도 신체활동, 스트레스 인지율, 체중조절 노력, 수면시간, 여자는 음주, 비만, 총근육량, 격렬한 신체활동, 체중조절 노력, 수면시간이었다. 만성질환 특성에 따라서는 고혈압, 당뇨병, 류머티스관절염은 남녀 모두 질환이 없는 군의 골밀도가 유의하게 높았고, 고콜레스테롤혈증, 골관절염은 여자, 빈혈과 우울증은 남자에서 각각 유의한 차이가 있었으며 모두에서 질환이 없는 군의 골밀도가 높았다. 단변량 분석에서 골밀도에 유의한 차이가 있었던 식품섭취 특성으로는 남자와 여자 모두 단백질 섭취량, 칼슘 섭취량, 인 섭취량, 탄수화물 섭취량 비율, 단백질 섭취량 비율, 지방 섭취량 비율이었으며, 여성건강 특성으로는 경구 피임약 복용여부, 여성호르몬제 복용여부, 임신횟수, 폐경여부, 초경연령, 첫 출산연령이 유의한 차이를 보였다(p<0.05). 다변량 분석 결과에서는 남자의 경우 총근육량이 많을수록, 체질량지수가 높을수록, 연령이 낮을수록, 초졸에 비해 대졸 이상, 허리둘레가 적을수록, 초졸에 비해 고졸, 체중조절 노력을 실천할수록, 중등도 신체활동을 실천하는 경우에 골밀도가 유의하게 높았으며, 성인 여자의 경우 연령이 낮을수록, 총근육량이 많을수록, 폐경 전일수록, 초졸에 비해 고졸, 체질량지수가 높을수록, 초졸에 비해 대졸이상, 중졸, 경제활동을 할수록, 초경 연령이 빠를수록, 여성호르몬제를 복용할수록, 지방 섭취량 비율이 권장량 범위 이상일수록, 체중조절 노력을 할수록, 격렬한 신체활동을 하는 경우의 골밀도가 유의하게 높았다(p<0.05). 이상의 결과 성인 남자에서는 총근육량이, 성인 여자에서는 연령과 총근육량이 가장 중요한 골밀도 관련 요인으로 남녀 모두에서 수정 가능한 가장 중요한 요인은 총근육량이었다. 따라서 골다공증의 사전 예방 및 건강증진을 위해서는 성장기부터 지속적으로 최대 근육량 및 골양을 유지할 수 있도록 조기에 적극적인 교육과 중재를 실시하여야 할 것이다.

Keywords

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