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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.
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.
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.
Total LM has a protective effect on BMD and FM can have a detrimental effect on BMD besides its skeletal loading effect.
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Uric acid has been reported to function both as an oxidant or antioxidant depending on the context. A previous study in the Korean population reported a positive linear association between serum uric acid level and arterial stiffness in men, but little is known about how serum uric acid level is related to the risk of increased arterial stiffness in Korean postmenopausal women.
We performed a cross-sectional study of 293 subjects who participated in a health examination program run by the health promotion center of Gangnam Severance Hospital between October 2007 and July 2010. High brachial-ankle pulse wave velocity was defined as a brachial-ankle pulse wave velocity of more than 1,450 cm/s. The odds ratios (ORs) for high brachial-ankle pulse wave velocity were calculated using multivariate logistic regression analysis across uric acid quartiles after adjusting for other indicators of cardiovascular risk.
The 293 postmenopausal women were divided into quartiles according to uric acid level. The mean brachial-ankle pulse wave velocity values of each quartile were as follows: Q1, 1,474 cm/s; Q2, 1,375 cm/s; Q3, 1,422 cm/s; Q4, 1,528 cm/s. The second quartile was designated as the control group based on mean brachial-ankle pulse wave velocity value. Multivariate adjusted ORs (95% confidence intervals) for brachial-ankle pulse wave velocity across the uric acid quartiles were 2.642 (Q1, 1.095–6.3373), 1.00, 4.305 (Q3, 1.798–10.307), and 4.375 (Q4, 1.923–9.949), after adjusting for confounding variables.
Serum uric acid level has a J-shaped association with arterial stiffness in Korean postmenopausal women.
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Pregnancy considerably alters cardiovascular dynamics, and thereby affects the transition of blood pressure after delivery in women. We aimed to analyze the association between parity and blood pressure in Korean adult women.
We included 8,890 women who participated in Korean National Health and Nutrition Examination Survey between 2010 and 2012. We divided the population according to the menopause status and analyzed the association between parity and blood pressure by using multiple regression analysis, and on hypertension, by using logistic regression analysis.
Systolic and diastolic blood pressures were significantly associated with parity in premenopausal women (β=-0.091 [P<0.001] and β=-0.069 [P<0.001], respectively). In the analysis that excluded women receiving antihypertensive medication, the systolic and diastolic blood pressure of postmenopausal women were significantly associated with parity (β=-0.059 [P=0.022] and β=-0.054 [P=0.044], respectively). Parity was found to prevent hypertension after adjustment for confounders in postmenopausal women (odds ratio, 0.55; 95% confidence interval, 0.310-0.985).
We found that parity prevented hypertension in Korean women.
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Although several risk factors associated with reduced age at natural menopause (ANM) have been investigated, the results are inconsistent. Excessive stress, which leads to elevation of stress hormones, can also negatively affect reproductive ability, including by accelerating menopause. However, a direct association between stress level and ANM has not yet been demonstrated. Therefore, the object of this study was to investigate the association between stress level and ANM in Korean women.
Study participants were Korean women between 40 and 70 years old who were in natural menopause during the 5th Korean National Health and Nutrition Examination Survey (n=3,176). The level of stress in daily life was estimated based on data from the mental health topics of the survey. We used the t-test and one-way analysis of variance to analyze the correlation between stress level and ANM. Regression (β) coefficients calculated by multiple regression analysis were used to estimate various factors affecting ANM.
Women who experienced a high level of stress in daily life had a lower mean ANM than women with a low stress level (50.17±3.7 and 50.58±3.5 years, respectively), with a statistically significant correlation (P<0.05). This correlation was still observed after adjusting for age, body mass index, menstrual regularity, and personal income (P<0.05 for variables).
In Korean women between 40 and 70 years of age who are in natural menopause, there is a statistically significant correlation between stress level and ANM. In particular, women who experience a high level of stress in daily life have reduced ANM.
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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.
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.
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).
This study does not support the idea that coffee is a risk factor for impaired bone health in Korean premenopausal women.
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With metabolic syndrome (MS) being a major risk factor for cardiovascular disease, and central obesity being a major predisposing factor for MS, intensive research is currently being performed on cutoff values according to race and sex. Menopause is an especially significant factor in designating cutoff values for female central obesity, as menopause brings sudden bodily changes that induce central obesity and increased prevalence of MS. Therefore this study aimed to investigate the cutoff values for the obesity index and its validity in predicting the criteria for MS in Korean women according to menstrual status.
The study focused on 3,103 women 20 years of age or older participating in the 2007 Korea National Health and Nutrition Examination Survey. Definitions of non-adipose components of MS were defined by the International Diabetes Federation, and menstrual status was judged on the basis of survey results. The sensitivity, specificity, and positive and negative predictive values of the central obesity index (body mass index [BMI], waist circumference [WC], waist-to-height ratio [WHtR]) according to menstrual status for two or more non-adipose components of MS were calculated based on the Youden index.
Area under the curve (AUC) values predicting the presence of two or more metabolic risk factors were higher in pre-menopausal women, with AUC values for BMI, WC, and WHtR being, in pre- and post-menopausal women, 23.1 kg/m2 vs. 23.9 kg/m2, 76.1 cm vs. 82.5 cm, and 0.49 vs. 0.53, respectively. The WC cut off (76 cm) for pre-menopausal women was found to be more sensitive and more effective at screening for MS risks than the cutoff value given by the Korea Society for the Study of Obesity.
The central obesity index showed better predictability for MS risk in pre-menopausal women. Because the central obesity index cutoff values are lower in pre-menopausal women, the possibility of metabolic risk can be considered for pre-menopausal women with WC lower than 85 cm. Assessment and control of other risks are needed accordingly for preventing the development of MS.
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Whole body vibration (WBV) confers a continuous vibration stimuli to the body. While some reports have described the effects of WBV on bone mineral density, muscle mass, muscle power, study of WBV effects on body composition in postmenopausal women is rare. The aim of this pilot study was to examine the effect of WBV on the changes of body weight and body composition in postmenopausal women.
Fifteen postmenopausal healthy and obese women who were on staff of one university hospital staff located in Suwon, Korea were voluntarily recruited. Inclusion criteria were age over 50 years, and body mass index (BMI) ≥25 kg/m2. WBV group training was performed in 10 minute sessions twice weekly for 8 weeks. Before and after training, anthropometric measurements and body composition analysis were performed.
Weight (-1.18 ± 1.61 kg), BMI (-0.49 ± 0.66 kg/m2), waist circumference (-2.34 ± 2.48 cm) and muscle mass (-0.54 ± 0.59 kg) decreased significantly the 8 week intervention. Decrease of muscle mass was correlated with weight (r = 0.621, P = 0.013), BMI (r = 0.596, P = 0.019) and percent body fat (r = -0.518, P = 0.048). Linear regression analysis revealed that the changes of muscle mass had negative relationship with percent body fat change and a positive relationship with body weight changes.
WBV might display a weak but positive effect on body weight and waist circumference reduction in healthy postmenopausal obese women. However, attention must be given to avoid a decrease of muscle mass.
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The study of the correlation of menopausal symptoms with heart rate variability (HRV) has not been adequate. The aim of this study was to investigate the relationship between postmenopausal symptoms measured by the menopause rating scale (MRS) and HRV.
We assessed postmenopausal symptoms (using MRS) with age, BMI, educational status, occupation, marital status, alcohol and caffeine consumption, smoking history, exercise, duration of sleep and amenorrhea, degree of anxiety and depression, menarcheal age, and heart rate variability. For evaluation of HRV, the record of electrocardiogram for 5 minutes in the resting state was divided into temporal categories and frequency categories, and analyzed.
No significant differences in age, BMI, duration of amenorrhea, heart rate, systolic blood pressure, diastolic blood pressure, fasting blood sugar, triglyceride, and high-density lipoprotein were observed between two groups, which were divided according to menopausal symptoms. Low frequency/high frequency (LF/HF) ratio was significantly higher in symptomatic women, compared with asymptomatic women (P < 0.05). No significant differences of HRV index by the severity of postmenopausal symptoms were observed. LF/HF ratio of HRV parameters showed a significant increase in moderate or severe degree of "hot flashes" and "sleep problem" score (P < 0.05). Anxiety scale in symptomatic women was significantly higher than in asymptomatic women (P < 0.05).
The above data suggest that postmenopausal symptoms are associated with altered autonomic control of heart rate. In particular, hot flashes and sleep problems in moderate or severe degree are related to increase of sympathetic nerve activity.
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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.
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.
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.
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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