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.
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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)
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)
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.
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.
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.
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.
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.
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.
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.
Background : Osteoporosis has been a rising problem as growth of older age population increased caused by elongation of life. The purpose of this research was to find out about the mean values and differences of BMD by age, relationships between body weight and bone mineral density (BMD) and differences of BMD between pre-and post-menopausal status based on data of lumbar spines and left hip joint performed by dual energy X-ray absorptiometry(DEXA).
Methods : We evaluated 502 female patients who visited Namwon Medical Center from Jan. 1998 to Dec. 1999. The bone mineral density (gm/cm2) of lumbar spines (L2-L4) and left hip joint were evaluated by DEXA machine.
Results : The BMD of lumbar spines was highest at fourth decades, rapidly declined at fifth to sixth decades ad slowly declined at eighth decades. The density of left hip joint was highest at fourth decades, but progressively declined to eighth decades. The relationship between body weight and BMD showed positive correlation (p<0.05). The BMD of pre- & postmenauposal women showed significant difference (p<0.001).
Conclusion : The BMD of Korean women is rapidly declining after menopause. Thus enthusiastic treatment of osteoporosis is needed at this period.
Background : Osteoporosis is an important and common medical problem in postmenopausal women. Depression is another major public health concern. Due to the high prevalence of both depression and osteoporosis, even a weak association between them might result in a greater health problem. We have investigated whether depression is associated with bone mineral density (BMD) in peri- and postmenopausal women.
Methods : The study subjects who visited the office of family medicine department and the health screening and diagnosis center in one general hospital from January to May, 2000 were selected. BMD was measured at the lumbar spine using Dual Energy X-ray Absorptiometry. We evaluated the depression scale using the Beck Depression Inventory. The subjects who had disorders known to interfere with bone metabolism or those who had taken medication related to depression were excluded from the study.
Results : Significant positive correlation were noted between BMD and height and weight (P<0.05) but no correlation was found with depression in perimenopausal women. In postmenopausal women, significant negative correlation was noted between BMD and age, and postmenopausal duration and depression. Significant positive correlation was found between BMD and height and weight (P<0.05).
Conclusion : Our results showed that depression was associated with BMD in postmenopausal women which was independent of other factors strongly associated with osteoporosis.
Background : The study was done to examine the role of long-term diving(5-20m depth) on regional bone mineral density(BMD) in women.
Methods : We compared woman divers(n=38) with matched non-diver controls(n=38) according to age, weight, and duration of menopause. BMD(g/cm2)of the proximal femur (femoral neck, trochanter, Wards’s triangle) was assessed by dual-energy X-ray absorptiometry (DEXA, Hologic QDR-1500).
Results : There was no significant difference between groups for proximal femur BMD. But in premenopausal group, BMD of divers was higher than controls in femur neck and trochanter (P<0.05). Correlations analysis revealed that body weight of divers was significantly correlated to femoral neck BMD (P<0.05). In multiple regression analysis, menopause and age of postmenopausal divers was a predictors of femoral neck BMD in divers.
Conclusion : These result suggest that diving is has osteogenic effect on women.
Background : Several studies have reported that muscle strength and bone mineral density have a significant positive correlation and most previous literature on muscle strength and bone mineral density examined their association. To evaluate the association between grip strength and radius bone mineral density, more precise PQCT was used rather than SPA or DEXA.
Methods : The study was performed from June to August 1999 in Pundang community with 154 postmenopausal women who undertaken osteoporosis screening program who participated in this study. Bone mineral density was measured at the radius using PQCT (peripheral quantitive computed tomography). Grip and pinch strength were measured in both the dominate and nondominant hand using a dyanometer. Other data were obtained from the questionnaire.
Results : Grip and pinch strength of the dominant hands were significantly higher than the nondominant hands. There was no significant difference in bone mineral density by exercise and fracture history. Age-adjusted partial correlation analysis indicated a significant positive correlation of radius BMD with dominant hands grip strength. Significant positive correlations also were found between radius BMD and pinch strength.
Conclusion : Subjects with stronger grip strength had a low BMD. There was a significant positive correlationship between bone mineral density and dominant hand grip strength. The data suggest that grip strength is a weak predictor of radius bone mineral density and provide a feasible way of predicting it.
Background : Osteoporosis is a skeletal condition that is characterized by reduction in bone volume and an increased vulnerability to fracture, practically of the proximal femur and vertebrae. But the etiology of osteoporosis in most men without history of alcohol abuse, or glucocorticoid excess in unknown. Several studies revealed that bone density in aged men was associated with serum sex steroids or sex hormone binding globulin (SHBG).
Methods : We have analyzed bone density and sex steroids, and SHBG of healthy 100 middle aged men who visited one university hospital located in Taejon city from Jan. 1997 to Nov. 1997. Aim of this study as to determine whether bone density in middle aged men was associated with serum sex steroids or SHBG.
Results &
Conclusion : Body mass index was significantly associated with serum FEI. BMI also associated negatively with SHBG. Bone density at lumbar spine was significantly positively associated with FEI (Free Estradiol Index) (r=0.359, P<0.001). SHBG was negatively associated (r=-0.273, P<0.01) with lumbar bone mineral density. After controlling for age, FEI and SHBG were still associated with BMD of lumbar spine. Because of these associations, multiple stepwise regression models were constructed, and accounted for 12-17% of the variability in bone density. Also, these results showed consistent, significant positive associations between bone density and FEI, BMI in middle aged men. Therefore, our data suggest that FEI and BMI may play an important role in the maintenance of the male skeleton.
Background : The lack of standardization in measuring bone mineral density(BMD) is generally recognized as an important and unresolved issue. The National Health Insurance System in Korea covers the cost of osteoporosis treatment according to the relative value(T score < -1.0) of normal BMD. We analyzed numerous research papers published in Korea which related to BMD, and calculated the normal BMD of Korean women using cross0calibration equipment on three different DEXA scanners(Lunar/Norland/Hologic).
Methods : We searched for key words such as 'osteoporosis' and 'bone mineral density' in the Korean Medical Journal CD-ROM from 1987 to 1988. we received 145 full texts, and analyzed 114 original articles all of which used one of the above three scanners, over 100 normal Korean women as subjects and focused on the lumber spine. We found five articles that fit the criteria. Among the scanners used in the five articles are three were Lunar, one Hologic and one Norland. We substituted the results of Norland and Hologic with Lunar's using a cross-calibration equation, and calculated the mean BMD according to age by using a weighted average. Standard deviations of the calibrated data were calculated by using pooled estimates of variance equation.
Results : The lumbar spine BMD values of normal Korean women were 1.181±0.683(g/cm2) in their thirties, forties, sixties were 1.128±0.144, 0.989±0.161, 0.862±0.162, respectively in Lunar scanner, 1.020±0.568, 0.974±0.124,0.854±0.138, 0.746±0.139, respectively in Norland seanner.
Conclusion : we calculated the lumbar spine BMD values for normal Korean women among three major companies using DEXA scanners. Further studies on BMD in randomly selected healthy adult women are needed.
Background : In postmenopausal women, progesterone should be added to protect the endometrium from hyperplasia or carcinoma induced by the unopposed estrogen. However, the effects of progestogen on bone mineral densities and serum lipoproteins have not been precisely evaluated in Korean postmenopausal women.
Methods : To evaluate the effects of progestogen on bone mineral densities and serum lipoprotein in estrogen replacement therapy, we conducted a 2-year trial of long conjugated equine estrogen(conjugated estrogen 0.625mg/day) with or without cyclic progestogen(MPA 5mg/day for 12 days) in 120 postmenopausal women. In all subjects, bone mineral density was measured in lumbar vertebra(L2-L4) and femur neck using dual energy X-ray absorptiometry(DEXA) and serum lipoprotein was measured from the beginning of the treatment, 12 months, and 24 months later, respectively.
Results : BMD of femur neck in both groups increased but not significantly compared to basal level at 12 months and/or 24 months of treatment. As for BMD of lumbar spine, it increased significantly in both groups. Both groups showed a significant decrease in the levels LDL cholesterol, but there was no statistical significance in serum triglycerides. Conjugated estrogen plus MPA group in contrast to conjugated estrogen only group showed a significant decrease in total cholesterol levels.
Conclusion : These results suggest that the addition of MP of the daily of 5mg for 12 days cyclically in estrogen replacement treatment appear to be effective in postmenopausal women with protection on bone mineral density and maintenance of long-term favorable effects on serum lipoprotein.
Background : It is widely accepted that muscle strength and bone mineral density have a significant positive correlation and most previous literature focus on the association between specific muscle groups and adjacent bones. This study examined the association of grip strength with bone density at distant sited, such as spine and femur area in peri- and postmenopausal women.
Methods : The study subjects were 30 perimenopausal and 108 postmenopausal women aged 40 years and older. Bone mineral density was measured at the lumbar spine and femoral area using dual energy x-ray absorptiometry. Grip strength was measured in both the dominant and nondominant hands using a dynamometer. Other data were gathered from the questionnaire.
Results : Significant negative correlations were noted between spinal and femoral bone mineral density and age and postmenopausal duration, and significant positive correlations were found between spinal and femoral bone mineral density and body weight, height, body mass index and both grip strength. Those who exercised had significantly higher spinal bone mineral density than those who did not and smokers had significantly lower spinal bone density than nonsmokers. There was no significant difference in bone mineral density by estrogen and calcium use. The multiple regression analysis examined the association of grip strength in the dominant hand to bone mineral density after adjustment for the confounding covariates.
Conclusion : Weak grip strength in the dominant hand is a marker for lower bone mineral density in peri- and postmenopausal women. Grip strength can be a useful index of osteoporosis.
Background : To predict the therapeutic efficacy of osteoporosis, one or two years is needed to evaluate the therapeutic effect by the measurement of bone mineral density(BMD), whereas three to six months is sufficient with bone markers. Using this information, we can change therapeutic plan or modulate drug dosage if necessary. This approach would provide appropriate therapy for osteoporosis. The purpose of this study is to evaluate the association between the percentage change of BMD which was measured by peripheral quantitative computed tomography(pQCT), and bone markers after 1 year of hormone replacement therapy(HRT) in healthy postmenopausal women.
Methods : Bone mineral density of nondominant distal forearm in 89 postmenopausal women was measured by pQCT. We measured serum alkaline phosphatase(ALP) and intact osteocalcin(iOC, Novocalcin™) as bone formation markers, urinary deoxypyridinoline(dPyr, PyriLinks-D™) as bone resorption marker by using enzyme immunoassay. After 1 year of HRT, 54 subjects dropped out and 33 subjects were reevaluated.
Results : After 1 year of HRT, the dropout rate was 61%. There was no significant difference in age, age of menopause, years since menopause, initial BMD, initial bone markers between remained and drop-out groups. But osteocalcin level was significantly high in remained group(p=0.02). ALP(-27.6%), iOC(-29.9%), dPyr(-25.2%) were significantly decreased after 1 year of HRT(p<0.001). Trabecular BMD was increased by 2.4%(p=0.003), but the percentage change of total and cortical BMD was not significant(p>0.05). The levels of BMD and bone markers between before and after was significantly correlated, demonstrating the homogeneity of response to HRT. The percentage change of trabecular BMD was negatively correlated with the percentage change of dPyr after HRT(r=-0.45, p=0.01). The variance of the percentage change of dPyr contributed to the percentage chang of trabecular BMD by 20%. There was no correlation between the percentage change of total BMD or cortical BMD and the change of ALP, iOC, or dPyr after HRT.
Conclusion : After 1 year of HRT in postmenopausal women, all biochemical bone markers were decreased significantly, whereas only trabecular BMD measured by pQCT was increased significantly. This result suggests that bone markers was more sensitive than BMD to monitor the therapeutic efficacy of HRT. The percentage change of trabecular BMD was correlated with the change of dPyr after HRT only. dPyr might be the most sensitive marker among bone markers tested. Therefore, we can predict the change of BMD after HRT through monitoring the levels of dPyr.
Background : Previous studies have suggested that regular exercise may increase bone mineral density. However the effects on bone mineral density are different depending on the types of exercises and recent studies on the effects of different exercises on bone mineral density are insufficient. This study was conducted to assess the effects of 2 different exercises(Judo, Taekwondo) and physical fitness(back muscle strength, grip strength, broad jump, vertical jump, flexibility, sit ups) on regional BMD.
Methods : Subjects were healthy adults female volunteers aged 19 to 22 years and consisted of eight Judo athletes, twelve Taekwondo athletes, and eight nonathletic controls. We measured their bone mineral density of lumbar spine, femur neck, femoral greater trochanter, Ward's triangle, femoral shaft and distal radius using dual exergy X-ray absorptiometry and assessed their physical fitness. We investigated the mean differences of regional bone mineral density between the groups and the relationships between physical fitness and regional bone mineral density.
Results : ANCOVA revealed that there were significant differences in the regional bone mineral density between the groups. The Judo athletes group had significantly higher bone density of greater trochanter, femoral shaft, distal radius, femoral neck and lumbar spine that the control group and had significantly higher bone density of greater trochanter, femoral shaft and distal radius than the Taekwondo athletes group. There were no significant differences of bone density in all the regions between the Taekwondo athletes and the control groups. Partial correlation coefficients between the back muscle strength and the bone density of Ward's triangle, greater trochanter, distal radius, femoral neck, femoral shaft, and lumbar were 0.581, 0.570, 0.526, 0.502, 0.424 and 0.418, respectively(P<0.05). Correlation coefficients between the broad jump and the bone density of femoral neck, greater trochanter, and femoral shaft were 0.577, 0.539 and 0.457, respectively(P<0.05). Correlations of the grip strength, flexibility, sit ups and vertical jump with bone density of all regions were not high(r≤0.5).
Conclusion : Different types of exercises showed different effects of bone density. The back muscle strength among the physical fitness factors was considered to be the most important predictor of bone density. In the future, further studies are necessary for the effects of other exercises on bone density.
Background : The improvement is social economic standard of living and aging bring high attention to osteoporosis in women. Many studies have been released so far about how effectively Hormone Replacement Therapy(HRT) in postmenopausal women works for the increase in Bone Mineral Density(BMD) in hip and vertebrae with the different rate of bone formation. In addition, it has been believed that HRT could increase BMD of hip and lumbar vertebrae reduce fractures caused by osteoporosis. In this study, we will find the effect of HRT on the increase in BMD of lumbar vertebrae and hip in postmenopausal women, by measuring and comparing BMD of lumbar vertebrae with high rate of trabecular bone to that of hip with high rate of cortical bone one year after HRT in postmenopausal women.
Methods : Subjects were 48 out of 325 postmenopausal women patients who visited osteoporosis clinic, Sun Hospital, Taejeon, from January, 1995 to December, 1995 and had the osteoporosis test and the vertebrae osteoporosis test one year after. We compared and analyzed the change of BMD in each part by retesting BMD of lumbar vertebrae and hip one year after the continuous HRT in women. SPSS/PC was used for statistical procedure.
Results : Subjects have mean age of 54.8±4.5 years, mean menopausal age of 48.4±3.5 years, mean postmenopause period of 6.5±5.9 years, mean body mass index 23.4±3.1kg/m², mean weight of 56.7±7.8kg and mean height of 154±5.5cm. No correlation was observed of their age, menopausal age, the number of years since menopause and body mass index to the changing rate of BMD in lumbar vertebrae and femur one year after HRT in women. The BMD prior to treatment was, respectively, as follows ; L2-L4(0.8983±0.11g/cm²), Hip(neck, 0.7597±0.10g/cm² ; trochanter, 0.6259±0.08g/cm² ; Ward's triangle, 0.5186±0.90g/cm²), and that one year after treatment ; L2-L4(0.9277±0.11g/cm²), Hip(neck 0.7592±0.00g/cm² ; trochanter, 0.6322±0.08g/cm² l Ward's triangle, 0.5340±0.09g/cm²). There was significant increase in BMD of lumbar vertebrae and femur Ward's triangle(P<0.01) among BMD of each part one year after HRT, but BMD of femur nexk and that of trochanter region has no significant increase.
Conclusion : It was found that one year treatment with HRT in postmenopausal women resulted in significant increase in BMD of not only lumbar vertebrae with lots of trabecular bone but also Ward's triangle regions of femur, regardless of age and postmenopausal period of postmenopausal women at the beginning of treatment. It is considered that HRT may be effective in preventing osteoporotic fractures of lumbar vertebrae and hip on postmenopausal women, and that postmenopausal period would not be an important factor in the beginning of HRT treatment.
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