The Association between Bone Mineral Density, Bone Turnover Markers, and Nutrient Intake in Pre- and Postmenopausal Women

Jiyoun Park; Miyoun Choi; Seonheui Lee; Yoonho Choi; Yookyoung Park

doi:10.4163/kjn.2011.44.1.29

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Park, Choi, Lee, Choi, and Park: The Association between Bone Mineral Density, Bone Turnover Markers, and Nutrient Intake in Pre- and Postmenopausal Women

Research Article

Korean Journal of Nutrition

Korean Journal of Nutrition 2011; 44(1): 29-40.

Published online: 28 February 2011

DOI: https://doi.org/10.4163/kjn.2011.44.1.29

The Association between Bone Mineral Density, Bone Turnover Markers, and Nutrient Intake in Pre- and Postmenopausal Women

Jiyoun Park¹, Miyoun Choi², Seonheui Lee¹, Yoonho Choi³, Yookyoung Park^2,⁴

¹Center for Health Promotion, Samsung Medical Center, Seoul 135-710, Korea.

²Department of Medical Nutrition, Kyung Hee University, Yongin 446-701, Korea.

³Sungkyunkwan University School of Medicine, Seoul 136-720, Korea.

⁴Research Institute of Medical Nutrition, Kyunghee University, Seoul 130-701, Korea.

To whom correspondence should be addressed. (ypark@khu.ac.kr)

Received 13 September 2010 Revised 14 December 2010 Accepted 11 February 2011

Abstract

The purpose of this study was to examine the association among bone mineral density (BMD), biochemical bone markers, nutrients, and salt intake in premenopausal and postmenopausal women. We evaluated 431 subjects who visited a health promotion center of a university hospital between January 2008 and July 2009. We excluded those who were taking medications or who had an endocrine disorder affecting osteoporosis. The subjects were divided into premenopausal (n = 283) and postmenopausal (n = 143) women. We evaluated the correlation among BMD of the lumbar spine, femoral neck, and total femoral, as well as biochemical bone markers, hormone, serum profiles, general characteristics, nutrient intakes, and food intake frequencies. From a stepwise multiple regression analysis, lumbar spine BMD was positively correlated with weight (p < 0.001) and negatively correlated with osteocalcin (OC)(p < 0.001), Femoral neck BMD was positively correlated with weight (p < 0.001) and negatively correlated with C-telopeptide (CTx) and alkaline phosphatase (ALP)(p < 0.001, p < 0.05). In premenopausal women, femoral total BMD was positively correlated with BMI (p < 0.001) and negatively correlated with CTx (p < 0.001). In postmenopausal women, lumbar spine BMD was positively correlated with calcium intake (p < 0.01) and negatively correlated with sodium intake (p < 0.01). Femoral neck and femoral total BMD were both positively correlated with weight (p < 0.001), and femoral neck BMD was negatively correlated with age and ALP (p < 0.001, p < 0.05). Femoral total BMD was negatively correlated with age and OC (p < 0.001, p < 0.01). These results suggest that reducing sodium intake may play an important role delaying bone resorption and preventing a decrease in BMD.

Keywords: bone mineral density (BMD), osteocalcin (OC), C-telopeptide (CTx), premenopausal women, postmenopausal women

Figures and Tables

Table 1

Anthropometric measurements of subjects

1) Mean ± standard deviation 2) WC: waist circumference 3) SBP: Systolic Blood pressure 4) DBP: Diastolic Blood pressure 5) Significantly different between premenopausal and postmenopausal women by Student t-test (^**: p < 0.01, ^***: p < 0.001)

Table 2

Bone turnover markers and BMD of subjects

1) Mean ± standard deviation 2) OC: osteocalcin 3) s-CTx: serum C-telopeptide 4) Total ALP: total serum alkaline phosphatase 5) Significantly different between premenopausal and postmenopausal women by Student t-test (^***: p < 0.001)

Table 3

Comparison of BMD between premenopausal and postmenopausal women

1) N (%) 2) LS: Lumbar spine 3) FN: Left femoral Neck 4) FT: Left femoral total 5) χ² value: significance as determined by chi-square test ^***: p < 0.001

Table 4

Pearson correlation coefficients among bone mineral density, bone turnover markers and female hormone of subjects (n = 431)

^*: p < 0.05, ^**: p < 0.01, ^***: p < 0.001

Table 5

Serum lipid & mineral levels in pre and postmenopausal women

1) Mean ± standard deviation 2) TG: Triglyceride 3) TC: Total cholesterol 4) HDL-C: High density lipoprotein-cholesterol 5) LDL-C: Low density lipoprotein-cholesterol 6) Significantly different between premenopausal and postmenopausal women by Student t-test (^*: p < 0.05, ^**: p < 0.01, ^***: p < 0.001)

Table 6

Mean daily energy and nutrient intakes of subjects

1) Mean ± standard deviation 2) Significantly different between premenopausal and postmenopausal women by Student t-test (^*: p < 0.05, ^**: p < 0.01, ^***: p < 0.001)

Table 7

Correlation among BMD, bone turnover markers, hormone and anthropometric factors in premenopausal (n = 283) and postmenopausal women (n = 148)

1) WC: waist circumference 2) BFM: body fat mass 3) SBP: Systolic Blood pressure 4) DBP: Diastolic Blood pressure

^*: p < 0.05, ^**: p < 0.01, ^***: p < 0.001

Table 8

Stepwise multiple regression analysis of the relation of variables on spine BMD, neck BMD in pre and postmenopausal women after adjusting by age, height, weight

^*: β unstandardized coefficients, ^†: SE standard error. Regession equations, Premenopausal women

y = 0.242 + 0.054 × weight-0.080 × OC-0.330 × P (serum) + 0.000 × K (diet), Postmenopausal women: y = -32.229 + 0.056 × Height-0.052 × Age-0.037 × OC + 0.510 × Ca (serum) + 0.147 × Na (serum) + 0.147 × Fat (diet) + 0.000 × Na (diet) + 0.001 × Ca (diet)

Table 9

Stepwise multiple regression analysis of the relation of variables on Left femoral Total BMD in pre and postmenopausal women

^*: β unstandardized coefficients, ^†: SE standard error.

Regession equations, Premenopausal women: y = 3.861 + 0.252 × BMI-0.060 × Body fat mass

-1.947 × CTx-0.063×Cl (serum) + 0.000 × K (diet)

Postmenopausal women: y = -0.451-0.050 × Age + 0.032 × Weight + 0.378 × P (serum)-0.028 × OC

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