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Original Articles

Low bone mineral density is associated with high-frequency hearing impairment in women over 50: an observational study in Korea
Sang-Hoon Lee, Seung-Soo Lee, Hun-Yi Park, Bom-Taeck Kim
Korean J Fam Med 2025;46(6):418-425.   Published online November 14, 2024
DOI: https://doi.org/10.4082/kjfm.23.0130
Background
Osteoporosis and hearing impairment are known to be associated, but specific data regarding gender, bone mineral density (BMD) measurement sites, and hearing frequency ranges remain unclear. This study aimed to clarify the relationship between hearing loss and BMD in adults over the age of 50. Additionally, the study sought to determine the frequency ranges of pure tone audiometry (PTA) related to osteoporosis, identify BMD measurement sites, and investigate gender differences.
Methods
A total of 1,523 adults (651 men and 872 women) over the age of 50, who participated in a medical health check-up at a university hospital, were included. PTA was conducted to assess hearing, and BMD was measured using dual-energy X-ray absorptiometry at the lumbar vertebrae (LV) and femur.
Results
In women over the age of 50, a significant association was observed between hearing impairment and osteoporosis (P<0.01), but no such association was found in men. Lumbar BMD (L1–4) in women was significantly associated with hearing loss at 4,000 and 8,000 Hz (both P<0.05), whereas femoral neck and total femur BMD showed no significant relationship. In multiple logistic regression analysis, the odds ratio (OR) between osteoporosis and hearing threshold at 4,000 Hz (OR, 2.078; 95% confidence interval [CI], 1.092–3.954) and 8,000 Hz (OR, 2.648; 95% CI, 1.543–4.544) remained statistically significant in women after adjusting for age and other risk factors.
Conclusion
In women over the age of 50, low BMD at the LV is significantly associated with hearing impairment, particularly at the high frequencies of 4,000 and 8,000 Hz.

Citations

Citations to this article as recorded by  
  • Towards early detection and prevention: proactive screening strategies in primary care
    Su Hwan Cho
    Korean Journal of Family Medicine.2025; 46(6): 379.     CrossRef
  • 3,349 View
  • 87 Download
  • 1 Web of Science
  • 1 Crossref
Association between Chronic Atrophic Gastritis and Bone Mineral Density among Women Older than 40 Years of Age in Korea
Seulki Lee, Jae Moon Yun, Jin-Ho Park, Hyuktae Kwon
Korean J Fam Med 2024;45(4):199-206.   Published online February 15, 2024
DOI: https://doi.org/10.4082/kjfm.22.0139
Background
Chronic atrophic gastritis causes hypochlorhydria, hypergastrinemia, and malabsorption of nutrients, leading to lower bone mineral density. The few studies that investigated the association between chronic atrophic gastritis and bone mineral density have reported inconsistent findings. As such, the present study assessed the association between chronic atrophic gastritis and bone mineral density among a large sample of women >40 years of age in Korea.
Methods
Data from 8,748 women >40 years of age who underwent esophagogastroduodenoscopy and bone densitometry were analyzed. Chronic atrophic gastritis was diagnosed using esophagogastroduodenoscopy. Bone mineral density of the lumbar vertebrae (L), femur neck, and femur total, measured using dual-energy X-ray absorptiometry, were the primary outcome variables. Low bone mineral density, which could be diagnosed as osteoporosis or osteopenia, was defined and analyzed as a secondary outcome. Linear regression was used to calculate adjusted mean values of bone mineral density. The association between low bone mineral density and chronic atrophic gastritis was analyzed using multiple logistic regression.
Results
The adjusted mean bone mineral density for L1–L4 was 1.063±0.003, femur neck (0.826±0.002), and femur total (0.890±0.002) were significantly lower in patients with chronic atrophic gastritis than others (1.073±0.002, 0.836±0.001, 0.898±0.002, respectively; all P<0.01). Women with chronic atrophic gastritis exhibited an increased likelihood for osteopenia or osteoporosis, even after adjusting for age and other confounding factors (odds ratio, 1.25; 95% confidence interval, 1.13–1.40; P<0.01). However, subgroup analysis revealed statistical significance only in postmenopausal women (odds ratio, 1.27; P<0.001).
Conclusion
Chronic atrophic gastritis was associated with lower bone mineral density and a higher risk for osteopenia or osteoporosis among postmenopausal women.

Citations

Citations to this article as recorded by  
  • Association between gastric polyps and decreased bone mineral density in patients with chronic gastritis
    Guotao Liu, Jianyuan Zhang
    Scientific Reports.2025;[Epub]     CrossRef
  • Clinical Utility of Trabecular Bone Score in Gastroenterology: A Narrative Review
    Ivna Olic, Piero Marin Zivkovic, Ivana Tadin Hadjina, Ivan Zaja
    Biomedicines.2025; 13(6): 1331.     CrossRef
  • The Interconnected Nature of Smoking, Depression, and Obesity in Behavioral Medicine
    Joung Sik Son
    Korean Journal of Family Medicine.2024; 45(4): 181.     CrossRef
  • 5,389 View
  • 102 Download
  • 3 Web of Science
  • 3 Crossref
The Associations between Bone Mineral Density and Oxidative Stress Biomarkers in Postmenopausal Women
Sanaz Malekian, Mojgan Mirghafourvand, Farzad Najafipour, Alireza Ostadrahimi, Nafiseh Ghassab-Abdollahi, Azizeh Farshbaf-Khalili
Korean J Fam Med 2023;44(2):95-101.   Published online March 20, 2023
DOI: https://doi.org/10.4082/kjfm.22.0022
Background
Oxidative stress plays an essential role in bone health among postmenopausal women. This study aimed to compare the oxidative stress biomarkers among postmenopausal women aged 50–65 years with normal bone mineral density, osteopenia, and osteoporosis.
Methods
In this observational study, 120 women with normal bone mineral density, 82 with osteopenia, and 86 with osteoporosis were selected based on the densitometry data obtained from the dual-energy X-ray absorptiometry method. The serum total antioxidant capacity (TAC), superoxide dismutase (SOD) activity, and malondialdehyde (MDA) levels were measured using biochemical methods. A binary logistic regression model adjusted for confounders was used to estimate the risk of osteopenia and osteoporosis. The P-value of <0.05 was considered statistically significant.
Results
There were significant differences between the three groups in age, menopausal age, body mass index, and education (P<0.05). According to the binary logistic regression model, higher SOD activity and serum TAC levels were associated with a lower risk of osteoporosis (adjusted odds ratio [aOR], 0.991; 95% confidence intervals [CI], 0.986 to 0.996; and aOR, 0.373; 95% CI, 0.141 to 0.986, respectively). MDA was a significant risk factor for osteopenia in postmenopausal women (aOR, 1.702; 95% CI, 1.125 to 2.576).
Conclusion
Higher SOD activity and serum TAC levels in the studied postmenopausal women were associated with a significantly lower risk of osteoporosis. Moreover, the risk of osteopenia increased significantly with higher serum MDA levels.

Citations

Citations to this article as recorded by  
  • Oxidative stress in bone healing: mechanisms, disease contexts, and therapeutic strategies
    Wei Fu, Dandan Pan, Yuan Liu, Zuoqiang He, Xiaojiang Hu
    European Journal of Medical Research.2026;[Epub]     CrossRef
  • Exploring the application of dietary antioxidant index for disease risk assessment: a comprehensive review
    Hossein Pourmontaseri, Sina Bazmi, Matin Sepehrinia, Ayda Mostafavi, Reza Arefnezhad, Reza Homayounfar, Farhad Vahid
    Frontiers in Nutrition.2025;[Epub]     CrossRef
  • Neurokinin Antagonists to Treat Vasomotor Symptoms—Possible Implications for Long-Term Health and Disease
    Angelo Cagnacci, Anjeza Xholli, Marta Fiamberti, Ambrogio Pietro Londero
    Journal of Clinical Medicine.2025; 14(19): 6852.     CrossRef
  • Pilot Study Assessing the Efficacy of Melatonin and Osteogenic Loading on Bone Health in a Postmenopausal Population with Osteopenia: MelaOstrong Randomized Controlled Trial
    Afsana Jahan, Yong Myoung, Afsin Malik, Michael R. Gionfriddo, Paula A. Witt‐Enderby
    Journal of Pineal Research.2025;[Epub]     CrossRef
  • Effects of Nigella sativa on bone turnover markers in postmenopausal women: a comprehensive review
    Seyedeh Fatemehzahra Mousavi zargar, Farhang Soltani Bajestani, Mohsen Sahebanmaleki, Elyas Nattagh Eshtivani, Mohammad Rashidmayvan
    Phytomedicine Plus.2025; 5(4): 100904.     CrossRef
  • Investigating the Effects of Occupational Noise and Extremely Low‐Frequency Electromagnetic Field Exposure on Oxidative Response in Power Plant Workers
    Sediqeh Jafarimanesh, Hadi Ehsani, Fatemeh Shaki, Mahmood Moosazadeh, Seyed Ehsan Samaei
    Bioelectromagnetics.2025;[Epub]     CrossRef
  • Women’s Health and Primary Care
    Seung-Won Oh
    Korean Journal of Family Medicine.2024; 45(1): 1.     CrossRef
  • Effects of cosmos caudatus (Kenikir) antioxidant properties on bone metabolism marker in rat
    Gadis Meinar Sari, Idha Kusumawati, Yoga Akbar Arifandi, Julian Benedict Swannjo
    Current Research in Physiology.2024; 7: 100128.     CrossRef
  • Exogenous and endogenous antioxidants in osteoporosis risk: causal associations unveiled by Mendelian Randomization analysis
    Yuancheng Li, Huaqian Qi, Xin Huang, Gang Lu, Huashan Pan
    Frontiers in Physiology.2024;[Epub]     CrossRef
  • Proteomic Biomarkers Associated with Low Bone Mineral Density: A Systematic Review
    Adriana Becerra-Cervera, Anna D. Argoty-Pantoja, Diana I. Aparicio-Bautista, Priscilla López-Montoya, Berenice Rivera-Paredez, Alberto Hidalgo-Bravo, Rafael Velázquez-Cruz
    International Journal of Molecular Sciences.2024; 25(14): 7526.     CrossRef
  • 6,490 View
  • 109 Download
  • 10 Web of Science
  • 10 Crossref
The Relationship between Dietary Na/K Ratio and Bone Mineral Density in Korean Middle-Aged Women
Seong Su Choi, Yun-A Kim, Hyun Ji Kim, Yoon Jeong Cho, Geon Ho Lee
Korean J Fam Med 2023;44(1):21-27.   Published online January 19, 2023
DOI: https://doi.org/10.4082/kjfm.21.0208
Background
Dietary Na+ or Na+/K+ ratio has been reported to be associated with bone mineral density (BMD). However, this remains unclear, and only a few studies have been reported on the Korean population. Therefore, this study aimed to determine the association between dietary Na+, K+, and Na+/K+ ratios and BMD in middle-aged Korean women.
Methods
This study used data from the Korea National Health and Nutrition Examination Survey 2008–2011. A total of 3,690 women aged >50 years were included. Study participants were classified into quartiles (lowest quartile Q1–highest quartile Q4) according to dietary Na+, K+, and Na+/K+ ratio, and we examined the association of these parameters with BMD. Total femur and lumbar spine BMD were measured using dual-energy X-ray absorptiometry. Multiple linear regression analyses were performed using IBM SPSS ver. 19.0.
Results
The mean age was 62 years, and a significant negative trend in the β-coefficient regarding dietary Na+ was only observed in the total femur BMD. However, the total femur and lumbar spine BMD decreased from Q1 to Q4 regarding the dietary Na+/K+ ratio (P-value for trend: 0.044 for total femur BMD and 0.002 for lumbar spine BMD).
Conclusion
A significant negative trend in the β-coefficient for both total femur and lumbar spine BMD was observed regarding the Na+/K+ ratio. Therefore, based on the results of this study, a higher dietary Na+/K+ ratio may be associated with a lower BMD.

Citations

Citations to this article as recorded by  
  • Mechanical and biological properties of sodium, potassium, and carbonate-containing strontium Hydroxyfluorapatite bioceramics
    Jihen Ben Slimen, Luís Javier Del Valle, Samira Jebahi, Mustapha Hidouri
    Chemical Physics Impact.2026; 12: 101050.     CrossRef
  • Bioactive Compounds and Health Functions of Plums: Current Status and Future Opportunities
    Ming-Qiang Xu, Samuel Ariyo Okaiyeto, Xiao-Xiao Niu, Qing-Hui Wang, Sriram K. Vidyarthi, Haiou Wang, Li-Zhen Deng, Parag Prakash Sutar, Hong-Wei Xiao
    Food Reviews International.2025; 41(5): 1360.     CrossRef
  • Does Changing the Ratio of Dietary Sodium-to-Potassium Intake Affect Bone Mineral Density?
    Soo Young Kim
    Korean Journal of Family Medicine.2023; 44(1): 1.     CrossRef
  • 6,298 View
  • 112 Download
  • 4 Web of Science
  • 3 Crossref
Background
Milk consumption is associated with bone mineral density (BMD), but reports are limited in terms of participant age, sex, and number of study subjects. We investigated the association between milk consumption and BMD in South Korean adults (≥20 years).
Methods
We analyzed men and women aged ≥20 years who participated in the Korean National Health and Nutrition Examination Survey, 2008–2011. We used linear regression to calculate the mean BMD and 95% confidence interval (CI) based on the frequency of milk consumption. Multivariate logistic regression analysis was used to estimate the odds ratios (ORs) and 95% CI for T-scores ≤-2.5 (osteoporosis) in both men aged ≥50 years and postmenopausal women.
Results
In total 8,539 subjects were studied. Drinking milk more than once a day was associated with higher BMD in the total femur and femoral neck in men aged <50 years and lumbar spine in men aged ≥50 years, compared to less than once a week. It was also associated with lower ORs for osteoporosis of the femoral neck and lumbar spine in men aged ≥50 years (OR, 0.35; 95% CI, 0.125–0.979 and OR, 0.34; 95% CI, 0.143–0.804, respectively). In postmenopausal women who consumed milk 2–6 times weekly, higher BMD and lower OR for osteoporosis were observed in the total femur (OR, 0.23; 95% CI, 0.055–0.958).
Conclusion
This study suggests that frequent milk consumption could potentially reduce osteoporosis incidence in South Korean adults. Further prospective study is necessary to elucidate the effect of milk consumption on BMD.

Citations

Citations to this article as recorded by  
  • Dietary riboflavin (vitamin B2) intake and osteoporosis in U.S. female adults: unveiling of association and exploration of potential molecular mechanisms
    QianKun Yang, Li Zhang, Dong Sun, Shen Jie, XiaoLiang Tao, Qing Meng, Fei Luo
    Nutrition Journal.2025;[Epub]     CrossRef
  • Is it advisable for Asians to drink milk, especially those at risk of osteoporosis?
    Hao-tian Jiao, Yu-Shan Yue, Shuai Yuan, Xiao-jie Zhou, Chong Li
    Frontiers in Nutrition.2025;[Epub]     CrossRef
  • Graphene-based biosensors in milk analysis: A review of recent developments
    Sule Bayrak, Hazal Gergeroglu
    Food Chemistry.2024; 440: 138257.     CrossRef
  • New insights into dairy management and the prevention and treatment of osteoporosis: The shift from single nutrient to dairy matrix effects—A review
    Kaili Wang, Xu Zhao, Sijia Yang, Xiaoxi Qi, Aili Li, Wei Yu
    Comprehensive Reviews in Food Science and Food Safety.2024;[Epub]     CrossRef
  • Does Changing the Ratio of Dietary Sodium-to-Potassium Intake Affect Bone Mineral Density?
    Soo Young Kim
    Korean Journal of Family Medicine.2023; 44(1): 1.     CrossRef
  • Evaluation of the Association between Amount and Type of Milk Consumption and Periodontitis: Data from the Korea National Health and Nutrition Examination Survey (2016–2018)
    Eun Jeong Min, Siseong Jeong, Jun-Beom Park
    Nutrients.2023; 15(4): 914.     CrossRef
  • 7,340 View
  • 133 Download
  • 6 Web of Science
  • 6 Crossref

Case Report

Synchronous Occurrence of Bilateral Malignant Otitis Externa: Report of a Rare Case
Nur Adillah Lamry, Khairunnisak Misron, Tengku Mohamed Izam Tengku Kamalden, Azliana Aziz, Rosdan Salim
Korean J Fam Med 2021;42(6):483-486.   Published online May 27, 2020
DOI: https://doi.org/10.4082/kjfm.20.0071
Malignant otitis externa (MOE) is a rare and potentially life-threatening disease of the ear and temporal bone. Bilateral simultaneous MOE is extremely rare. Due to bilaterally symmetrical facial nerve palsy, it can easily be missed at the initial presentation, causing delay in management. Here, we report a case of bilateral MOE managed aggressively with regular ear toileting, ear packing with a ribbon gauze soaked with topical antimicrobials, and long-term intravenous and oral antibiotics. The patient showed good improvement in pain control, facial nerve status, and ear findings.

Citations

Citations to this article as recorded by  
  • External Auditory Canal Erosion at the 6 O’clock Spot
    Mounika Naidu Boya, Nicole Blumenstein, Miriam Redleaf
    Otology & Neurotology.2024; 45(8): e581.     CrossRef
  • Imaging of Pathologies of the Temporal Bone and Middle Ear: Inflammatory Diseases, Their Mimics and Potential Complications—Pictorial Review
    Christopher Kloth, Annika Beck, Nico Sollmann, Meinrad Beer, Marius Horger, Wolfgang Maximilian Thaiss
    Tomography.2023; 9(6): 2190.     CrossRef
  • 9,655 View
  • 84 Download
  • 2 Web of Science
  • 2 Crossref

Original Article

Association between Bone Mineral Density and Serum Iron Indices in Premenopausal Women in South Korea
Sung-Min Kim, A-Sol Kim, Hae-Jin Ko, Hana Moon, Hye-In Choi, Jieun Song
Korean J Fam Med 2020;41(3):175-182.   Published online May 20, 2020
DOI: https://doi.org/10.4082/kjfm.18.0142
Background
Osteoporosis is characterized by a decrease in bone mineral density (BMD) and increased risk of fragility fractures. Serum iron level may interact with bone health status. This study investigated the correlations of BMD with serum iron level, hemoglobin level, and total iron-binding capacity (TIBC).
Methods
We performed a retrospective analysis of data from the medical records of premenopausal women in South Korea. The women’s BMDs and the Z scores of the BMDs were verified using dual-energy X-ray absorption. The participants were stratified into quartiles for analyses of the associations of BMD with serum iron level, TIBC, and hemoglobin level.
Results
A simple linear regression analysis revealed associations of changes in BMD with iron level (β=-0.001, standard error [SE]=0.001, P<0.001), hemoglobin level (β=0.015, SE=0.003, P<0.001), and TIBC (β=0.001, SE=0.001, P<0.001). This pattern was also observed in a multiple linear regression analysis. A multivariate logistic regression analysis of iron level and TIBC for low BMD revealed odds ratios of 1.005 (P<0.001) and 0.995 (P<0.001), respectively.
Conclusion
This study demonstrated clear relationships of changes in BMD with serum iron level and TIBC, and thus confirms the usefulness of these markers in the clinical evaluation of iron storage and BMD in younger women.

Citations

Citations to this article as recorded by  
  • Development of novel hybrid nanomaterials with potential application in bone/dental tissue engineering: design, fabrication and characterization enriched-SAPO-34/CS/PANI scaffold
    Golnaz Navidi, Saeideh Same, Maryam Allahvirdinesbat, Parvaneh Nakhostin Panahi, Kazem Dindar Safa
    Journal of Biomaterials Science, Polymer Edition.2024; 35(13): 2090.     CrossRef
  • Effects of bone metabolism on hematopoiesis: A Mendelian randomization study
    Shun-Cheong Ho, Gloria Hoi-Yee Li, Anskar Yu-Hung Leung, Kathryn Choon-Beng Tan, Ching-Lung Cheung
    Osteoporosis and Sarcopenia.2024; 10(4): 151.     CrossRef
  • Does Changing the Ratio of Dietary Sodium-to-Potassium Intake Affect Bone Mineral Density?
    Soo Young Kim
    Korean Journal of Family Medicine.2023; 44(1): 1.     CrossRef
  • Associations of blood trace elements with bone mineral density: a population-based study in US adults
    Chunli Wu, Yao Xiao, Yuexia Jiang
    Journal of Orthopaedic Surgery and Research.2023;[Epub]     CrossRef
  • Effects of Rapid Weight Loss following Iron Supplementation on Bone Mineral Density and Serum Osteocalcin Levels in University Wrestlers
    Junghoon Lee, Junyung Sung, Taewoong Oh
    IJASS(International Journal of Applied Sports Sciences).2022; : 72.     CrossRef
  • Bone Mineral Density and Hemoglobin Levels: Opposite Associations in Younger and Older Women
    Tzyy-Ling Chuang, Malcolm Koo, Mei-Hua Chuang, Yuh-Feng Wang
    International Journal of Environmental Research and Public Health.2021; 18(10): 5495.     CrossRef
  • 7,000 View
  • 117 Download
  • 5 Web of Science
  • 6 Crossref

Case Report

Craniofacial Polyostotic Fibrous Dysplasia Initially Diagnosed in a Primary Care Unit
Antonio Miguel Cruz-Ferreira
Korean J Fam Med 2019;40(1):58-60.   Published online July 6, 2018
DOI: https://doi.org/10.4082/kjfm.17.0129
Fibrous dysplasia (FD) is a non-malignant bone tumor that typically behaves as a slow and indolent growing mass lesion. We report the case of a female patient presenting with headache and facial deformity and later diagnosed with polyostotic fibrous dysplasia (PFD). A 29-year-old woman visited Mealhada Primary Health Care Unit complaining of headache, nasal congestion, and hyposmia for several weeks. She also presented with facial deformity and painful swelling of the upper left orbit. X-ray imaging revealed a suspicious opacity in the left frontal sinus and a right shift of the nasal septum. Computed tomography and bone scintigraphy later confirmed a tumor involving the ethmoid and frontal bone. The patient was referred to the neurosurgery and otorhinolaryngology departments of a central hospital and the suspected diagnosis of PFD was confirmed. A watchful waiting approach with regular imaging screenings was proposed and accepted by the patient, who is now free of symptoms and more acceptant of the benign condition of her tumor. With this case, we aim to make family physicians more aware of this rare but relevant condition that can be difficult to diagnose. FD is a rare but benign tumor that occurs mainly in adolescents and young adults. Symptoms depend on the location and type of the tumor and include facial deformity, vision changes, nasal congestion, and headache. No clear guidelines exist for its treatment, and options include monitoring the progression of the tumor, in addition to medical or surgical approaches.

Citations

Citations to this article as recorded by  
  • Prolonged history of symptoms due to isolated fibrous dysplasia of the ethmoid sinus relieved by functional endoscopic sinus surgery: A case report
    Raghad Y. Albassami, Sultan K. Kadasah, Abdullah Musleh, Naif Abdulaziz M. Alqarni
    Acta Oto-Laryngologica Case Reports.2025; 10(1): 102.     CrossRef
  • Fibrous dysplasia
    Ivan Raška
    Clinical Osteology.2021; 26(3): 143.     CrossRef
  • 7,874 View
  • 93 Download
  • 1 Web of Science
  • 2 Crossref

Original Articles

The Association between Fat Mass, Lean Mass and Bone Mineral Density in Premenopausal Women in Korea: A Cross-Sectional Study
Jeehyun Kim, Hyuktae Kwon, Bo-Kyoung Heo, Hee-Kyung Joh, Cheol Min Lee, Seung-Sik Hwang, Danbee Park, Jae-Hong Park
Korean J Fam Med 2018;39(2):74-84.   Published online March 22, 2018
DOI: https://doi.org/10.4082/kjfm.2018.39.2.74
Background

We investigated the association between body composition, especially truncal or non-truncal fat mass (FM), and bone mineral density (BMD) in premenopausal women in Korea.

Methods

A cross-sectional study was performed using data from the Korea National Health and Nutrition Examination Survey IV and V (2008–2011). Total lean mass (LM), total FM (TFM), truncal FM, and non-truncal FM, and BMD of the total femur, femoral neck (FN), and lumbar spine were measured using dual-energy X-ray absorptiometry. The association between body composition and BMD was analyzed using multiple linear regression. The risk of low BMD according to quartiles of TFM, truncal FM, and non-truncal FM was calculated using logistic regression. Subgroup analysis according to body mass index was also performed.

Results

In 4,343 premenopausal women, total LM was positively associated with BMD regardless of weight adjustment. TFM, truncal FM, and non-truncal FM were inversely associated with BMD after adjusting for weight. Odds ratios (ORs) for low BMD and 95% confidence intervals (CIs) of the highest quartile of TFM, truncal FM, and non-truncal FM compared with the lowest quartile were calculated. The risk of low BMD of the FN was higher in the highest quartile of TFM (OR, 4.48; 95% CI, 1.11–18.01) and truncal FM (OR, 5.48; 95% CI, 1.75–17.20). Truncal FM and not-truncal FM had an inverse association with BMD in the non-obese and obese subgroups of women.

Conclusion

Total LM has a protective effect on BMD and FM can have a detrimental effect on BMD besides its skeletal loading effect.

Citations

Citations to this article as recorded by  
  • Gender as a moderator of the relationships among body composition, physical activity, basal metabolic rate, and BMI in Taiwanese university students
    Hsiang-Ping Wu, Hsiang-Yun Lan, Yu-Lun Tsai, Yu-Ting Chen, Huai-Shuo Huang, Jen-Jiuan Liaw, Yue-Cune Chang
    BMC Public Health.2026;[Epub]     CrossRef
  • Association between normal-weight obesity and bone mineral density in older Korean adults: A population-based cross-sectional study
    Jeonghyeon Kim, Seamon Kang, Hyunsik Kang
    Maturitas.2024; 180: 107891.     CrossRef
  • Sex and Obesity-Specific Associations of Ultrasound-Assessed Radial Velocity of Sound with Body Composition
    Simona Sulis, Darina Falbová, Radoslav Beňuš, Petra Švábová, Alexandra Hozáková, Lenka Vorobeľová
    Applied Sciences.2024; 14(16): 7319.     CrossRef
  • Clinical Characteristic of Patients Underwent Bone Mineral Density Examination in Prof. Dr. R. Soeharso Orthopaedic Hospital in 2022-2023: A Cross-Sectional Study
    R. Andhi Prijosedjati, Pamudji Utomo, Leli Sabariyah, Ahmad Fauzi
    (JOINTS) Journal Orthopaedi and Traumatology Surabaya.2024; 13(1): 1.     CrossRef
  • Influence of Muscle Mass and Strength on Bone Mineralisation with Consideration of Sclerostin Concentration
    Martyna Patalong-Wójcik, Anna Golara, Katarzyna Zając, Alicja Sokołowska, Mateusz Kozłowski, Aleksandra Tołoczko-Grabarek, Mariola Krzyścin, Agnieszka Brodowska, Agnieszka Janiec, Aleksandra Myszka, Aneta Cymbaluk-Płoska, Elżbieta Sowińska-Przepiera
    Biomedicines.2023; 11(6): 1574.     CrossRef
  • Associations of body mass index, body fat percentage and sarcopenia components with bone health estimated by second-generation high-resolution peripheral quantitative computed tomography in older adults with obesity
    Anoohya Gandham, Jakub Mesinovic, Mavil May Cervo, Costas Glavas, Paul Jansons, Carrie-Anne Ng, Juan Pena Rodriguez, Ayse Zengin, Maxine P. Bonham, Peter R. Ebeling, David Scott
    Experimental Gerontology.2023; 179: 112227.     CrossRef
  • Elevated circulating levels of IL-34 are strongly associated with osteoporosis
    Nader Tarabeih, Adel Shalata, Alexander Kalinkovich, Orabi Higla, Gregory Livshits
    Archives of Osteoporosis.2023;[Epub]     CrossRef
  • The role of FSH in body composition in hematopoietic cell transplant recipients
    Erica J. Roelofs, Donald R. Dengel, Qi Wang, James S. Hodges, Julia Steinberger, Scott Baker
    Pediatric Transplantation.2022;[Epub]     CrossRef
  • Association between body mass index, bone bending strength, and BMD in young sedentary women
    A. Auslander, M. T. C. Liang, J. Gavin, E. Jo, J. Rocha-Rangel, J.-H. Lin, Y.-L. Kwoh, S. B. Arnaud
    Osteoporosis International.2022; 33(3): 673.     CrossRef
  • Association of androgen excess and bone mineral density in women with classical congenital adrenal hyperplasia with 21-hydroxylase deficiency
    Dong Ho Lee, Sung Hye Kong, Han Na Jang, Chang Ho Ahn, Seung Gyun Lim, Young Ah Lee, Sang Wan Kim, Jung Hee Kim
    Archives of Osteoporosis.2022;[Epub]     CrossRef
  • The Relationship Between Bone Mineral Density and Body Composition Among Qatari Women With High Rate of Obesity: Qatar Biobank Data
    Abdelhamid Kerkadi, Shalima Lathief, Yasmen Khial, Toka Teleb, Grace Attieh, Md Mizanur Rahman, Zumin Shi, Abdelali Agouni
    Frontiers in Nutrition.2022;[Epub]     CrossRef
  • Associations between body mass index, body composition and bone density in young adults: Findings from Saudi cohort
    Abdulrahman Tajaldeen, Salem Saeed Alghamdi, Rowa Aljondi, Zuhier Awan, Nawal Helmi, Kareem Lingawi, Alaa Mujalad, Wala Alzahrani
    Journal of Radiation Research and Applied Sciences.2022; 15(1): 268.     CrossRef
  • Association of Short-Term Changes in Menstrual Frequency, Medication Use, Weight and Exercise on Bone Mineral Density in College-Aged Women
    Stacie H. Fleischer, Annalisa K. Freire, Katie Brown, Andrew Creer, Dennis L. Eggett, Susan Fullmer
    International Journal of Environmental Research and Public Health.2022; 19(16): 10363.     CrossRef
  • Analysing body composition as compositional data: An exploration of the relationship between body composition, body mass and bone strength
    D Dumuid, JA Martín-Fernández, S Ellul, RS Kenett, M Wake, P Simm, L Baur, T Olds
    Statistical Methods in Medical Research.2021; 30(1): 331.     CrossRef
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    Jihan Kim, Sami Lee, Sung Soo Kim, Jong-Pyo Lee, Jong Sung Kim, Jin Gyu Jung, Seok Jun Yoon, Kyu Pil Kim, Chan-Keol Park, Yong-Hwan Kim
    BMC Women's Health.2021;[Epub]     CrossRef
  • Determinants of Bone Health Status in a Multi-Ethnic Population in Klang Valley, Malaysia
    Chin Yi Chan, Shaanthana Subramaniam, Norazlina Mohamed, Soelaiman Ima-Nirwana, Norliza Muhammad, Ahmad Fairus, Pei Yuen Ng, Nor Aini Jamil, Noorazah Abd Aziz, Kok-Yong Chin
    International Journal of Environmental Research and Public Health.2020; 17(2): 384.     CrossRef
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    Fanjie Li, Yibin Du
    Journal of Orthopaedics.2020; 22: 53.     CrossRef
  • Bone Mineral Density of Femur and Lumbar and the Relation between Fat Mass and Lean Mass of Adolescents: Based on Korea National Health and Nutrition Examination Survey (KNHNES) from 2008 to 2011
    Aram Kim, Seunghui Baek, Seyeon Park, Jieun Shin
    International Journal of Environmental Research and Public Health.2020; 17(12): 4471.     CrossRef
  • The Association between High Body Mass Index and Early Clinical Outcomes in Patients with Proximal Femur Fractures
    Michael Müller, Alexander Gutwerk, Frederik Greve, Lisa Völker, Michael Zyskowski, Chlodwig Kirchhoff, Peter Biberthaler, Dominik Pförringer, Karl Braun
    Journal of Clinical Medicine.2020; 9(7): 2076.     CrossRef
  • Bone Health and its Relation to Energy Intake, Fat Mass and its Distribution
    Nayera E. Hassan, Sahar A. El-Masr, Rokia A. El Bann, Muhammad Al-Tohamy, Dalia El-Lebedy, Dalia Adel Abdel, Darin Amin, Safinaz Megahed, Aya Khalil
    Pakistan Journal of Biological Sciences.2020; 23(8): 1075.     CrossRef
  • Anti-fracture Efficacy of Monthly Risedronate Compared with That of Weekly Risedronate in Postmenopausal Korean Women with Osteoporosis: A Nationwide Cohort Study
    Yong Ho Cho, Kyung Hyun Bae, Dong Ryul Lee, Jungun Lee
    Korean Journal of Family Medicine.2020; 41(5): 339.     CrossRef
  • Lean mass and peak bone mineral density
    Huy G. Nguyen, Minh TD. Pham, Lan T. Ho-Pham, Tuan V. Nguyen
    Osteoporosis and Sarcopenia.2020; 6(4): 212.     CrossRef
  • Associations between body mass index, body composition and bone density in young adults: findings from a southern Brazilian cohort
    Isabel Oliveira Bierhals, Juliana dos Santos Vaz, Renata Moraes Bielemann, Christian Loret de Mola, Fernando Celso Barros, Helen Gonçalves, Fernando César Wehrmeister, Maria Cecília Formoso Assunção
    BMC Musculoskeletal Disorders.2019;[Epub]     CrossRef
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Relationship between Blood Mercury Concentration and Bone Mineral Density in Korean Men in the 2008–2010 Korean National Health and Nutrition Examination Survey
Yang Hee Kim, Jae Yong Shim, Min Seok Seo, Hyung Ji Yim, Mi Ra Cho
Korean J Fam Med 2016;37(5):273-278.   Published online September 21, 2016
DOI: https://doi.org/10.4082/kjfm.2016.37.5.273
Background

The results of previous studies on the association between blood mercury (Hg) and bone mineral density (BMD) are inconsistent. We therefore used a large-scale nationwide representative sample of Korean men to investigate the relationship between these two parameters.

Methods

A nationwide cross-sectional study was conducted using data from the 2008 to 2010 Korean National Health and Nutrition Examination Survey to evaluate the relationship between blood Hg and BMD and the prevalence of osteopenia or osteoporosis in 1,190 men over 50 years of age. BMD was measured by dual-energy X-ray absorptiometry. Osteopenia and osteoporosis were diagnosed for each body site according to World Health Organization T-score criteria.

Results

After adjusting for age, body mass index, caloric energy and calcium intake, vitamin D levels, fish consumption, alcohol consumption, smoking, and exercise, quartiles of blood Hg were positively associated with femur neck T-scores in multiple linear regression analysis (β=0.06, P-value=0.03). Compared with the lowest blood Hg quartile, the odds ratios and 95% confidence intervals for diagnosis of osteopenia or osteoporosis in the second and fourth quartiles were 0.63 (0.41–0.99) and 0.57 (0.36–0.91), respectively, in the femur neck after adjusting for the same co-variables.

Conclusion

High blood Hg levels were associated with reduced odds of decreased femur neck BMD in Korean men. However, subgroup analysis did not show a significant protective effect of blood Hg on osteoporotic fractures. Further research is necessary to clarify the association between blood Hg and BMD.

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  • Associations between multiple metals exposure and bone mineral density: a population-based study in U.S. children and adolescents
    Jian Han, Jiaqing Sun, Lin Yuan, Luyao Lou, Xiaofeng Jiang
    BMC Musculoskeletal Disorders.2025;[Epub]     CrossRef
  • Metallic Contaminants and Osteoporosis: a Review of the Gut-Bone Axis
    Yongjie Yang, Shuqi Yuan, Tianbao Gong, Jiaxiang Zhang, Haitao Ma, Defu Yu, Tao Chen
    Biological Trace Element Research.2025; 204(5): 3522.     CrossRef
  • Metals accumulation affects bone and muscle in osteoporotic patients: A pilot study
    Beatrice Battistini, Chiara Greggi, Virginia Veronica Visconti, Marco Albanese, Alessandra Messina, Patrizia De Filippis, Beatrice Gasperini, Angela Falvino, Prisco Piscitelli, Leonardo Palombi, Umberto Tarantino
    Environmental Research.2024; 250: 118514.     CrossRef
  • Trends in the prevalence of osteoporosis and effects of heavy metal exposure using interpretable machine learning
    Hewei Xiao, Xueyan Liang, Huijuan Li, Xiaoyu Chen, Yan Li
    Ecotoxicology and Environmental Safety.2024; 286: 117238.     CrossRef
  • Association of blood mercury levels with bone mineral density in adolescents aged 12–19
    Ke Xu, Bingqian Gao, Tingfeng Liu, Jiayi Li, Yixin Xiang, Yicheng Fu, Mingyi Zhao
    Environmental Science and Pollution Research.2023; 30(16): 46933.     CrossRef
  • Relationship of blood heavy metals and osteoporosis among the middle-aged and elderly adults: A secondary analysis from NHANES 2013 to 2014 and 2017 to 2018
    Zengfa Huang, Xiang Wang, Hui Wang, Shutong Zhang, Xinyu Du, Hui Wei
    Frontiers in Public Health.2023;[Epub]     CrossRef
  • Associations of blood trace elements with bone mineral density: a population-based study in US adults
    Chunli Wu, Yao Xiao, Yuexia Jiang
    Journal of Orthopaedic Surgery and Research.2023;[Epub]     CrossRef
  • Normal concentration range of blood mercury and bone mineral density: a cross-sectional study of National Health and Nutrition Examination Survey (NHANES) 2005–2010
    Yuchen Tang, Qiong Yi, Shenghong Wang, Yayi Xia, Bin Geng
    Environmental Science and Pollution Research.2022; 29(5): 7743.     CrossRef
  • Associations of multiple metals with bone mineral density: A population-based study in US adults
    Mu-hong Wei, Yuan Cui, Hao-long Zhou, Wen-jing Song, Dong-sheng Di, Ru-yi Zhang, Qin Huang, Jun-an Liu, Qi Wang
    Chemosphere.2021; 282: 131150.     CrossRef
  • Occurrence of mercury in the knee joint tissues
    Magdalena Babuśka-Roczniak, Barbara Brodziak-Dopierała, Joanna Bem, Anna Kruczek, Elżbieta Cipora, Wojciech Roczniak
    Polish Annals of Medicine.2021;[Epub]     CrossRef
  • Exposure to heavy metals and the risk of osteopenia or osteoporosis: a systematic review and meta-analysis
    C. Jalili, M. Kazemi, E. Taheri, H. Mohammadi, B. Boozari, A. Hadi, S. Moradi
    Osteoporosis International.2020; 31(9): 1671.     CrossRef
  • Relationship between heavy metal accumulation and histological alterations in voles from alpine and forest habitats of the West Carpathians
    Zuzana Kompišová Ballová, Filip Korec, Katarína Pinterová
    Environmental Science and Pollution Research.2020; 27(29): 36411.     CrossRef
  • Long-Term Accumulation of Metals in the Skeleton as Related to Osteoporotic Derangements
    Geir Bjørklund, Lyudmila Pivina, Maryam Dadar, Yuliya Semenova, Salvatore Chirumbolo, Jan Aaseth
    Current Medicinal Chemistry.2020; 27(40): 6837.     CrossRef
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  • 13 Web of Science
  • 13 Crossref
Background

An association between arterial stiffness and osteoporosis has previously been reported. Therefore, we investigated the relationship between arterial stiffness, measured by brachial-ankle pulse wave velocity, and bone mineral density in a sample of healthy women undergoing routine medical checkup.

Methods

We retrospectively reviewed the medical charts of 135 women who had visited the Health Promotion Center (between May 2009 and December 2012). Brachial-ankle pulse wave velocity was measured using an automatic wave analyzer. Bone mineral density of the lumbar spine (L1-L4) and femur was measured by dual-energy X-ray absorptiometry. Metabolic syndrome was defined according to National Cholesterol Education Program-Adult Treatment Panel III criteria, using body mass index >25 kg/m2 instead of waist circumference >88.9 cm.

Results

Pearson's correlation analysis revealed significant inverse relationships between pulse wave velocity and bone mineral density of the lumbar spine (r=-0.335, P<0.001), femur neck (r=-0.335, P<0.001), and total femur (r=-0.181, P=0.04). Pulse wave velocity showed the strongest association with age (r=0.586, P<0.001). Multiple regression analysis identified an independent relationship between pulse wave velocity and lumbar spine bone mineral density in women after adjusting for age, metabolic syndrome, body mass index, smoking status, alcohol intake, and exercise (r=-0.229, P=0.01).

Conclusion

This study confirmed an association between arterial stiffness and bone mineral density in women.

Citations

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  • A univariate and multivariate Mendelian randomization study of the causal association of arterial stiffness with bone mineral density and osteoporosis
    Bowen Hong, Shaoshuo Li, Yi Zhou, Jiapeng Ye, Mao Wu, Yang Shao, Jianwei Wang
    Psycho-Oncologie.2025; 19(1s): 4561.     CrossRef
  • Arterial stiffness and risk of new-onset fragility fracture in Chinese men and women: The Kailuan cohort study
    Lu Guo, Nan Zhang, Yimeng Zhang, Lei Xing, Wenqi Xu, Wenjuan Li, Lisha Zhang, Xiaoli Hou, Shuohua Chen, Shouling Wu, Faming Tian
    Bone.2024; 180: 116991.     CrossRef
  • Relationship Between the Lipid Accumulation Product Index and Arterial Stiffness in the Chinese Population With Hypertension: A Report From the China H-Type Hypertension Registry Study
    Yumeng Shi, Lihua Hu, Minghui Li, Wei Zhou, Tao Wang, Lingjuan Zhu, Huihui Bao, Ping Li, Xiaoshu Cheng
    Frontiers in Cardiovascular Medicine.2022;[Epub]     CrossRef
  • Brachial-ankle pulse wave velocity is associated with the risk of osteoporosis: a cross-sectional evidence from a Chinese community-based cohort
    Kun Tang, Qiao Zhang, Nianchun Peng, Ying Hu, Shujing Xu, Miao Zhang, Rui Wang, Lixin Shi
    Journal of Orthopaedic Surgery and Research.2021;[Epub]     CrossRef
  • Poor Bone Quality is Associated With Greater Arterial Stiffness: Insights From the UK Biobank
    Zahra Raisi-Estabragh, Luca Biasiolli, Jackie Cooper, Nay Aung, Kenneth Fung, José M Paiva, Mihir M Sanghvi, Ross J Thomson, Elizabeth Curtis, Julien Paccou, Jennifer J Rayner, Konrad Werys, Henrike Puchta, Katharine E Thomas, Aaron M Lee, Stefan K Piechn
    Journal of Bone and Mineral Research.2020; 36(1): 90.     CrossRef
  • Osteoporosis is inversely associated with arterial stiffness in the elderly: An investigation using the Osteoporosis Self‐assessment Tool for Asians index in an elderly Chinese cohort
    Yan Xuan, Weiliang Wang, Hong Zhang, Isabella Tan, Mark Butlin, Alberto Avolio, Junli Zuo
    The Journal of Clinical Hypertension.2019; 21(3): 405.     CrossRef
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Helicobacter pylori: A Possible Risk Factor for Bone Health
Yun Hee Chung, Jong Seop Gwak, Sung Woo Hong, Jung Hyeon Hyeon, Cheol Min Lee, Seung Won Oh, Hyuktae Kwon
Korean J Fam Med 2015;36(5):239-244.   Published online September 18, 2015
DOI: https://doi.org/10.4082/kjfm.2015.36.5.239
Background

Helicobacter pylori (H. pylori) infection may cause systemic inflammation and increase the production of tumor necrosis factor-α, interleukin-1, and interleukin-6. Unfortunately, bone mineral density also may be affected by these cytokines. This study aimed to evaluate the association between bone mineral density and H. pylori infection.

Methods

A cross-sectional study evaluated 1,126 men undergoing a comprehensive health screening in a private Korean screening center. Subjects' sera were tested for H. pylori antibodies (immunoglobulin G) using an enzyme-linked immunosorbent assay, and bone mineral densities (g/cm2) of the lumbar spine, femoral neck, and total femur were obtained using dual-energy X-ray absorptiometry. To evaluate the difference in bone mineral density according to H. pylori infection status, the adjusted mean bone mineral densities at each site were compared after adjusting for potential confounders, including age, sex, body mass index, smoking, alcohol consumption, and exercise.

Results

H. pylori infection was associated with a significant decrease in mean lumbar bone mineral density (H. pylori-positive, 1.190 g/cm2; H. pylori-negative, 1.219 g/cm2; P=0.006), which was greatest among men who were ≥50 years old (H. pylori-positive, 1.193 g/cm2; H. pylori-negative, 1.233 g/cm2; P=0.006). However, no significant association was observed in the bone mineral densities of the total femur and femoral neck.

Conclusion

In men, H. pylori infection was negatively associated with lumbar bone mineral density. This association may be useful in the early detection, prevention, and management of male osteoporosis.

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  • Exploring osteomicrobiology: A narrative review of the gut-bone axis in osteoporosis
    Hugo S. Pereira, Muaz Rashid, Ahmad Alissa, Salman Keraidi, Nicolas Wipf, Aubrie M. Sowa, Jake M. McDonnell, Stacey Darwish, Joseph S. Butler
    Irish Journal of Medical Science (1971 -).2025; 194(6): 2265.     CrossRef
  • Impact of Helicobacter pylori eradication therapy on quality of life and symptoms in osteoarthritis symptoms in infected patients: A nonblinded clinical trial
    Ghazaleh Heidari, Shahin Asgari-Savadjani, Mohammad Karami-Horestani, Awat Feizi
    Journal of Research in Medical Sciences.2025;[Epub]     CrossRef
  • Changes in the composition of the fecal metabolome and gut microbiota contribute to intervertebral disk degeneration in a rabbit model
    Shuai Cheng, Jian Yu, Meiling Cui, Hongmin Su, Yang Cao
    Journal of Orthopaedic Surgery and Research.2024;[Epub]     CrossRef
  • Sphingolipid-Induced Bone Regulation and Its Emerging Role in Dysfunction Due to Disease and Infection
    Anouska Seal, Megan Hughes, Fei Wei, Abinaya S. Pugazhendhi, Christopher Ngo, Jonathan Ruiz, Jonathan D. Schwartzman, Melanie J. Coathup
    International Journal of Molecular Sciences.2024; 25(5): 3024.     CrossRef
  • Is Helicobacter pylori infection associated with osteoporosis? a systematic review and meta-analysis
    Chuang Xiong, Runhan Zhao, Jingtao Xu, Hao Liang, Jun Zhang, Yanran Huang, Xiaoji Luo
    Journal of Bone and Mineral Metabolism.2023; 41(1): 74.     CrossRef
  • Bone Fragility in Gastrointestinal Disorders
    Daniela Merlotti, Christian Mingiano, Roberto Valenti, Guido Cavati, Marco Calabrese, Filippo Pirrotta, Simone Bianciardi, Alberto Palazzuoli, Luigi Gennari
    International Journal of Molecular Sciences.2022; 23(5): 2713.     CrossRef
  • H. Pylori is related to osteoporosis but only in premenopausal female: a cross-sectional study
    Jing-Wei Wang, Feng-Xiao Dong, Hui Su, Licun Zhu, Sujun Shao, Hong Liu
    BMC Musculoskeletal Disorders.2020;[Epub]     CrossRef
  • Infection by CagA-Positive Helicobacter pylori Strains and Bone Fragility: A Prospective Cohort Study
    Luigi Gennari, Daniela Merlotti, Natale Figura, Christian Mingiano, Maria Beatrice Franci, Barbara Lucani, Tommaso Picchioni, Mario Alessandri, Maria Stella Campagna, Sara Gonnelli, Simone Bianciardi, Maria Materozzi, Carla Caffarelli, Stefano Gonnelli, R
    Journal of Bone and Mineral Research.2020; 36(1): 80.     CrossRef
  • Helicobacter pylori Related Diseases and Osteoporotic Fractures (Narrative Review)
    Leon Fisher, Alexander Fisher, Paul N Smith
    Journal of Clinical Medicine.2020; 9(10): 3253.     CrossRef
  • Bone of Contention: Helicobacter pylori and Osteoporosis—Is There an Association?
    Konstantinos Papamichael, Garyfallia Papaioannou, Marcy A. Cheifetz, Adam S. Cheifetz
    Digestive Diseases and Sciences.2019; 64(10): 2736.     CrossRef
  • Relationship between Helicobacter pylori infection and osteoporosis: a systematic review and meta-analysis
    Taiwu Wang, Xiang Li, Qi Zhang, Bingjie Ge, Jinhai Zhang, Lei Yu, Tongjian Cai, Yao Zhang, Hongyan Xiong
    BMJ Open.2019; 9(6): e027356.     CrossRef
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Breast Feeding Is Associated with Postmenopausal Bone Loss: Findings from the Korea National Health and Nutrition Examination Survey
Hyun Joo Kim, Hyuktae Kwon, Seung-Won Oh, Cheol Min Lee, Hee-Kyung Joh, Youngju Kim, Yoo-Jin Um, Sang Hyun Ahn
Korean J Fam Med 2015;36(5):216-220.   Published online September 18, 2015
DOI: https://doi.org/10.4082/kjfm.2015.36.5.216
Background

Postmenopausal osteoporosis is a common disease which can cause various morbidity and economic burden. Lactation is known to cause a decline in bone mineral density (BMD), but there are controversies on whether decreased BMD is fully recovered after lactation and whether lactation duration has an influence on postmenopausal BMD. This study was conducted to see whether breastfeeding is associated with postmenopausal bone loss using a highly representative sample of Korean population.

Methods

Retrospective cross sectional study was done using data collected from Korea National Health and Nutrition Examination Survey V. The study outcome was BMD measured with dual-energy X-ray absorptiometry and divided into 2 groups: normal or low BMD (T score<-1), and breastfeeding duration was categorized into 4 groups (never, 1st, 2nd, and 3rd tertile). Logistic regression analysis was done to examine the association between lactation duration and BMD.

Results

Among 1,694 postmenopausal women (mean age, 63.5±9.1), 85.71% were in low BMD group. Compared to never breastfeeding group, postmenopausal women with longer than 79 months of breastfeeding duration are more likely to have low BMD (adjusted risk ratio [ARR]=1.24; 95% confidence interval, 1.17 to 1.32). As the duration of breastfeeding increases, ARR and risk difference for low BMD also increases (P for trend=0.008).

Conclusion

The study results showed that total breastfeeding duration was associated with postmenopausal low BMD. All women planning on breastfeeding should be aware of its risks and should take adequate dietary calcium and vitamin D before, during, and after breastfeeding.

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  • Associations of PFAS concentrations during pregnancy and midlife with bone health in midlife: Cross-sectional and prospective findings from Project Viva
    Pi-I Debby Lin, Andres Cardenas, Lisa B. Rokoff, Sheryl L. Rifas-Shiman, Mingyu Zhang, Julianne Botelho, Antonia M. Calafat, Diane R. Gold, Ami R. Zota, Tamarra James-Todd, Russ Hauser, Thomas F. Webster, Emily Oken, Abby F. Fleisch
    Environment International.2024; 194: 109177.     CrossRef
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    Chrislyn Ng, Anne Trinh, Roger Zebaze, Cat Shore-Lorenti, Peter R Ebeling, Frances Milat
    JBMR Plus.2024;[Epub]     CrossRef
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    Celeste M. Sheftel, Luma C. Sartori, Emily R. Hunt, Robbie S. J. Manuel, Autumn M. Bell, Rafael R. Domingues, Lella A. Wake, Brandon R. Scharpf, Chad M. Vezina, Julia F. Charles, Laura L. Hernandez
    Physiological Reports.2022;[Epub]     CrossRef
  • Did parity affect bone mineral density of women in past populations? Parturition scars and BMD of Neolithic to modern skeletons from north-central Poland
    Wiesław Lorkiewicz, Justyna Karkus, Joanna Mietlińska, Michał Stuss, Ewa Sewerynek, Damian Plażuk, Elżbieta Żądzińska
    Journal of Archaeological Science.2020; 124: 105264.     CrossRef
  • Association of breastfeeding and postmenopausal osteoporosis in Chinese women: a community-based retrospective study
    Guiming Yan, Yaqi Huang, Hong Cao, Jie Wu, Nan Jiang, Xiaona Cao
    BMC Women's Health.2019;[Epub]     CrossRef
  • Could use of Selective Serotonin Reuptake Inhibitors During Lactation Cause Persistent Effects on Maternal Bone?
    Samantha R. Weaver, Laura L. Hernandez
    Journal of Mammary Gland Biology and Neoplasia.2018; 23(1-2): 5.     CrossRef
  • Previous Adolescent Pregnancy and Breastfeeding Does Not Negatively Affect Bone Mineral Density at the Age of Peak Bone Mass
    Jarinthorn Teerapornpuntakit, Pharuhas Chanprapaph, Narattaphol Charoenphandhu
    Breastfeeding Medicine.2018; 13(7): 500.     CrossRef
  • Incorporation of Flaxseed Flour as a Dietary Source for ALA Increases Bone Density and Strength in Post‐Partum Female Rats
    Danielle Cavalcante Ribeiro, Aline D'Avila Pereira, Fernanda Carvalho de Santana, Jorge Mancini‐Filho, Eduardo Moreira da Silva, Carlos Alberto Soares da Costa, Gilson Teles Boaventura
    Lipids.2017; 52(4): 327.     CrossRef
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The Relationship between Body Fat Percent and Bone Mineral Density in Korean Adolescents: The Fifth Korea National Health and Nutrition Examination Survey (KNHANES V-1), 2010
Hee-Cheol Jeon, Kayoung Lee, Jinseung Kim, Tae-Jin Park, Dae-Won Kang, Da-Jung Park
Korean J Fam Med 2014;35(6):303-308.   Published online November 21, 2014
DOI: https://doi.org/10.4082/kjfm.2014.35.6.303
Background

The relationships of total and regional body fat percent with bone mineral density (BMD) in Korean adolescents were examined using the Fifth Korea National Health and Nutrition Examination Survey (KNHANES V-1), 2010.

Methods

Body fat percent at whole body (WBFP), trunk (TBFP), and extremities (both upper and lower extremities fat mass/body weight, EBFP), ratio of trunk fat mass to extremities fat mass (TEFR), and BMD at whole body, total femur, and lumbar spine were measured by dual energy X-ray absorptiometry in a population-based sample of 433 boys and 362 girls, aged 12 to 18 years. The analyses were conducted using linear regression analysis with complex sampling design.

Results

After adjusting for confounders such as age, height, weight, serum 25-(OH) vitamin D concentration, energy intake, calcium intake, physical activity, and menarche status for girls, WBFP, TBFP, and EBFP were inversely associated with whole and regional BMD in both sexes (P < 0.05). TEFR was positively associated with whole and regional BMD in boys after adjusting for confounders, while it was negatively associated in girls (P < 0.05). However, the associations were non-significant when bone mass-free lean mass was adjusted instead of bodyweight except for a positive association between TEFR and BMD in boys.

Conclusion

In Korean adolescents, total and regional body fat percent is not independently associated with BMD after adjusting for bone mass-free lean mass but higher fat in trunk as compared to extremities may be protective for BMD in boys.

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    BMC Endocrine Disorders.2023;[Epub]     CrossRef
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    Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy.2022; Volume 15: 1473.     CrossRef
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    Gao-Xiang Wang, Ze-Bin Fang, Hui-Lin Li, De-Liang Liu, Shu-Fang Chu, Heng-Xia Zhao
    Frontiers in Endocrinology.2022;[Epub]     CrossRef
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    Marjan Jeddi, Arash Ardalan, Seyed Taghi Heydari, Mohammad Hossein Dabbaghmanesh
    Archives of Osteoporosis.2021;[Epub]     CrossRef
  • Relationship Between Bone Mineral Density and Body Composition According to Obesity Status in Children
    Young-Gyun Seo, YoonMyung Kim, Hyunjung Lim, Min Jae Kang, Kyung Hee Park
    Endocrine Practice.2021; 27(10): 983.     CrossRef
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    Kai-Li Deng, Wan-Yu Yang, Jin-Li Hou, Hui Li, Hao Feng, Su-Mei Xiao
    International Journal of Environmental Research and Public Health.2021; 18(22): 12126.     CrossRef
  • Body composition and bone mineral density in childhood
    Lisa B. Rokoff, Sheryl L. Rifas-Shiman, Karen M. Switkowski, Jessica G. Young, Clifford J. Rosen, Emily Oken, Abby F. Fleisch
    Bone.2019; 121: 9.     CrossRef
  • Detrimental Effects of Higher Body Mass Index and Smoking Habits on Menstrual Cycles in Korean Women
    An Na Jung, Ju Hwan Park, Jihyun Kim, Seok Hyun Kim, Byung Chul Jee, Byung Heun Cha, Jae Woong Sull, Jin Hyun Jun
    Journal of Women's Health.2017; 26(1): 83.     CrossRef
  • Association between serum ferritin and hemoglobin levels and bone health in Korean adolescents
    Dong-Wook Jung, Joo-Hyun Park, Do-Hoon Kim, Moonyoung Choi, Shinhye Kim, Hyonchong Kim, Da-eun Seul, Soo Gyeong Park, Jin-Hyung Jung, Kyungdo Han, Young-Gyu Park
    Medicine.2017; 96(51): e9403.     CrossRef
  • Association between Anthropometric Indices, Body Composition and Bone Parameters in Thai Female Adolescents
    Rapheeporn Khwanchuea, Chuchard Punsawad
    The Indian Journal of Pediatrics.2017; 84(12): 908.     CrossRef
  • Prevalence of Vitamin D Deficiency and Insufficiency in Korean Children and Adolescents and Associated Factors
    Anna Lee, Se Hwi Kim, Chung Mo Nam, Young-Jin Kim, Soo-Ho Joo, Kyoung-Ryul Lee
    Laboratory Medicine Online.2016; 6(2): 70.     CrossRef
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Review

A Primary Care Approach to Myelodysplastic Syndromes
Djamshed Samiev, Vijaya R. Bhatt, Joel D. Armitage, Lori J Maness, Mojtaba Akhtari
Korean J Fam Med 2014;35(3):111-118.   Published online May 22, 2014
DOI: https://doi.org/10.4082/kjfm.2014.35.3.111

Myelodysplastic syndromes (MDS) are probably the most common hematologic malignancies in adults over the age of 60 and are a major source of morbidity and mortality among older age groups. Diagnosis and management of this chronic blood cancer has evolved significantly in recent years and there are Food and Drug Administration-approved therapies that can extend patients' life expectancy and improve quality of life. Primary care physicians (PCPs) are often involved in the process of diagnosis and follow-up of MDS patients, especially those in low-risk groups. They can therefore play an important role in improving patient care and quality of life by ensuring early referral and participating in supportive management. There is also a shortage of oncologists which increases the importance of the role of PCPs in management of MDS patients. In the face of limited resources, PCPs can improve access and quality of care in MDS patients. This article provides an overview of the common manifestations, diagnostic approaches, and therapeutic modalities of MDS for PCPs, with a focus on when to suspect MDS, when a referral is appropriate, and how to provide appropriate supportive care for patients diagnosed with MDS.

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Original Articles

Association between Bone Mineral Density and Sleep Duration in the Korean Elderly Population
Narae Kim, Hyun-Rim Choi, Sang-Won Kim, Byung-Sung Kim, Chang-Won Won, Sun-Young Kim
Korean J Fam Med 2014;35(2):90-97.   Published online March 24, 2014
DOI: https://doi.org/10.4082/kjfm.2014.35.2.90
Background

An association between sleep duration and a wide spectrum of diseases has been reported, but little is known about its relationship with bone mineral density (BMD). Previously conducted studies in Korea and abroad have reported results that are controversial. The present study sought to assess whether sleep duration can be considered an independent risk factor of osteoporosis.

Methods

We included participants over the age of 60 years with data on self-reported habitual sleep duration and BMD measured with dual X-ray absorptiometry. Comprehensive data on the study sample was obtained from the Korea National Health and Nutritional Survey performed from 2008 to 2010. Sex-stratified multiple regression analyses were conducted with adjustments for possible confounding factors.

Results

There was a significant inverse dose-dependent association between sleep duration and BMD measured at total hip, femur neck, and lumbar spine for women and total hip and femur neck for men. Sex-stratified regression analyses adjusted for age and body mass index revealed that sleep duration had a negative correlation with BMD at total hip and femoral neck for both women (β = -0.0048; P = 0.0172 for total hip, β = -0.0037; P = 0.0303 for femur neck) and men (β = -0.0057; P = 0.0218 for total hip, β = -0.0057; P = 0.0143 for femur neck). For women, the significance remained after further adjustment of confounding variables.

Conclusion

Prolonged sleep duration appears to have a significant association with lower total hip and femur neck BMD in elderly women but not in elderly men.

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Coffee Consumption and Bone Mineral Density in Korean Premenopausal Women
Eun-Joo Choi, Kyae-Hyung Kim, Young-Jin Koh, Jee-Sun Lee, Dong-Ryul Lee, Sang Min Park
Korean J Fam Med 2014;35(1):11-18.   Published online January 23, 2014
DOI: https://doi.org/10.4082/kjfm.2014.35.1.11
Background

Although Asian people are known to have lower bone mass than that of Caucasians, little is known about coffee-associated bone health in Asian. This study aimed to assess the relationship between coffee consumption and bone mineral density (BMD) in Korean premenopausal women.

Methods

Data were obtained from the Fourth Korea National Health and Nutrition Examination Survey 2008-2009. The study population consisted of 1,761 Korean premenopausal women (mean age 36 years) who were measured for lumbar spine and femoral neck BMD and who completed a standardized questionnaire about coffee intake frequency. We excluded the participants who took hormone replacement therapy or medication for osteoporosis. The cross-sectional relationship between coffee consumption and impaired bone health (osteopenia or osteoporosis) was investigated by bone densitometry.

Results

Coffee consumption showed no significant association with BMD of either femoral neck or lumbar spine, independent of other factors. The adjusted odds ratios for BMD for those who consumed once in a day, twice a day and three times a day were 0.94 (0.70-1.26), 0.93 (0.67-1.28), and 1.02 (0.69-1.50), respectively (P for trend = 0.927).

Conclusion

This study does not support the idea that coffee is a risk factor for impaired bone health in Korean premenopausal women.

Citations

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  • Exploring the dual effects of coffee water extract on osteoclastogenesis and osteoblastogenic mechanisms: in vitro and in vivo insights
    Yue Miao, Shuwen Lei, Chunyan Zhao, Lei Zhao, Qingfei Zou, Qiuping Wang, Chao Tan, Chunxiu Peng, Jiashun Gong
    Food Science and Human Wellness.2026; 15(3): 9250396.     CrossRef
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    Xiang Zhang, Jin Xu
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    Meng-Ying Lu, Jerry Cheng-Yen Lai, Shaw-Ji Chen
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    N. K. Berman, S. Honig, B. N. Cronstein, M. H. Pillinger
    Osteoporosis International.2022; 33(6): 1235.     CrossRef
  • The association of coffee consumption with the risk of osteoporosis and fractures: a systematic review and meta-analysis
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    Roger Rodrigo Fernandes, Paula Katherine Vargas Sanchez, Ana Luisa Riul Sório, Carolina Alves Freiria de Oliveira, Milla Sprone Tavares Ricoldi, Luiz Gustavo de Sousa, Adalberto Luiz Rosa, Selma Siéssere, Karina Fittipaldi Bombonato-Prado
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Association between Sarcopenia, Bone Density, and Health-Related Quality of Life in Korean Men
Seon Won Go, Young Hwa Cha, Jung A Lee, Hye Soon Park
Korean J Fam Med 2013;34(4):281-288.   Published online July 24, 2013
DOI: https://doi.org/10.4082/kjfm.2013.34.4.281
Background

Sarcopenia is the loss of muscle mass leading to decreased muscle strength, physical disability, and increased mortality. The genesis of both sarcopenia and osteoporosis is multifactorial, and several factors that play a role in osteoporosis are thought to contribute to sarcopenia. This study evaluated the association between sarcopenia and bone density and health-related quality of life in Korean men.

Methods

We used the data of 1,397 men over 50 years of age from the 2009 Korean National Health and Nutrition Examination Survey. Sarcopenia was defined as the appendicular skeletal muscle mass divided by height2 (kg/m2) < 2 standard deviations below the sex-specific mean for young adults. Health-related quality of life was measured by the EuroQol-5 dimension (EQ-5D) instrument. Logistic regression analysis was performed to evaluate the relationship between sarcopenia, bone density, and health-related quality of life.

Results

The T-score of the lumbar spine, total femur, and femur neck in bone mineral density in subjects with sarcopenia were lower than those in subjects without sarcopenia. The score of the EQ-5D index was significantly lower and the rate of having problems with individual components of health-related quality of life was higher in the sarcopenic group. After adjustment for age and body mass index, the odds ratios (ORs) (95% confidence interval [CI]) for sarcopenia were 2.06 (1.07-3.96) in osteopenic subjects and 3.49 (1.52-8.02) in osteoporotic subjects, respectively. After adjustment, the total score of the EQ-5D index was significantly lower in the sarcopenic subjects. The ORs (95% CI) for having problems of mobility and usual activity of the EQ-5D descriptive system were 1.70 (1.02-2.84) and 1.90 (1.09-3.31), respectively.

Conclusion

Sarcopenia was associated with decreased bone mineral density in Korean men. In addition, sarcopenia was related to poor quality of life, especially with regard to mobility and usual activity. Greater attention to and evaluation for sarcopenia are needed in subjects showing low bone mineral density to prevent and manage poor quality of life.

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The Relationship between Prevalence of Osteoporosis and Proportion of Daily Protein Intake
Junga Kim, Byungsung Kim, Hani Lee, Hyunrim Choi, Changwon Won
Korean J Fam Med 2013;34(1):43-48.   Published online January 28, 2013
DOI: https://doi.org/10.4082/kjfm.2013.34.1.43
Background

The association between daily protein intake and osteoporosis is still controversial and only a few studies have explored the issue in Korea. This study investigated the relationship between daily protein intake and the prevalence of osteoporosis in Korean adults.

Methods

This study analyzed data extracted from the Korean National Health and Nutrition Examination Survey 4. Participants were aged 19 years or older and had never been treated for osteoporosis. The percentage of calories coming from protein intake was assessed by 24-hour recall method, and participants were divided into three groups according to recommended daily dietary protein intake as a proportion of total daily calories (i.e., <10%, 10%-20%, and >20%). A lumbar or femur neck bone mineral density T-score less than -2.5 was indicative of the presence osteoporosis. The influence of daily protein intake on the prevalence of osteoporosis was analyzed.

Results

In both sexes, the group with the highest protein intake had significantly lower odds of developing lumber osteoporosis when compared to the group with the lowest protein intake, after adjusting for associated factors (females: odds ratio [OR], 0.618; 95% confidence interval [CI], 0.610 to 0.626; P for trend <0.001; males: OR, 0.695; 95% CI, 0.685 to 0.705; P for trend <0.001).

Conclusion

Sufficient daily protein intake lowered the prevalence of osteoporosis in Korean adults. Further prospective studies are necessary to verify the preventive effect of adequate protein intake on osteoporosis.

Citations

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Bone Mineral Density and Food-frequency in Korean Adults: The 2008 and 2009 Korea National Health and Nutrition Examination Survey
Eui-Hyun Yoon, Hyoung Noh, Hyang-Mee Lee, Hwan-Sik Hwang, Hoon-Ki Park, Yong-Soon Park
Korean J Fam Med 2012;33(5):287-295.   Published online September 27, 2012
DOI: https://doi.org/10.4082/kjfm.2012.33.5.287
Background

Diet and Nutrition are important modulators of bone health in men and women. We investigated the associations between frequency of food intake among certain food groups and bone mineral density (BMD) in a large population of Korean adults.

Methods

We used the data from Korea National Health and Nutrition Examination Survey during 2008 to 2009. Participants were aged 20 years and over. BMDs were measured at lumbar spine and femoral neck with dual-energy X-ray absorptiometry. Dietary and supplement intakes were assessed by food-frequency questionnaire. We used multiple linear regression analysis to evaluate the relationships between annual food-frequency of each food group and BMD.

Results

After adjustment of multiple covariates, femoral neck and lumbar BMD significantly increased as the frequency of fruit consumption increased in both men and women. Frequency of other carbohydrates consumption was significantly associated with greater femoral neck and lumbar BMD for women. Frequency of milk and dairy product consumption was significantly associated with greater femoral neck BMD in men. Other food groups, however, had no significant associations with BMDs.

Conclusion

Frequent consumption of fruit has a positive association with BMDs in men and women. Milk and dairy products and other carbohydrates also had positive effects on BMD for men and women, respectively.

Citations

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Association between Serum Cholesterol Level and Bone Mineral Density at Lumbar Spine and Femur Neck in Postmenopausal Korean Women
Jeong-Ho Go, Yun-Mi Song, Joo-Hyun Park, Jae-Young Park, Yun-Ho Choi
Korean J Fam Med 2012;33(3):166-173.   Published online May 24, 2012
DOI: https://doi.org/10.4082/kjfm.2012.33.3.166
Background

Blood lipid profiles have been suggested to be a risk factor for osteoporosis. However, the association between lipid profiles and bone mineral density (BMD) is still unclear. This study aimed to evaluate an association between blood lipid profiles and BMD through both a cross-sectional and a longitudinal study.

Methods

Study subjects were 958 postmenopausal Korean women who have repeatedly undertaken laboratory tests and BMD measurements at lumbar spine and femur neck with an interval of 7.1 years. The associations between lipid profiles and BMD were examined using Spearman correlation analysis with an adjustment for age, smoking, alcohol drinking, physical activity, body mass index, and follow-up duration.

Results

Lumbar spine BMD was not associated with total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), and high density lipoprotein cholesterol (HLD-C) regardless of when the measurement was performed. In an analysis using data measured at the beginning of the study, femur neck BMD was not associated with TC and LDL-C. However, femur neck BMD showed weak but significantly positive correlation with HDL-C (correlation coefficient, 0.077; 95% confidence interval, 0.005 to 0.149). When the analysis was repeated with data measured at the end of the follow-up, there was no significant correlation between femur neck BMD and any lipid profile. In addition, change in femur neck BMD during follow-up was not associated with the change in lipid profiles.

Conclusion

Although further study with a consideration of calcium intake and osteoporosis medication seems necessary, this study found no association between serum lipid profiles and BMD in postmenopausal Korean women.

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The Impact of Body Weight Change on Bone Mineral Density of the Lumbar Spine in Perimenopausal Women: A Retrospective, One-year Follow-up Study
Ha-Rin Lee, Sung-Soo Hong, Sang-Yeoup Lee, Young-Hye Cho, Hyun-Ji Park, Dong-Wook Jung, Jeong-Gyu Lee, Yun-Jin Kim, Ji-Eun Kim
Korean J Fam Med 2011;32(4):219-225.   Published online May 31, 2011
DOI: https://doi.org/10.4082/kjfm.2011.32.4.219
Background

Low body weight was one of the risk factors of osteoporosis. Little is known about the correlation between body weight change and bone mineral density (BMD) in Korean women. Therefore, this study was designed to reveal the impact of body weight change on BMD of the lumbar spine in perimenopausal women.

Methods

105 healthy perimenopausal women aged between 44 and 50 years old were enrolled from August 2002 to March 2009. BMD was measured by dual energy X-ray absorptiometry. Partial correlation coefficients between body weight change and BMD change were calculated after the adjustments for several variables. BMD changes among groups based on BMI and the percentage change in body weight during 1-year follow-up period were compared.

Results

At both baseline and year 1, BMD of lumbar spine tended to be associated more with body weight. There was a significant association between body weight change and BMD change in lumbar spine during 1-year follow-up period. The weight gain group relatively showed an increase in BMD of lumbar spines than weight loss group. There was no BMD change in BMI less than 23 kg/m2 group, but in case of BMI more than 23 kg/m2 group, BMD in weight gain group increased more than the weight maintaining group.

Conclusion

This study demonstrated that body weight change is associated with change in BMD of lumbar spine in perimenopausal women especially if they are overweight.

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    Magnetic Resonance Imaging.2025; 117: 110320.     CrossRef
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    Jihan Kim, Sami Lee, Sung Soo Kim, Jong-Pyo Lee, Jong Sung Kim, Jin Gyu Jung, Seok Jun Yoon, Kyu Pil Kim, Chan-Keol Park, Yong-Hwan Kim
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    Petteri Oura, Jaakko Niinimäki, Jaro Karppinen, Marjukka Nurkkala
    Spine.2019; 44(21): E1264.     CrossRef
  • Underweight Young Women Without Later Weight Gain Are at High Risk for Osteopenia After Midlife: The KOBE Study
    Yukako Tatsumi, Aya Higashiyama, Yoshimi Kubota, Daisuke Sugiyama, Yoko Nishida, Takumi Hirata, Aya Kadota, Kunihiro Nishimura, Hironori Imano, Naomi Miyamatsu, Yoshihiro Miyamoto, Tomonori Okamura
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Association of the Metabolic Syndrome and Bone Mineral Density in Postmenopausal Women.
Jong Chang Park, Hyuk Jung Kweon, Yun Kyo Oh, Hyun Jin Do, Seung Won Oh, Youl Lee Lym, Jae Kyung Choi, Hee Kyung Joh, Dong Yung Cho
Korean J Fam Med 2010;31(1):9-15.   Published online January 20, 2010
DOI: https://doi.org/10.4082/kjfm.2010.31.1.9
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 profi les 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 stratifi ed by body mass index, corrected bone mineral density revealed no signifi cant 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.

Citations

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  • 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
    Hyeon Hwa Lee, Mi Ah Han, Jong Park
    Journal of Health Informatics and Statistics.2019; 44(3): 245.     CrossRef
  • Prevalence of osteoporosis according to nutrient and food group intake levels in Korean postmenopausal women: using the 2010 Korea National Health and Nutrition Examination Survey Data
    Young-Suk Lim, Sang-Wha Lee, Zuunnast Tserendejid, So-Yeon Jeong, Gyeongah Go, Hae-Ryun Park
    Nutrition Research and Practice.2015; 9(5): 539.     CrossRef
  • Analysis of Bone Mineral Density, Biochemical Index and Nutrient Intakes of 30-70 Years Old Women: Based on 2011 KNHANES
    Jae Ok Koo, Myung Sook Kim
    Korean Journal of Community Nutrition.2014; 19(4): 328.     CrossRef
  • Evaluation of Diet Quality according to Self-Rated Health Status of Korean Middle-Aged Women -Based on 2008~2009 Korean National Health and Nutrition Examination Survey-
    Hye-Jin Lee, Kyung-Hea Lee
    Journal of the Korean Society of Food Science and Nutrition.2013; 42(9): 1395.     CrossRef
  • Analysis of Body Composition, Dietary Behaviors and Life style of 30~50 year old Women Living in Seoul
    Jae Ok Koo, Seoyun Park
    Korean Journal of Community Nutrition.2012; 17(4): 440.     CrossRef
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Evaluation of Osteoporosis Self-Assessment Tool Usefulness as a Screening Test for Osteoporosis in Korean Men.
Chang Hun Lee, Seung Won Oh, Jeung Hwan Seung, Hyun Jin Do, Youl Lee Lym, Jae Kyung Choi, Hee Kyung Joh, Hyuk Jung Kweon, Dong Yung Cho
Korean J Fam Med 2009;30(12):944-950.   Published online December 20, 2009
DOI: https://doi.org/10.4082/kjfm.2009.30.12.944
Background
This study was done to determine whether the Osteoporosis Self-assessment Tool (OST) can predict central bone mineral density in Korean men above 50 years, as defi ned by dual energy X-ray absorptionmetry (DXA). Methods: We applied the OST index to Korean men aged over 50 in Health Promotion Center of Konkuk University Hospital from September 2005 to September 2008. The calculated OST risk index was based on weight and age, truncated to an integer. Results: The study population was 276 men. The mean age, height and weight of the men were 59.7 ± 6.69 years, 167.6 ± 6.14 cm and 67.5 ± 8.93 kg respectively. By DXA, 4.7% of the men had a T score of -2.5 or less, and 46.4% had a T score of -2 or less at the spine, total hip, or femoral neck. The OST index ranged from -4 to 7. Using a cutoff score of 0, we predicted osteoporosis with a sensitivity of 85% and a specifi city of 62%. The receiver operating characteristic curve showed an area under the curve of 0.77. When the subjects were analyzed by age and smoking status, the predictive value of the OST was maintained. Conclusion: The OST is a simple and useful method to predict osteoporosis in Korean men.

Citations

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  • Development and Validation of Osteoporosis Risk-Assessment Model for Korean Men
    Sun Min Oh, Bo Mi Song, Byung-Ho Nam, Yumie Rhee, Seong-Hwan Moon, Deog Young Kim, Dae Ryong Kang, Hyeon Chang Kim
    Yonsei Medical Journal.2016; 57(1): 187.     CrossRef
  • Evaluation of the Predictive Index for Osteoporosis as a Clinical Tool to Identify the Risk of Osteoporosis in Korean Men by Using the Korea National Health and Nutrition Examination Survey Data
    Ji Hyun Moon, Lee Oh Kim, Hyeon Ju Kim, Mi Hee Kong
    Korean Journal of Family Medicine.2016; 37(6): 346.     CrossRef
  • A New Predictive Index for Osteoporosis in Men under 70 Years of Age: An Index to Identify Male Candidates for Osteoporosis Screening by Bone Mineral Density
    Lee Oh Kim, Hyeon-Ju Kim, Mi Hee Kong
    Journal of Osteoporosis.2014; 2014: 1.     CrossRef
  • 3,227 View
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  • 3 Crossref

Review

Risk Factors and Assessment of Low Bone Mass in the Young Adult Female.
Hee Jeong Choi
Korean J Fam Med 2009;30(12):924-933.   Published online December 20, 2009
DOI: https://doi.org/10.4082/kjfm.2009.30.12.924
Although low bone mass and accelerated bone loss can occur early in life, osteoporosis is usually considered a disorder of postmenopausal women. However, some premenopausal women are also at risk for osteoporosis. Because of a lack of knowledge and few practice recommendations for premenopausal women, it can be more difficult to determine the potential risk and to manage the low bone mass in these women. Low bone density in the young adult female may refl ect attainment of a lower peak bone mass or be secondary to progressive bone loss following attainment of peak bone density. Early bone health is a key determinant of future osteoporosis, optimizing the bone gain by young adulthood and minimizing the bone loss by menopause is the important preventive strategies. Low bone mass in the young adult female may be associated with prolonged amenorrhea, anorexia nervosa, chronic glucocorticoid therapy and diseases that affect calcium and vitamin D metabolism. Also, bone loss may be associated with common conditions such as smoking, dieting, low calcium intake, and low physical activity. This review addresses peak bone mass accrual, risk factors, screening or evaluation and management of low bone mass in young adult female.

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  • Bone Mineral Density, Biochemical Bone Turnover Markers and Factors associated with Bone Health in Young Korean Women
    Young-Joo Park, Sook Ja Lee, Nah-Mee Shin, Hyunjeong Shin, Yoo-Kyung Kim, Yunjung Cho, Songi Jeon, Inhae Cho
    Journal of Korean Academy of Nursing.2014; 44(5): 504.     CrossRef
  • Structural Model for Osteoporosis Preventive Behaviors in Postmenopausal Women: Focused on their Own BMD Awareness
    Young Joo Park, Sook Ja Lee, Nah Mee Shin, Hyun Cheol Kang, Sun Haeng Kim, Tak Kim, Song I Jeon, In hae Cho
    Korean Journal of Adult Nursing.2013; 25(5): 527.     CrossRef
  • A Study on the Level of Awareness and Self-Efficacy of Osteoporosis in Young Women
    Euysoon Choi, Ju Young Lee
    Korean Journal of Women Health Nursing.2010; 16(2): 204.     CrossRef
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Original Article

Biochemical Markers and Health Behavior Related with Bone Mineral Density in Adult Men.
Eun Hae Kim, Hee Kyung Joh, Eun Young Kim, Dong Yung Cho, Hyuk Jung Kweon, Jae Kyung Choi, Youl Lee Lym, Hyun Jin Do, Seung Won Oh
Korean J Fam Med 2009;30(5):359-368.   Published online May 10, 2009
DOI: https://doi.org/10.4082/kjfm.2009.30.5.359
Background
More than half of the causes of male osteoporosis is due to secondary osteoporosis. Therefore, it is important to detect and modify its related factors. The aim of this study was to fi nd related lifestyle factors and biochemical markers with low bone mineral density (BMD) in Korean men.Methods: A cross-sectional analysis was performed in men aged 40-69 years who visited a hospital for health checkup from January to March 2007. BMD was measured at proximal femur and lumbar spine by dual energy x-ray absorptionmetry. Lifestyle factors were estimated by a self-administered questionnaire and fasting glucose, uric acid, gamma glutamyltransferase, alkaline phosphatase, creatinine, free testosterone, 25-OH vitamin D, urine deoxypyridinoline, osteocalcin were measured. Multivariate logistic regression was used to fi nd the association to the lowest tertile of BMD. Results: A total of 152 subjects were included. After multivariate analysis adjusted with age, BMI, smoking, alcohol and exercise, different factors were correlated with low bone density in each site of femoral neck and lumbar spine. Factors correlated at both sites were BMI and exercise; lower BMI and doing no exercise increased risks of low bone density. Increasing age and alcohol intake ≥ 14 drinks/week were associated with lower BMD at femoral neck. The factors associated with lower lumbar spine BMD only were lower level of uric acid and higher level of urine deoxypyridinoline.Conclusion: Different factors were associated with low bone density at femoral neck and lumbar spine in men. BMI and exercise were related in both sites; age, alcohol intake, uric acid and deoxypyridinoline were related on either site.

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  • Hyperuricemia protects against low bone mineral density, osteoporosis and fractures: a systematic review and meta‐analysis
    Nicola Veronese, Sara Carraro, Giulia Bano, Caterina Trevisan, Marco Solmi, Claudio Luchini, Enzo Manzato, Riccardo Caccialanza, Giuseppe Sergi, Davide Nicetto, Emanuele Cereda
    European Journal of Clinical Investigation.2016; 46(11): 920.     CrossRef
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    Yun Hee Chung, Jong Seop Gwak, Sung Woo Hong, Jung Hyeon Hyeon, Cheol Min Lee, Seung Won Oh, Hyuktae Kwon
    Korean Journal of Family Medicine.2015; 36(5): 239.     CrossRef
  • Blood levels related to the Z-score of bone mineral density in young males and females
    Sun-Hyung Joo, Min-Tae Kim, Jae-Hwan Cho, Hae-Kag Lee, Jae-Ouk Ahn
    Journal of Physical Therapy Science.2015; 27(4): 1117.     CrossRef
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    Young-Ran Kim, Hae-Sung Nam, Tae-Yong Lee
    Journal of the Korea Academia-Industrial cooperation Society.2013; 14(3): 1180.     CrossRef
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Review

Weight and Bone Mineral Density: The Summary of Epidemiological Evidence.
Hyun Ah Park, Hye Jin Kim, Tae Jun Kim, Jin Joo Park, Jin Kyun Park
Korean J Fam Med 2009;30(3):167-174.   Published online March 20, 2009
DOI: https://doi.org/10.4082/kjfm.2009.30.3.167
Not only bone mineral density (BMD) is strongly associated with body weight, but also weight change infl uences BMD change. The weight change related bone change is more marked in women especially after menopause, in the elderly, in the underweight and in persons who have the history of weight cycling. Because of the health impacts of obesity, weight reduction has been often recommended in practices. Therefore various intervention methods have been tried to reduce the weight change related bone change such as hormone therapy, raloxifene, exercise, and calcium supplementation. This review summarizes the epidemiological evidences of the weight change related bone change and the associated factors.

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Original Articles

The Relationship of Serum Homocysteine Levels with Lumbar and Femoral Bone Mineral Density.
Yoen Jung Lee, Sang Wha Lee, Hong Soo Lee, Kyung Won Shim, Sooa Kim, Eui Jeong Woo, Na Yeon Kim
J Korean Acad Fam Med 2008;29(3):175-181.   Published online March 10, 2008
Background
Recently, an elevated serum homocysteine level has been reported to be associated with increased fracture risk and reduced bone mineral density (BMD). So far, little research has been done to evaluate such association in Korean population. Therefore, we investigated the association between serum homocysteine levels and BMD in Korean adults. Methods: The subjects consisted of 2,750 adults who visited a health promotion center at a university hospital from January 2005 to March 2006. Self-administered questionnaires provided information about lifestyle and medical history. Fasting plasma samples were collected and BMD of the lumbar spine and femoral neck were obtained by dual energy X-ray absorptiometry. To adjust for menopausal state, the female subjects were divided into three groups according to age (≤45 yrs, 46∼55 yrs, 55 yrs <). Multiple linear regression analysis was used to evaluate the association between serum homocysteine levels and BMD in each gender and age group. Results: The results adjusted for alcohol and smoking history showed significant association between serum homocysteine levels and BMD in women (Lumbar spine: Ղ=-0.006, P=0.015, Femoral neck: Ղ=-0.065, P=0.012) but not in men (Lumbar spine: Ղ=0.001, P=0.240, Femoral neck: Ղ=0.001, P=0.242). With analyses by three age groups, plasma homocysteine level was associated with both lumbar and femoral BMD in age 46∼55 women (Lumbar spine: Ղ=-0.014, P=0.024, Femoral neck: Ղ= -0.007, P=0.019). Conclusion: Our study suggests that increased serum homocysteine level is an independent risk factor for low BMD among women, especially perimenopausal women. Further studies about the sexual differences and the mechanisms linking serum homocysteine level to BMD are needed. (J Korean Acad Fam Med 2008;29:175-181)
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Relationship between Fatty Liver and Osteoporosis in Postmenopausal Women.
Kyung Hee Han, Hee Jeong Choi, Seung Hee Hong, Sang Hwan Kim
J Korean Acad Fam Med 2008;29(2):114-120.   Published online February 10, 2008
Background
The objective of the current study was to evaluate the association between fatty liver and osteoporosis in Korean postmenopausal women. Methods: We examined postmenopausal women who participated in a health screening test from April 2004 to November 2007. Data about lifestyle and current medical diseases and medications were collected from medical records and medical interviews. Body weight, height, waist circumference and blood pressure were measured. Bone mineral density (BMD) was measured by dual- energy X-ray absorptiometry and body composition analyzer and abdominal ultrasonography were conducted for each participant. Results: One thousand two hundred forty-five postmenopausal women were selected for this study. In postmenopausal women, the spine BMD levels (g/cm2) were significantly different in each subjects with normal (0.819± 0.004), mild (0.846±0.007), moderate (0.844±0.009) and severe (0.779±0.031) fatty liver adjusted for age (P<0.01). The proportion of osteoporosis were significantly different in each subjects with normal (39.1%), mild (30.3%), moderate (31.6%) and severe (56.3%) fatty liver. A multiple logistic regression analysis was performed to determine the association between fatty liver and osteoporosis after age, body mass index, smoking, alcohol drinking and regular exercise. In severe fatty liver compared to the normal subjects of fatty liver, adjusted odds ratio was 3.6 (95% CI 1.2∼10.9). Conclusion: In severe fatty liver disease, the proportion of osteoporosis was increased and the bone mineral density was lower than the normal subjects of fatty liver. (J Korean Acad Fam Med 2008;29:114-120)
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The Relationship of Subclinical Hypothyroidism with Bone Mineral Density and Biochemical Bone Markers in Postmenopausal Women.
Chang O Kim, Kye Seon Park, Kyung Chae Park, Kyung Kyun Shin, Moon Jong Kim, Young Jin Lee
J Korean Acad Fam Med 2008;29(1):41-47.   Published online January 10, 2008
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Impact of Smoking and Alcohol Intake on Bone Mineral Density in Men.
Nam Seok Joo, Mi Hee Kong, Bom Taeck Kim, Sat Byul Park, Tae Young Lee, Kwang Min Kim
J Korean Acad Fam Med 2006;27(11):911-916.   Published online November 10, 2006
Background
: Smoking may be a factor that decreases bone mineral density. Alcohol also may be a factor that increases or decreases bone mineral density. The authors investigated the relationship among life style-related smoking and alcohol intake and the bone mineral density and the amount that may result in the incidence of osteoporosis in Korean men over forties.

Methods : In 1,650 men over forties, we compared the mean values of bone mineral density by factors. Multiple logistic regression analysis was done on the incidence of osteoporosis and the statistically significant factors after adjustment for age, body index, and daily activity.

Results : In men, who smoked over 30 pack-years, the bone mineral density of the spine (P<.001) and the femur (ward; P=.001, neck; P=.003) was statistically significantly low before and after adjusting (spine P=.001, femur ward P=.010, femur neck P=.016) for age, body mass index, and daily activity. In men who were presently drinking alcohol, the bone mineral density of the femur increased significantly (P<.001), but drinking alcohol only influenced the bone mineral density of the femur neck after adjustment (P=.025). In men who drank 200∼300 g per week, the bone mineral density of the femur increased significantly (ward P=.001, neck P<.001), and it influenced the bone mineral density of the femur neck (P= .046) after adjustment. The odds ratio was 1.5 in men who smoked over 30 pack-years in the incidence of osteoporosis, and was statistically significant.

Conclusion : As the odds ratio for incidence of osteoporosis increased in men who smoked over 30 pack-years, it is important to stop smoking.
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The Relationship between Bone Mineral Density and Body Composition Variables Measured by DEXA in Postmenopausal Women.
Soo Hyun Cho
J Korean Acad Fam Med 2005;26(3):158-166.   Published online March 10, 2005
Background
: This study was aimed to quantify the relationship between the bone mineral density and the body composition in Korean postmenopausal women.

Methods : Whole and regional body composition and bone mineral density (BMD) were measured with DEXA in 149 postmenopausal women. Data were analysed using ANOVA test, Pearson correlation and multiple linear regression.

Results : The mean age was 53.4±6.9 years, the mean years since menopause(YSM) was 5.4±6.7 years, the mean height was 154.5±4.9 cm and the mean weight was 56.8±7.4 kg. They were classified under non-osteoporosis (n=40), osteopenia (n=66) or osteoporosis (n=43) group. There were significant differences in age, YSM, height, total lean body mass, bone mineral content (BMC), regional lean body mass of leg and trunk and regional BMD among the three groups (P<0.05). In contrast, weight, BMI, total fat mass and body fat percentage were not significantly different among the three groups. The BMD of total body, lumbar spine and proximal femur had a negative correlation with age and YSM but positive correlation with height, weight, total lean body mass (P<0.05). From multiple linear models, age, total lean body mass, total fat mass and YSM were found to be the best predictor of total BMD (R2=0.460, P<0.05) and age and total lean body mass were found to be the best predictor of BMD of lumbar spine (R2=0.223, P<0.001) and proximal femur (R2=0.351, P<0.001).

Conclusion : From these results it is suggested that lean body mass is the major determinant of BMD at total, lumbar spine and proximal femur in postmenopausal women.
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The Relationship between Sex Hormones and Bone Turnover Markers in Adult Men.
Won Joo Cho, Jae Hoon Hur, Moon Jong Kim, Young Gon Kang, Kyung Che Park, So Lim Kim, Kyung Gyun Shin, Yong Jin Lee
J Korean Acad Fam Med 2004;25(8):596-602.   Published online August 10, 2004
Background
: Bone mass changes in men is related to age, BMI, sex hormones and other factors. In prior studies, bone markers were negatively correlated with bone mineral density, free testosterone, and estrogen and was positively correlated with SHBG. In a study of sex hormones and bone markers in Korean men estradiol was negatively correlated with deoxypyridinoline. In this study, the relationship of testosterone, estradiol, calculated free testosterone, FEI and SHBG to bone turnover markers in adult men were investigated.

Methods : This was a cross-sectional study of 184 men who had undertaken a health screening program in one general hospital in Bundang from November, 2001 to February, 2003. We surveyed information concerning the past medical history, current medication, alcohol consumption amount per week and smoking amount by means of self questionnaire records. Serum total testosterone, estradiol, SHBG and osteocalcin, alkaline phosphatase were measured at a fasting state. Urine was tested for deoxypyridinoline. Free testosterone was calculated using albumin, SHBG, and total testosterone level.

Results : Deoxypyridinoline adjusted by age, BMI was negatively correlated with FEI (r=-0.17, P=0.020) and was positively correlated with smoking amount (r=0.20 P= 0.007). Osteocalcin was negatively correlated with calculated free testosterone and ethanol consumption amount (r=-0.186, P=.0.12, r=-0.186, P=0.012). Multiple regression analysis showed that the most powerful factor influencing deoxypyridinoline was smoking amount (R2= 0.046), followed by FEI, BMI, and the one influencing osteocalcin was BMI (R2=0.050), ethanol amount and calculated free testosterone. After adjusting for age, BMI, drinking amount and smoking amount FEI shown to be a predictor of deoxypyridinoline (β=-0.08, p<0.01, R2=0.101). After adjusting for age, BMI, and drinking amount calculated free testosterone was shown to be a predictor of osteocalcin (β=-0.570, P<0.01, R2=0.130) in multiple regression model.

Conclusion : In adult men, FEI shown to be a predictor of deoxypyridinoline and calculated free testosterone to be a predictor of osteocalcin as an independent variable.
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A Study of Treatment Realities and Recognition of Male Osteoporosis.
Young Suk No, Tae Hwan Kwak, Soo Hyoun Chang
J Korean Acad Fam Med 2004;25(7):527-533.   Published online July 10, 2004
Background
: Osteoporosis has been thought of as a disease of women, but the incidence of male osteoporosis is increasing and is expected to keep rising due to alcohol abuse, smoking and increased life expectancy for men. This study was done to evaluate how many men recognized the significance of osteoporosis and its management.

Methods : There were 138 male subjects who underwent Bone Mineral Density (DEXA) from January 2000 to August 2003 at Sung Nam Central Hospital. We reviewed their BMD results and formed questionnaires which were constructed to evaluate men's recognition and treatment realities of osteoporosis. Telephone interviews and mailing services were utilized. The respondents were 96 (69.6%) and analysis was done.

Results : The average age of the 138 men was 55. Among them, there were 55 (39.9%) and 68 (49.3%) men who had been diagnosed with osteopenia and osteoporosis, respectively. Information on osteoporosis was obtained mainly from mass media like TV and newspaper (57.3% of total answers). The reason for undergoing test for osteoporosis was related to the annual screening tests (40.6% of total answers). Most of these people were likely to ignore the significance of osteoporosis, because only 26 percent answered they should receive proper treatment in case of osteoporosis although they did not have any symptoms at the time of the diagnosis. Among these osteoporotic patients, 76.7 percent did not seek any medical care and the most common reason for refusal to treatment was no existing symptoms for osteoporosis. Among the total, 67.4 percent of the patients said there had been no change of life behavior after the diagnosis.

Conclusion : We found that men had relatively more knowledge of osteoporosis than we expected, but they knew little about the need for treatment and possible severe complications like major fractures that may occur. Also, we found the diagnosis of osteoporosis has little effect on behavioral changes. In conclusion, family physicians should take more interest in the education of patients to increase compliance for its treatment.
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The Effect of Hormone Replacement Therapy and Related Factors on the Change of Bone Mineral Density in Early Postmenopausal Women in Ulsan-si, Korea.
Tae Heum Jeong, Chang Yoon Kim, Kong Joon Sa, Moon Chan Kim, Chang Seop Kim
J Korean Acad Fam Med 2004;25(3):233-243.   Published online March 10, 2004
Background
: Hormone replacement therapy (HRT) has been used as a effective therapeutic strategy of postmenopausal osteoporosis. However, the studies on HRT are insufficient, particularly in early postmenopausal women in Korea. This study was designed as a community based clinical trial and was conducted for 1 year.

Methods : One hundred and forty early postmenopausal women aged 49 to 54 years who resided in Ulsan in Korea were enrolled in this study. The osteoporosis prone life style and general characteristics of the participants and their measured BMD were investigated. The therapy groups included 45 women who were assigned to one of the following regimens in 28 day cycles for 1 year: (1) conjugate equine estrogen (CEE), 0.625 mg/d daily, medroxyprogesterone acetate (MPA) 2.5 mg/d daily and calcium 500 mg/d daily (2) CEE 0.625 mg/d daily, MPA 10 mg/d for days 1 through 12 and calcium 500 mg/d daily.

Results : The women in the therapy groups had an average gain of 5.4%, 4.2%, 2.1%, 4.9% in BMD in the lumbar spine, femur total, femur neck and ward's area, respectively. HRT has significantly influenced the BMD after controlling age, month since menopause, alcohol intake, smoking, calcium intake, exercise, body mass index and baseline BMD. The baseline BMD and the BMI were factors that influenced the effect of HRT in BMD.

Conclusion : HRT had positively influenced the BMD in Korean women. The baseline BMD and the BMI were predictors of the effect of HRT in BMD change.
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Evaluation of Simple Tool as a Screening Test for Osteoporosis and Osteopenia in Korean Postmenopausal Women .
Hye Joon Park, Kyung Hee Park, Geun Min Park, Yoo Jin Paek, Jung Jin Cho
J Korean Acad Fam Med 2003;24(8):702-708.   Published online August 10, 2003
Background
: Osteoporosis is an important health concern among the postmenopausal women. Therefore, it is necessary to find out acceptable screening tools for osteoporotic patients. The purpose of this study was to evaluate the Risk Index by OSTA as a screening test for osteoporosis.

Methods : The study population was 322 naturally caused menopausal women in Korea. Their was of femoral neck and lumbar spine BMD measured by DEXA. Risk Index by OSTA, based on weight and age, was calculated and the sensitivity and specificity for osteoporosis and osteopenia were evaluated. To find out the proper cut-off point for osteoporosis and osteopenia among the postmenopausal women in Korea, we also compared the sensitivity and specificity of each Risk Index value.

Results : The mean age and ages at menopause were 59.1(±6.2) and 50.7 (±2.7) years, respectively. The prevalence of osteoporosis was 9.6% with femoral neck BMD. For oeteoporosis, using a cut-off point of -1 yielded a sensitivity of 74.3% and a specificity of 52.2% with femoral neck BMD. Using a cut-off of -2 yielded a sensitivity of 87.3% and a specificity of 70.9%. The ROC curve showed an AUROC 0.88 for Risk Index in identifying osteoporosis.

Conclusion : The Risk Index is an acceptable, simple and useful method in the diagnosis of osteoporosis with a Risk Index of -2 in Korean postmenopausal women.
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Influence of HMG-CoA Reductase Inhibitors on Bone Mass in Postmenopausal Women.
Sang Yeoup Lee, Yun Jin Kim
J Korean Acad Fam Med 2003;24(5):451-455.   Published online May 10, 2003
Background
: It is controversial whether the use of HMG CoA reductase inhibitors (statins) is associated with an increased bone mineral density (BMD) in humans. The purpose of this study was to assess the influence of statins on BMD in Korean postmenopausal women.

Methods : Forty-four postmenopausal women (aged 54.3±5.8 years) were included. The statin users (n=24) were administered either simvastain, atorvastatin, pravastatin, or lovastatin. The control group (n=20) did not take statins. BMD of the spine were measured by dual-energy X-ray absorptiometry. Alkaline phosphatase (ALP) was tested as a bone marker. The data were analysed with two-sample t test and paired t-test.

Results : The mean annual spinal BMD changes of the study groups were -1.5±5.6% for statin users and -0.2±4.2% for control group. There was no statistically significant difference in mean annual spinal BMD changes (P=0.696). The mean annual ALP changes of the study groups were -5.6±18.1% for the statin users and -0.4±13.9% for the control group. There was no statistically significant difference in mean annual ALP changes (P=0.246). In each group, the spinal BMD significantly was not changed after 1 year (P>0.05).

Conclusion : This study suggest that statins do not protect from bone loss in Korean postmenopausal women.
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The Relationship between Testosterone and Bone Mineral Density in Middle Aged Men.
So Lim Kim, Soo Kyung Jung, Moon Jong Kim, Jean Lee, Young Gon Kang, Young Jin Lee, Chul Young Bae
J Korean Acad Fam Med 2003;24(4):365-374.   Published online April 10, 2003
Background
: With the population aging, osteoporosis is becoming a major health issue. Although not as common as women, osteoporosis and its clinical end point of fracture are significant health care concern in men. Despite the considerable public health burden, our understanding of their pathogenesis is incomplete, and several factors known to affect bone metabolism in men are still controversial. So this study was made to investigate relationship between testosterone and bone mineral density in men.

Methods : This was a cross-sectional study of 432 men undertaken health screening program in Pundang CHA General Hospital from January 2000 to December 2000. We surveyed information concerning exercise and consumption of alcohol and smoking by means of self questionnaire records. Serum total testosterone, SHBG, and osteocalcin were measured at a fasting state. Second morning urine was tested for deoxypyridinoline. BMD was assessed using pQCT.

Results : FTI (free testosterone index) was positively correlated with BMD (r=0.265, P<0.01). Age, osteocalcin, SHBG, and urine deoxypridinoline were negatively correlated with BMD (r=-0.397, P<0.01, r=-0.121, P<0.05, r=-0.214, P<0.01, and r=-0.126, P<0.01). BMI and total testosterone had no significant correlation with BMD, and there were no apparent association among the level of alcohol and tobacco use, regular exercise and BMD. FTI was not independently correlated with BMD after age, BMI and urine deoxypyridinoline were adjusted, but showed a trend to significantly predict BMD (β=0.10, P=0.052).

Conclusion : These data suggest that FTI may play a role in determination of BMD in men, allowing the potential for clinical intervention. But further investigation of the role of testosterone in bone metabolism in men is necessary.
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Factors Relating to Bone Mineral Density of Adult Man in Korea.
Seung Whan Lee, Sung Hee Lee, Young Rok Kweon, Han Jin Lee
J Korean Acad Fam Med 2003;24(2):158-165.   Published online February 10, 2003
Background
: The bone mineral densities of men decrease with increasing age like women. The incidence of osteoporosis gradually increase according to increasing proportion of older people, but the studies on osteoporosis of men are now beginning. The association between the bone mineral density and behavioral factors among adult men in Korea were studied.

Methods : The study subjects who visited health promotion center of one hospital located in Seoul from April to May 2001, aged 28 to 76 years, were all mearsured bone mineral density at left calcaneus using quantitative ultrasonography (QUS). We interviewed all subjects to get the information about past medical history and behavioral risk factors such as smoking, drinking, intake of dairy food, and exercise patterns. We also checked height, weight, blood chemistry including alkaline phosphatase and Prostate Specific Antigen. We calculated the Pearson's partial correlation coefficient between Speed of Sound (SOS) and each variables after adjusting age and body weight, and compare the mean SOS among each categories of the variables using Analysis of Covariance (ANACOVA). Finally, multiple regression analysis was done, using the model including significant variables of baseline analysis.

Results : One hundred six men, who did not have any metabolic disease influencing bone mineral density, were included. Age and smoking amount were negatively correlated and body weight was positively correlated with SOS. In univariate analysis, exercise, past history of fracture and dairy food intake was significantly associated with bone mineral density of men. In multiple regression analysis, body weight and dairy food intake were positively associated, but age and smoking amounts were negatively associated with bone mineral density.

Conclusion : To increase bone mineral density of men, one should maintain adequate body weight, ingest dairy food regulary and reduce smoking amount or quit smoking.
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Changes of BMD & Markers of Bone Turnover after 1-year Treatment with HRT and Fluocalcic in Postmenopausal Korean Women with Decreased BMD.
Han Jin Oh, Hyun Koo Yoon, In Kwon Han
J Korean Acad Fam Med 2002;23(8):1033-1041.   Published online August 10, 2002
Background
: Although fluoride has an ability to increase BMD at lumbar spine, it does not result in a reduction in vertebral fractures. After the introduction of monofluorophosphate instead of NaF, there is a revival of the use of fluoride in the treatment of osteoporosis.
Methods
: We evaluated 39 subjects out of the 50 who finished a 1-year treatment. Fifty postmenopausal Korean women with decreased bone density were enrolled from Oct. 2000 to Mar. 2001 and stratified 2-groups by treatment regimen. One group was treated with Fluocalcic± (Disodium monofluorophosphate; 100 mg and calcium carbonate; 1,250 mg) and HRT, the other group with HRT only at climacteric clinic in Samsung Cheil Hospital & Women's Healthcare Center. Markers of bone turnover, changes of BMD and demographic data were obtained and compared in both groups.
Results
: Compared with the baseline value, osteocalcin and total alkaline phosphatase, the formation markers of bone turnover were not decreased significantly after 3-month treatment in HRT and fluoride treated group. But, DPYD, the resorption marker, was decreased slightly after the 3-months treatment. Changes of both resorption and formation markers of bone turnover in HRT only treated group were significantly decreased after the treatment. The spinal BMD increased significantly compared to the baseline value in both groups. Changes of spinal BMD after 1-year treatment in HRT and fluoride treated group was increased significantly than HRT only group (15.1±12.6% vs 4.2±3.4%).
Conclusion
: This study shows that changes of spinal BMD after combined treatment with HRT and fluoride were increased significantly than HRT only treatment. Therefore, combined use of Fluoride and HRT was effective to increase spinal BMD in postmenopausal women with decreased spinal BMD.
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Bone Acquisition Related Health Behavior Factors and Nutritional Uptake in High School Girl Student.
Sun Myeong Ock, Churl Min Kim, Chan Myung Ock, Whan Seok Choi
J Korean Acad Fam Med 2002;23(7):905-916.   Published online July 10, 2002
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Changes of Bone Mineral Density and Biochemical Bone Markers during Perimenopausal Period for Healthy Women: Retrospective Cohort Study.
Seongwook Kang, Seongwook Hwang, Moonjong Kim, Seunggon Choi, Jeen Lee, Younggon Kang, Youngjin Lee, Chulyoung Bae
J Korean Acad Fam Med 2002;23(7):897-904.   Published online July 10, 2002
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The Association between Blood Pressure and Bone Mineral Loss in Perimenopausal Women; A Cross Sectional Study.
Nam Wook Yoo, Sang Yeoup Lee, Young Joo Kim, Sang Han Choi, Yun Jin Kim
J Korean Acad Fam Med 2002;23(6):787-793.   Published online June 30, 2002
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Randomized Controlled Trial

Changes of bone mineral density after 2-yrs treatment with HRT and alendronate in osteoporotic Korean women.
Han Jin Oh, Sang Man Kim, Dong Hee Cho, Hyun Koo Yoon, In Kwon Han
J Korean Acad Fam Med 2002;23(4):475-484.   Published online April 1, 2002
Background
: Alendronate is on of the anti-resorptive drugs for the treatment of osteoporosis and results in a decrease of bone turnover. HRT is also known to decrease the bone turnover. Combination therapy with HRT and alendronate has made significant increase of BMD in postmenopausal women. But there were no available long-term results about combination therapy of HRT and alendronate on Korean osteoporotic women.

Methods : Eighty postmenopausal women with osteoporosis who visited the Climacteric Clinic in Samsung Cheil Hospital & Women's Health Care Center from April to July 1999 were subjects. Randomized open labeled case control study was made. We evaluated 37 postmenopausal osteoporotic Korean women who were treated for 2 years after enrollment. Subjects in Group I were treated with HRT only and group II had HRT with alendronate 10 mg daily. Subjects also were measured BMD at lumbar spine and makers of bone turnover before, one and two year after treatment.

Results : Common reasons for dropouts were side effects of HRT such as breast tenderness, irregular vaginal bleeding, economic problems, long distance from clinic etc. BMD in lumbar spine was increased 10.1% in the first year, and 12.0% in the second year in subjects treated with HRT and alendronate. But in HRT only group BMD increased to 6.4% in the first year and 7.8% at second year. Markers of bone turnover were decreased significantly in both groups compared with baseline value, but the percent changes of markers after 1 year and 2 years between the two groups were not significant.

Conclusion : This study demonstrated that, in postmenopausal Korean women with osteoporosis, 2 years of combination therapy with HRT and alendronate resulted in a significant and sustained increase in spinal BMD than HRT and alendronate resulted in a significant and sustained increase in spinal BMD than HRT only group.
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Original Articles
Correlation between body composition and spinal bone density in young women.
Jee Hye Han, Kyung Hee Cho
J Korean Acad Fam Med 2002;23(2):215-223.   Published online February 1, 2002
Background
: Body weight is a well known factor of bone density. However, studies for correlation between body fat, lean body mass and bone density are inconsistent in premenopausal women. We reviewed the relations of body weight, body mass index(BMI), body fat, body fat percent, fat free mass and spinal bone density.

Methods : We collected data of healthy young women of 20-39 years old who visted a health promotion center of a general hospital from March to August, 2000. and examined the correlation of body weight, BMI, body fat, body fat percent, fat free mass and spinal bone density.

Results : The total number of observation was 309, the average age was 34±4 year old, the average body weight was 55.4±7.7 kg, the height was 158±5 cm, the BMI was 22.05±2.80 kg/m², the body fat percent was 25.5±5.3%, and the spinal bone density was 1.007±0.116g/cm² The incidence of normal bone weight group, 72.6%, 26.8%, 0.5%, respectively, in the normal weight group, and 90.9%, 9.1%, 0%, respectively, in the obese group. In linear regression analysis, the spinal bone density correlated with age, height, weight, BMI, body fat, and fat free mass. In stepwise multiple regression analysis, the fat free mass was a significant factor(R2=0.065(p<0.001)) of the spinal bone density.

Conclusion : The spinal bone density was correlated with age, height, body weight, BMI, fat mass, and fat free mass. The multiple regression analysis suggested that only fat ree mass was significantly correlated with spinal bone density.
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The relationship between grip strength and radial BMD in middle aged men.
Young Ah Choi, In Suk Park, Moon Jong Kim, Kyung Gin Kim, Young Gon Kang, Ho Taek Lee, Young Jin Lee, Chul Young Bae
J Korean Acad Fam Med 2001;22(10):1520-1530.   Published online October 1, 2001
Background
: Although it has become obvious that male osteoporosis represent a public health issue, few studies has been done in Korea concerning the association between grip strength and bone mineral density(BMD) in men. This study was undertaken to enforce the necessity of muscle strengthening exercise program to improve BMD in middle-aged men by evaluate the association between grip strength and BMD.

Methods : The study was performed from January to December 1998 in the health screening center of CHA hospital with 174 men who measured both BMD and grip strength. BMD was measured at the proximal and distal radius of the dominant hand using Osteoplan p-DXA and grip strength was measured from the dominant hand using dynamometer. Daily calcium intake was measured through the interview with the diet therapist. Other datas were obtained from the questionnaire.

Results : We found a significant positive correlation between grip strength and BMD of distal and proximal radius(r=0.208; P<0.01, r=0.2555; P<0.01) and a significant negative correlation between age and BMD of distal and proximal radius(r=-0.313; P<0.01,r=-0.190; P<0.05). There was no correlation between calcium intake and BMD. BMI was correlated significantly only with BMD of distal Radius(r=0.194; P<0.05). There was no significant difference in BMD either by smoking or exercise. The multiple regression analysis showed that grip strength was independently correlated with BMD of the proximal radius significantly(β=1.731, P<0.05), but not with BMD of the distal radius after adjusting the confounding variables.

Conclusion : In conclusion, there is a significant correlation between grip strength and BMD in middle aged men. Therefore it can be safely concluded that it is helpful to carry out muscle strengthening program to improve muscle strength and increase BMD for preventing male osteoporosis.
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Background
: Increased BMD after treatment means that the treatment regimen was effective to prevent fracture associated with osteoporosis. But changes of BMD reflected at least after 1-year. Now we use markers of bone turnover more easily, and they reflects bone metabolism faster than BMD within 3-4 months. Some data showed that changes of bone markers after 3-months could predict the changes of the BMD after 1-year.

Methods : 126 postmenopausal Korean women with osteoporosis were evaluated who visited Samsung Cheil hospital from Aug. 1997 to July 2000, with respect to markers of bone turnover and BMD at lumbar spine. Subjects were classified into 3 groups. HRT only group, HRT with alendronate group and HRT with calcitonin group. To evaluate the effectiveness of treatment regimen, we compared changes of markers after 3 months and changes of spinal BMD after 1 year treatment among 3 groups. And also evaluate the predictability of the changes of markers of bone turnover after 3 months about the changes of spinal BMD, multiple regression analysis were made.

Results : Our results showed those findings. 1. Percent changes of markers of bone turnover decreased significantly compared with baseline(osteocalcin 30.4 53.4%, total alkaline phosphtase 26.7 20.0%, deoxypyridinoline 19.0 30.1%, and mean percent changes of markers among three groups showed no significant differences. 2. No significant relationships were noted between percent changes of spinal BMD and percent changes of markers of bone turnover. 3. Percent changes of BMD at lumbar spine were increased significantly after 1 year treatment(HRT only 5.6 3.6%, HRT with calcitonin 7.8 4.5%, HRT with alendronate 9.8%, 4.7%).

Conclusion : These results made conclusion that changes of markers of bone trunover after 3 months couldn't predict the changes of spinal BMD after 1-year treatment. But, HRT with antiresorptive agent may be effective in treating postmenopausal osteoporotic Korean women.
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The relationship between osteoarthritis and bone mineral density in the lumar spine.
Jeong Yeol Oh, Choon Woo Lee, Dong Jin Jeon, Hee Tak Ryu
J Korean Acad Fam Med 2001;22(7):1043-1051.   Published online July 1, 2001
Background
: Osteoporosis is becoming major health problem in old age and menopausal women, and osteoarthritis is most common joint disease in both ages. The inverse relationship between osteoporosis and osteoarthritis was first noticed 20years ago. However the subject had not been studied in korea. Thus, our objectives is to examine the influence of osteoarthritis on bone density measurements.

Methods : The study group consisted of 120 women, aged over 40 years, who visited for health examination in Health Center of Poondang-Jesaeng general hospital from October 1998 to April 1999. Bone mineral density(BMD) of the lumar spine was measured, using dual energy X-ray absorptiometry(Lunar, Expert XL), and lateal lumbar spine radiograph was taken. Severity of osteoarthritis were scored on osteophytes, disk space narrowing and vertebral body sclerosis.

Results : Postmenopausal women had significantly lower BMD than premenopausal women(P<0.001). Age(r=-0.545,p<0.001), body mass index(r=0.264,p<0.01) and education(r=0.284, p<0.001) were significantly correlated with BMD, but smoking, exercise, radiogrphic OA variables not correlated. However, stepwise multiple regression analysis using osteoporosis related variables and OA variables is indicated that menopausal status, body mass index, age, osteophytes were significantly associated factor with BMD, and lumbar osteophytes explained 2.7% of variation in lumbar spine BMD.

Conclusion : We conclude that, among women, lumbar BMD is higher in those with osteophytosis of the lumbar spine. The effect is largely directed by osteophytes being included in the BMD measurement.
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Effects of tibolone on postmenopausal osteoporosis, lipid, mammograph compared with continuous combined hormone replacement therapy.
Seong Hee Yang
J Korean Acad Fam Med 2001;22(6):904-914.   Published online June 1, 2001
Background
: Hormone replacement therapy is effective for improvement of climacteric symptoms, and prevention of postmenopausal osteoporosis but patient compliance is very low. The aim of the study was to assess the comprarative effects on bone mineral density(BMD). lipid, mammographic finding, biochemical bone markers of tibolone and continuous combined hormone replacement therapy in postemeopusal women.

Methods : Body mass index, BMD in the spine and femur neck. lipid, alkaline phosphatase, serum osteocalcin, urine deoxypyridinolone were measured before and after 1 year therapy in 88 post - menopausal subjects. Of theses, 54 women received CEE 0.625 ㎎ and MPA 2.5 ㎎ (CEE/MPA) per oral, 34 tibolone alone for 1 year.

Results : Body mass index didn't changed in both groups. Significantly increased mammographic density in CEE/MPA groups(p<0.05). Total cholesterol was decreased in both group, but no significant differences between the different treatment groups. Triglyceride decreased in tibolone group and ther are significant difference between the two groups(p<0.01). HDL-cholesterol increased in CEE/MPA group(p<0.01) but decreased in tibolone group(p<0.01). There are significant difference in HDL- cholesterol response between two groups(p<0.01). LDL-cholesterol respone between two groups(p<0.05). Total alkaline phosphatase(TALP) and serum osteocalcin decreased in 새호 groups(p<0.01) but no differences between two groups. Urine deoxypyridinoline was not decreased in both groups and no differences between two groups. Spine bone mineral density(BMD) increased in both groups(p=0.0001) but no differences in treatment response between two groups. Femur neck BMD didn't not increased in both groups and no differenced of treatment responses between two groups. Urine deoxypyridinoline was not decreased in both groups and no differences between two groups.

Conclusion : Tibolone was effective on BMD of lumbar spine as much as CEE/MPA and may be safe in terms of mammographic changes in postmenopausal women.
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Factors which are related with BMD in Premenopausal women.
Yong June Chung, Keun Mi Lee, Jeong Won Park, Seung Pil Chung
J Korean Acad Fam Med 2001;22(3):363-370.   Published online March 1, 2001
Background
: As the mean life span is prolonged, the concern about health care in postmenopausal women is now promoted. Especially, osteoporosis is the serious health problem in postmenopausal women. Bone mineral density in postmenopause is controlled by that in premenopause. Therefore, we searched for the factors which contribute to bone mineral density in premenopause.

Methods : The study subjects who visited the Health Screening and Diagnosis Center in Yeungnam University Hospital from March 1998 to July 1999 was measured BMD at the lumbar spine using dual Energy X-ray Absorptiometry. Subjects were checked past medical history, life style (smoking, drinking, physical activity, exercise etc.), birth history, breast feeding, oral pill intake. The subjects who had disorders known to interfere with bone metabolism and premature menopausal and surgical menopausal women were excluded from the study. And we reviewed the results of the laboratory and radiologic findings which had done in Health Screening and Diagnosis Center.

Results : 352 women were included in this study. The number of normal BMD was 228 and the number of osteopenia was 124. Weight, height, BMI, exercise was significant positively correlated with bone mineral density(P<0.05). Previous operation history was significant negatively correlation with bone mineral density (P<0.05). Multiple logistic regression result showed that weight was the most significant factor affecting to BMD and the history of operation and exercise were significant factors affecting BMD(P<0.05).

Conclusion : In postmenopaual women, who has low weight, past operation history and lack of exercise, evaluation of BMD and education for prevention of osteoporosis are needed.
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