Journal List > Korean J Women Health Nurs > v.21(1) > 1089524

Chun and Chae: Problems with Bone Health and the Influencing Factors of Bone Mineral Density in Women across the Life Cycle

Abstract

Purpose

This study was conducted to identify the problem of bone health and potential influencing factors of bone mineral density (BMD) for women across the life cycle of menopause.

Methods

Complex sampling design data analysis was performed on the fifth Korea National Health and Nutrition Examination Survey 2010 in order to identify the problems with bone health, BMD and its influencing factors in 3,499 women who answered the menopausal status. Women's life cycle was categorized by premenopausal, postmenopausal, and elderly.

Results

35.1% of premenopausal women, 73.3% of postmenopausal women, and 96.0% of elderly women had problems with bone health that were related to low BMD. Influencing factors of BMD were residential area, alcohol drinking, and body mass index (BMI) for premenopausal women; age, residential area, education, marital status, income, and BMI for postmenopausal women; and age, education, and BMI for elderly women.

Conclusion

Problems with bone health required to be considered as a major health problem in all women regardless their life cycle. Interventions to maximize BMD need to be developed by considering its influencingfactors across the women's life cycle.

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Table 1.
General and Health related Characteristics (N=3,499)
Characteristics Categories Total (n=3,499) Premenopausal women (n=1,706) Postmenopausal women (n=964) Elderly women (n=829)
n(%) n(%) n(%) n(%)
Age (year) 19~29 409 (17.6) 409 (30.4) 0 (0.0) 0 (0.0)
  30~39 669 (19.5) 659 (33.3) 10 (1.0) 0 (0.0)
  40~49 628 (21.7) 535 (31.6) 93 (13.5) 0 (0.0)
  50~59 687 (18.0) 103 (4.7) 584 (61.5) 0 (0.0)
  60~69 277 (11.3) 0 (0.0) 277 (24.1) 290 (30.9)
  70~79 422 (9.0) 0 (0.0) 0 (0.0) 422 (52.2)
  ≥80 117 (2.9) 0 (0.0) 0 (0.0) 117 (16.9)
Residential area Metropolitan area 1,485 (44.0) 796 (47.5) 385 (41.7) 304 (35.2)
  Other area 2,014 (56.0) 910 (52.5) 579 (58.3) 525 (64.8)
Education ≤Elementary school 1.121 (28.0) 58 (4.2) 419 (43.0) 644 (88.5)
  Middle school 341 (9.8) 75 (4.9) 208 (23.8) 58 (5.8)
  High school 1,071 (34.8) 775 (47.7) 248 (24.7) 48 (4.9)
  ≥University 875 (27.5) 785 (43.3) 79 (8.5) 11 (0.9)
Marital status Unmarried 411 (16.7) 400 (28.3) 11 (1.1) 0 (0.0)
  Married 2,419 (66.3) 1,232 (66.6) 800 (83.0) 387 (40.8)
  Others 669 (17.1) 74 (5.1) 153 (15.9) 442 (59.2)
Occupation No 1,789 (47.9) 763 (42.8) 461 (43.6) 565 (71.6)
  Yes 1,710 (52.1) 943 (57.2) 503 (56.4) 264 (28.4)
Income 1st quartile 859 (27.6) 410 (28.4) 247 (26.7) 200 (26.1)
  2nd quartile 852 (25.0) 408 (24.6) 245 (26.2) 199 (24.7)
  3rd quartile 875 (24.8) 430 (24.6) 237 (25.7) 208 (24.3)
  4th quartile 857 (22.6) 431 (22.4) 222 (21.3) 204 (24.9)
Alcohol No 520 (17.3) 220 (13.4) 152 (18.4) 148 (37.1)
drinking ≤1 time 1,227 (46.1) 727 (46.3) 329 (48.0) 171 (41.6)
(per month) 2~4 times 613 (24.6) 414 (27.6) 145 (21.9) 54 (13.1)
  ≥5 times 291 (12.0) 182 (12.7) 73 (11.7) 36 (8.2)
Smoking No 3,031 (86.4) 1,450 (83.6) 886 (90.3) 695 (90.5)
  Yes 380 (13.6) 243 (16.4) 71 (9.7) 66 (9.5)
Physical No 1,790 (51.8) 899 (52.0) 482 (48.6) 409 (55.8)
activity Yes 1,612 (48.2) 792 (48.0) 471 (51.4) 349 (44.2)
BMI Underweight (<18.5) 194 (6.4) 144 (9.2) 16 (1.7) 34 (3.6)
  Normal (18.5~22.9) 1,548 (46.0) 934 (54.4) 351 (35.8) 263 (32.9)
  Overweight (23~24.9) 735 (20.7) 289 (16.2) 255 (27.6) 191 (25.7)
  Obesity (≥25) 978 (26.9) 337 (20.2) 341 (34.9) 300 (37.8)
Depressive No 2,836 (82.9) 1,461 (85.3) 766 (79.0) 609 (80.6)
symptom Yes 574 (17.1) 232 (14.7) 191 (21.0) 151 (19.1)
Stress Low 2,391 (68.6) 1,153 (67.0) 698 (70.9) 540 (70.6)
  High 1,020 (31.4) 540 (33.0) 260 (29.1) 220 (29.4)
Hormone No 3,075 (92.4) 1,658 (98.0) 735 (79.3) 682 (92.5)
therapy Yes 329 (7.6) 35 (2.0) 219 (20.7) 75 (7.5)

Valid percent;

Weighted percent; BMI=Body Mass Index.

Table 2.
Bone Health and Bone Mineral Density (T-score) across the Life Cycle (N=3,499)
Variables Premenopausal women (n=1,706) Postmenopausal women (n=964) Elderly women (n=829)
% % %
Osteopenia 33.5 57.3 38.8
Osteoporosis 1.6 16.0 57.2
Normal 64.9 26.7 4.0

Weighted percent.

Table 3.
Bone Mineral Density (T-score) across the Life Cycle (N=3,499)
Variables Premenopausal women (n=1,706) Postmenopausal women (n=964) Elderly wommen (n=829)
Mean SE Mean SE Mean SE
Total femur 0.30 .03 -0.22 .04 -1.40 .05
Femoral neck -0.37 .04 -1.16 .03 -2.32 .04
Lumbar spine -0.23 .03 -1.27 .05 -2.26 .06

Estimated mean; SE=standard error.

Table 4.
Bone Mineral Density (T-score) according to Women's Characteristics (N=3,499)
Characteristics Categories Premenopausal women (n=1,706) Postmenopausal women (n=964) Elderly women (n=829)
Mean SE t or F (p) Mean SE t or F (p) Mean SE t or F (p)
Age (year) 19~29 -0.24 .07 2.11            
  30~39 -0.41 .05 (.101) -0.63 .25 22.12      
  40~49 -0.44 .06   -0.71 .09 (<.001)      
  50~59 -0.40 .10   -1.12 .05        
  60~69       -1.52 .06   -1.84 .06 52.12
  70~79             -2.38 .05 (<.001)
  ≥80             -3.02 .11  
Residential Metropolitan area -0.47 .05 7.80 -1.29 .05 11.35 -2.34 .06 0.11
area Other area -0.28 .05 (.006) -1.06 .04 (.001) -2.31 .06 (.745)
Education ≤Elementary school -0.28 .13 2.22 -1.34 .05 9.33 -2.34 .04 7.88
  Middle school -0.51 .15 (.087) -1.06 .08 (<.001) -1.88 .13 (<.001)
  High school -0.30 .05   -0.98 .06   -1.87 .11  
  ≥University -0.44 .05   -0.89 .14   -1.99 .30  
Marital Unmarried -0.26 .07 2.66 -1.62 .43 7.18 -2.17 .06 9.73
status Married -0.42 .04 (.073) -1.10 .04 (.001) -2.42 .06 (.002)
  Others -0.26 .12   -1.43 .08        
Occupation No -0.42 .05 1.79 -1.24 .05 4.65 -2.33 .05 0.14
  Yes -0.34 .04 (.182) -1.09 .05 (.033) -2.30 .07 (.705)
Income 1st quartile -0.29 .07 0.93 -1.28 .06 5.55 -2.21 .07 1.60
  2nd quartile -0.39 .06 (.429) -1.05 .06 (.001) -2.33 .08 (.192)
  3rd quartile -0.40 .06   -1.28 .06   -2.37 .08  
  4th quartile -0.42 .05   -0.99 .08   -2.42 .08  
Alcohol No -0.54 .07 5.28 -1.10 .10 1.10 -2.50 .09 3.10
drinking ≤1 time -0.39 .05 (.002) -1.13 .06 (.351) -2.15 .09 (.028)
(per month) 2~4 times -0.29 .07   -1.06 .09   -2.32 .13  
  ≥5 times -0.19 .07   -0.88 .13   -2.11 .17  
Smoking No -0.24 .07 3.96 -1.25 .12 0.81 -2.59 .16 4.28
  Yes -0.40 .04 (.048) -1.14 .04 (.370) -2.26 .04 (.040)
Physical No -0.40 .05 1.88 -1.23 .05 3.91 -2.39 .06 7.00
activity Yes -0.33 .05 (.172) -1.08 .05 (.050) -2.17 .06 (.009)
BMI Underweight (<18.5) -0.87 .09 37.10 -1.48 .24 7.96 -3.34 .17 24.06
  Normal (18.5~22.9) -0.53 .04 (<.001) -1.35 .06 (<.001) -2.59 .06 (<.001)
  Overweight (23~24.9) -0.16 .08   -1.18 .06   -2.25 .07  
  Obesity (≥25) 0.10 .06   -0.92 .06   -2.04 .07  
Depressive No -0.29 .08 1.23 -1.17 .08 0.17 -2.36 .08 0.80
symptom Yes -0.38 .04 (.269) -1.14 .03 (.682) -2.27 .05 (.372)
Stress Low -0.32 .05 1.63 -1.16 .07 0.89 -2.26 .08 0.32
  High -0.40 .04 (.203) -1.14 .04 (.766) -2.30 .04 (.573)
Hormone No -0.41 .21 0.04 -1.07 .10 1.02 -1.83 .11 18.67
therapy Yes -0.37 .04 (.843) -1.17 .04 (.314) -2.33 .04 (<.001)

Estimated mean; SE=standard error; BMI=Body Mass Index.

Table 5.
Influencing Factors of Bone Mineral Density (N=3,499)
Factors Variables Categories β SE t p
Premenopausal Residential area Metropolitan area -.16 .06 -2.79 .006
women   Other area Reference      
(n=1,706) Alcohol No -.24 .08 -2.90 .004
  drinking ≤1 time -.12 .07 -1.63 .105
  (per month) 2~4 times -.02 .08 -0.25 .806
    ≥5 times Reference      
  BMI Underweight (<18.5) -.99 .12 -8.11 <.001
    Normal (18.5~22.9) -.66 .07 -9.99 <.001
    Overweight (23~24.9) -.26 .10 -2.67 .008
    Obesity (≥25) Reference      
      R2=.125, F=19.82, p<.001  
Postmenopausal Age (year) 30~39 .75 .26 2.93 .004
women   40~49 .58 .11 5.50 <.001
(n=964)   50~59 .32 .08 4.05 <.001
    60~69 Reference      
  Residential area Metropolitan area -.20 .06 -3.21 .002
    Other area Reference      
  Education ≤Elementary school -.33 .15 -2.20 .029
    Middle school -.20 .16 -1.27 .206
    High school -.04 .14 -0.26 .793
    ≥University Reference      
  Marital status Unmarried -.43 .29 -1.47 .143
    Married .21 .09 2.30 .023
    Others Reference      
  Income 1st quartile -.19 .10 -1.96 .052
    2nd quartile -.06 .09 -0.61 .543
    3rd quartile -.24 .11 -2.22 .028
    4th quartile Reference      
  BMI Underweight (<18.5) -.71 .25 -2.82 .005
    Normal (18.5~22.9) -.50 .08 -6.48 <.001
    Overweight (23~24.9) -.28 .08 -3.60 <.001
    Obesity (≥25) Reference      
      R2=.180, F=11.48, p<.001  
Elderly women Age (year) 60~69 1.25 .18 6.79 <.001
(n=829)   70~79 .70 .15 4.68 <.001
    ≥80 Reference      
  Education ≤Elementary school -.69 .23 -3.00 .003
    Middle school -.56 .24 -2.32 .021
    High school -.29 .27 -1.09 .275
    ≥University Reference      
  BMI Underweight (<18.5) -.75 .32 -2.35 .020
    Normal (18.5~22.9) -.35 .10 -3.49 .001
    Overweight (23~24.9) -.23 .12 -1.93 .056
    Obesity (≥25) Reference      
      R2=.325, F=12.34, p<.001  

BMI=Body Mass Index.

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