Journal List > Korean J Community Nutr > v.18(2) > 1038410

Mun, Kim, and Yang: Factors Associated with Bone Mineral Density in Korean Postmenopausal Women Aged 50 Years and Above: Using 2008-2010 Korean National Health and Nutrition Examination Survey

Abstract

The purpose of this study was to investigate factors associated with Bone Mineral Density (BMD) in Korean postmenopausal women. The data from 2008-2010 Korean National Health and Nutrition Examination Survey (KNHANES) were used for data analysis. Subjects were 2,701 postmenopausal women aged ≥ 50 years. BMDs at whole body, total femur, femoral neck, and lumbar spine were measured by Dual-energy X-ray absorptiometry (DXA). Dietary data from 24-hour dietary recall and a food frequency questionnaire containing 63 food items were used. The proportions of osteopenia at total femur, femoral neck, and lumbar spine were 37.4%, 54.5%, and 45.4%, respectively. The proportions of osteoporosis at total femur, femoral neck, and lumbar spine were 6.2%, 25.6%, and 34.3%, respectively. Age, anthropometric index including height, weight, and Body Mass Index (BMI), parathyroid hormone, and physical activity were related to BMD, but the relationships were site specific. Total femur BMD was explained by age, weight, parathyroid hormone and intakes of carbohydrate and fruits. Femoral neck BMD was related to age, weight, parathyroid hormone and intakes of riboflavin and fruits. Lumbar spine BMD was associated with age, weight, milk and dairy products, calcium intake, and exercise. These results indicated that adequate intakes of milk and dairy products, fruits, carbohydrate, calcium, riboflavin and exercise as well as weight maintenance might play an important role in maintaining optimum bone health in Korean postmenopausal women.

Figures and Tables

Fig. 1
Distribution of osteopenia and osteoporosis among study subjects.
kjcn-18-177-g001
Table 1
General characteristics of postmenopausal women by bone health status
kjcn-18-177-i001

1) P-values by one-way ANOVA for continuous variables and chi-square test for categorical variables

2) Values with different superscript letters within a row are significantly different means, based on one-way ANOVA followed by Scheffe's post hoc comparison test

Table 2
Pearson correlation coefficients between factors and bone mineral density in each site
kjcn-18-177-i002

1) Pearson correlation coefficient

Table 3
Partial correlation coefficients between nutrient intake and bone mineral density in each site
kjcn-18-177-i003

1) Adjusted for age, weight, exercise, smoking, alcohol drinking and dietary supplements

2) Adjusted for age, weight, exercise, parathyroid hormone, smoking, alcohol drinking and dietary supplements

3) Adjusted for age, weight, smoking, alcohol drinking and dietary supplements

Table 4
Partial correlation coefficients between food consumption frequency and bone mineral density in each site
kjcn-18-177-i004

1) Adjusted for age, weight, exercise, smoking, alcohol drinking and dietary supplements

2) Adjusted for age, weight, exercise, parathyroid hormone, smoking, alcohol drinking and dietary supplements

3) Adjusted for age, weight, smoking, alcohol drinking and dietary supplements

Table 5
Stepwise multiple regression analysis of several variables on bone mineral density in each site1)
kjcn-18-177-i005

1) Dependent variable was bone mineral density in each site. Independent variables were, age, weight, parathyroid hormone, exercise, intakes of energy, protein, carbohydrate, fiber, calcium, phosphorus, potassium, vitamin A, riboflavin, niacin, and MAR, and frequencies of meats and eggs, fruits, milk and dairy products, and fast foods. The entry point of the stepwise method was 0.05, and the removal point was 0.10

References

1. Basu S, Michaelsson K, Olofsson H, Johansson S, Melhus H. Association between oxidative stress and bone mineral density. Biochem Biophys Res Commun. 2001. 288(1):275–279.
2. Chae JW, Kim IH, Kwon WS, Lee KM, Jung SP, Moon Y. The relationship between body composition and bone mineral density in postmenopausal women. Yeungnam Univ J Med. 2003. 20(1):53–61.
3. Cheng XG, Yang DZ, Zhou Q, Zhuo TJ, Zhang HC, Xiang J, Wang HF, Ou PZ, Liu JL, Xu L, Huang GY, Huang QR, Barden HS, Weynand LS, Faulkner KG, Meng XW. Age-related bone mineral density, bone loss rate, prevalence of osteoporosis, and reference database of women at multiple centers in China. J Clin Densitom. 2007. 10(3):276–284.
4. Choe HJ, Lee DJ. Age-related change of spinal bone mineral density and accumulated bone loss rate in women. J Korean Soc Menopause. 2003. 9(2):171–176.
5. Chung YS. The medical treatment of osteoporosis. Korean J Med. 2010. 79(3):250–253.
6. Dalsky GP, Stocke KS, Ehsani AA, Slatopolsky E, Lee WC, Birge SJ. Weight-bearing exercise training and lumbar bone mineral content in postmenopausal women. Ann Intern Med. 1988. 108(6):824–828.
7. Dawson-Hughes B, Dalal GE, Krall EA, Sadowski L, Sahyoun N, Tannenbaum S. A controlled trial of the effect of calcium supplementation on bone density in postmenopausal women. N Engl J Med. 1990. 323(13):878–883.
8. Douchi T, Yamamoto S, Oki T. Difference in the effect of adiposity on bone density between pre and postmenopausal women. Maturitas. 2000. 34(3):261–266.
9. El Maghraoui A, Guerboub AA, Achemlal L, Mounach A, Nouijai A, Ghazi M, Bezza A, Tazi MA. Bone mineral density of the spine and femur in healthy Moroccan women. J Clin Densitom. 2006. 9(4):454–460.
10. Finkelstein JS, Lee ML, Sowers M, Ettinger B, Neer RM, Kelsey JL, Cauley JA, Huang MH, Greendale GA. Ethnic variation in bone density in premenopausal and early perimenopausal women: Effects of anthropometric and lifestyle factors. J Clin Endocrinol Metab. 2002. 87(7):3057–3067.
11. Garnero P, Delmas PD. New developments in biochemical markers for osteoporosis. Calcif Tissue Int. 1996. 59:Suppl 1. S2–S9.
12. Garnero P, Munoz F, Sornay-Rendu E, Delmas PD. Associations of vitamin D status with bone mineral density, bone turnover, bone loss and fracture risk in healthy postmenopausal women. Bone. 2007. 40(3):716–722.
13. Han IK. Hormone replacement therapy for osteoporosis. J Korean Med Assoc. 1995. 38(1):42–48.
14. Hwang YC, Ahn HY, Jeong IK, Ahn KJ, Chung HY. Optimal serum concentration of 25-hydroxyvitamin D for bone health in older Korean adults. Calcif Tissue Int. 2013. 92:68–74.
15. Kang BM, Kim MR, Yoon BK, Lee BS, Chung HW, Choi Hoon, Park HM, Kim JU. The influence of exercise on bone mineral density in Korean postmenopausal women. J Korean Soc Menopause. 2007. 13(2):131–136.
16. Kim HJ. Reserarch on relation of nutrients intake, health status, and bone mineral density in middle-aged women. J Korean Diet Assoc. 2003. 9(4):307–315.
17. Kim KR, Kim KH, Lee EK, Lee SS. A study on the factors affecting bone mineral density in adult women-based on the mothers of elementary school students. Korean J Nutr. 2000. 33(3):241–249.
18. Kim JH, Jung JC, Kim SO. Survey on the benefit coverage rate of national health insurance in 2004. 2004. Health Insurance Research Institute.
19. Kim MH, Kim JS, Kim YM. The relationship between bone mineral density and physical, obstetric characteristics in middle-aged women. J Korean Acad Adult Nurs. 2002. 14(4):532–542.
20. Lau EM, Suriwongpaisal P, Lee JK, Das De S, Festin MR, Saw SM, Khir A, Torralba T, Sham A, Sambrook P. Risk factors for hip fracture in Asian men and women-the Asian Osteoporosis Study (AOS). J Bone Miner Res. 2001. 16(3):572–580.
21. Lee HJ, Choi MJ, Lee IK. The effect of anthropometric measurement and body composition on bone mineral density of Korean women in Taegu. Korean J Nutr. 1996. 29(7):778–787.
22. Lim JS, Kim KM, Rhee Y, Lim SK. Gender-dependent skeletal effects of vitamin D deficiency in a younger generation. J Clin Endocrinol Metab. 2012. 97(6):1995–2004.
23. Maalouf G, Salem S, Sandid M, Attallah P, Eid J, Saliba N, Nehmé I, Johnell O. Bone mineral density of the Lebanese reference population. Osteoporos Int. 2000. 11(9):756–764.
24. Meyer HE, Søgaard AJ, Falch JA, Jørgensen L, Emaus N. Weight change over three decades and the risk of osteoporosis in men. Am J Epidemiol. 2008. 168(4):454–460.
25. Mikhail BI. Reduction of risk factors for osteoporosis among adolescents and young adults. Issues Compr Pediatr Nurs. 1992. 15(4):271–280.
26. Morton DJ, Barrett-Connor E, Kritz-Silverstein D, Wingard DL, Schneider DL. Bone mineral density in postmenopausal Caucasian, Filipina, and Hispanic women. Int J Epidemiol. 2003. 32(1):150–156.
27. Na HB. Factors affecting bone mineral density in Korean women by menopause. Korean J Community Nutr. 2004. 9(1):73–80.
28. Nam TH, Oh DJ, Han SS, Cha SU, Kim YW. A preliminary research on osteoporosis in women before and after menopause. J Phys Educ Sports Sci. 1997. 13:227–244.
29. National Institutes of Health. Osteoporosis prevention, diagnosis, and therapy. NIH Consens Statement. 2000. 17:1–45.
30. NOF Scientifis Statement. NOF'S updated recom-mendations for calcium and vitamin D3 intake. 2012. cited 2012 October 12. Available from http://www.nof.org/files/nof/public/co-ntent/file/218/upload/68.pdf.
31. Oh KW. Diabetes and osteoporosis. Korean Diabetes J. 2009. 33(3):169–177.
32. Okubo H, Sasaki S, Horiguchi H, Oguma E, Miyamoto K, Hosoi Y, Kim MK, Kayama F. Dietary patterns associated with bone mineral density in premenopausal Japanese farmwomen. Am J Clin Nutr. 2006. 83(5):1185–1192.
33. Park J, Choi M, Lee S, Choi Y, Park Y. The association between bone mineral density, bone turnover markers and nutrient intake in pre- and postmenopausal women. Korean J Nutr. 2011. 44(1):29–40.
34. Park YJ, Koo BS, Kang BS, Chun SH, Yoon JW. The menopausal age and climacteric symptoms and the related factors of Korean women. Korean J Women Health Nurs. 2001. 7(4):473–485.
35. Rikli RE, McManis BG. Effects of exercise on bone mineral content in postmenopausal women. Res Q Exerc Sport. 1990. 61(3):243–249.
36. Ross AC, Taylor CL, Yaktine AL, Del Valle HB, editors. Dietary reference Intakes for calcium and vitamin D. 2011. Washington D.C: The National Academies Press.
37. Sadat-Ali M, Al-Habdan IM, Al-Mulhim FA, El-Hassan AY. Bone mineral density among postmeno-pausal Saudi women. Saudi Med J. 2004. 25(11):1623–1625.
38. Shils ME, Olson JA, Shike M, Ross AC. Modern nutrition in health and disease. 1999. Nine edition. Riverwoods: Lippincott Williams and Wilkins;1353–1364.
39. Shin A, Lim S, Sung J, Myung S, Kim J. Dietary habit and bone mineral density in Korean postmenopausal women. Osteoporos Int. 2010. 21:947–955.
40. Sung CJ, Baek SK, Lee HS, Kim MH, Choi SH, Lee SY, Lee DH. A study of body anthropometry and dietary factors affecting bone mineral density in Korean pre-and postmenopausal women. J Korean Soc Food Sci Nutr. 2001. 30(1):159–167.
41. Wardlaw GM, Weese N. Putting calcium into perpective for your clients. Top Clin Nutr. 1995. 11(1):23–35.
42. Yoon EH, Noh H, Lee HM, Hwang HS, Park HK, Park YS. Bone mineral density and food-frequency in Korean adults: The 2008 and 2009 Korea national health and nutrition examination survey. Korean J Fam Med. 2012. 33:287–295.
43. You MH, Son BS, Park JA, Kim JO, Yang WH. Patterns of bone mineral density of adult women and its causal factors in Suwon Korea. Korean J Sanit. 2004. 19(3):71–80.
44. Youk JI. Female bone mineral density in an urban area and its relation with contributing factors. 2004. Graduate school of public health, Chungnam National University;26–30. Master thesis.
45. Yu CH, Lee JS, Lee LH, Kim SH, Lee SS, Kang SA. Nutritional factors related to bone mineral density in the different age group of Korean men. Korean J Nutr. 2004. 37(2):132–142.
TOOLS
Similar articles