대한지역사회영양학회지 (Korean Journal of Community Nutrition)

대한지역사회영양학회 (The Korean Society of Community Nutrition)
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폐경비만여성의 골밀도와 골대사 지표 및 식사의 질 상관성 조사

Relationship between Bone Mineral Density and Bone Metabolic Biochemical Markers and Diet Quality Index-International(DQI-I) in Postmenopausal Obese Women

  • 정연아 (원광대학교병원 영양팀) ;
  • 김미성 (원광대학교 식품영양학과) ;
  • 신새론 (원광대학교병원 가정의학과) ;
  • 한아름 (원광대학교병원 가정의학과) ;
  • 서검석 (원광대학교 의과대학 내과학교실, 소화기질환연구소) ;
  • 손정민 (원광대학교 식품영양학과)
  • Jeong, Yeonah (Department of Nutrition Services, Wonkwnag University Hospital) ;
  • Kim, Misung (Department of Food and Nutrition, Wonkwang University) ;
  • Shin, Saeron (Department of Family Medicine, Wonkwang University Hospital) ;
  • Han, Ahreum (Department of Family Medicine, Wonkwang University Hospital) ;
  • Seo, Geomsuk (Department of Internal Medicine, Digestive Disease Research Institute, Wonkwang University College of Medicine) ;
  • Sohn, Cheongmin (Department of Food and Nutrition, Wonkwang University)
  • 투고 : 2016.06.13
  • 심사 : 2016.06.22
  • 발행 : 2016.06.30
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초록

Objectives: This study compared the differences of postmenopausal women's bone mineral density in relation to the degree of obesity, metabolism index and dietary factors that affect bone mineral density. Methods: The subjects included in the study are 39 postmenopausal women of normal weight with body mass index less than $25kg/m^2$ and 32 postmenopausal who are obese. Anthropometry and biochemical analysis were performed and nutrient intakes and DQI-I were assessed. Results: Normal weight women were $56.03{\pm}3.76years$ old and obese women were $58.09{\pm}5.13years$ old and there was no significant difference in age between the two groups. The T-score of bone mineral density was $0.03{\pm}1.06$ in normal weight women and $-0.60{\pm}1.47$ in obese women and this was significantly different between the two groups (p<0.05). Blood Leptin concentration was significantly lower in normal weight women ($6.09{\pm}3.37ng/mL$) compared to obese women in ($9.01{\pm}4.99ng/mL$) (p<0.05). The total score of diet quality index-international was $70.41{\pm}9.34$ in normal weight women and $64.93{\pm}7.82$ in obese women (p<0.05). T-score of bone mineral density showed negative correlations with percentage of body fat (r = -0.233, p=0.05), BMI (r = -0.197, p=0.017), triglyceride (r = -0.281, p=0.020) and leptin (r = -0.308, p=0.011). The results of multiple regression analysis performed as the method of entry showed that with 22.0% of explanation power, percentage of body fat (${\beta}=-0.048$, p<0.05), triglyceride (${\beta}=-0.005$, p<0.05) and HDL-cholesterol (${\beta}=0.034$, p<0.01), moderation of DQI-I (${\beta}=-0.231$, p<0.05) affected T-score significantly. Conclusions: The results of the study showed that obese women have less bone density than those with normal weight women. In addition, the factor analysis result that affect bone mineral density showed that intake of fat is a very important factor. Therefore, postmenopausal women need to maintain normal weight and manage blood lipid levels within normal range. They also need to take various sources of protein and reduce consumption of empty calorie foods that have high calories, fat, cholesterol and sodium.

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참고문헌

  1. Baik IK, Shin C. Association of daily sleep duration with obesity, macronutrient intake, and physical activity. Korean J Community Nutr 2011; 16(3): 315-323. https://doi.org/10.5720/kjcn.2011.16.3.315
  2. Ministry of Health and Welfare and Korea Centers for Disease Control and Prevention. Korea Health Statistics 2014: Korea National Health and Nutrition Examination Survey [KNHANES VI-2] [internet]. 2015 [cited 2016 May 01]. Available from: https://knhanes.cdc.go.kr/knhanes/index.do.
  3. Neeland IJ, Turer AT, Ayers CR, Powell-Wiley TM, Vega GL, Farzaneh-Far R et al. Dysfunctional adiposity and the risk of prediabetes and type 2 diabetes in obese adults. JAMA 2012; 308(11): 1150-1159. https://doi.org/10.1001/2012.jama.11132
  4. Meier U, Gressner AM. Endocrine regulation of energy metabolism: review of pathobiochemical and clinical chemical aspects of leptin, ghrelin, adiponectin, and resistin. Clin Chem 2004; 50(9): 1511-1525. https://doi.org/10.1373/clinchem.2004.032482
  5. Kershaw EE, Flier JS. Adipose tissue as an endocrine organ. J Clin Endocrinol Metab 2004; 89(6): 2548-2556. https://doi.org/10.1210/jc.2004-0395
  6. Christenson RH. Biochemical markers of bone metabolism: an overview. Clin Biochem 1997; 30(8): 573-593. https://doi.org/10.1016/S0009-9120(97)00113-6
  7. Ministry of Health and Welfare and Korea Centers for Disease Control and Prevention. Korea Health Statistics 2010: Korea National Health and Nutrition Examination Survey [KNHANES V-1] [internet]. 2012 [cited 2016 May 01]. Available from: https://knhanes.cdc.go.kr/knhanes/index.do.
  8. Park JY, Choi MY, Lee SH, Choi YH, Park YK. The association between bone mineral density, bone turnover markers and nutrient intake in pre- and postmenopausal women. Korean J Nutr 2011; 44(1): 29-40. https://doi.org/10.4163/kjn.2011.44.1.29
  9. Filip R, Raszewski G. Bone mineral density and bone turnover in relation to serum leptin, alpha-ketoglutarate and sex steroids in overweight and obese postmenopausal women. Clin Endocrinol 2009; 70(2): 214-220. https://doi.org/10.1111/j.1365-2265.2008.03313.x
  10. Choi YH, Sung CJ. Effects of physiological factors and lifestyles on bone mineral density in postmenopausal women. Korean J Nutr 2007; 40(6): 517-525.
  11. Oh HJ, Lim CH, Chung HY, Han KO, Chang HC, Yoon HK et al. Effect of obesity on BMD in postmenopausal women. Korean J Obes 2000; 9(2): 122-127.
  12. Compston JE, Watts NB, Chapurlat R, Cooper C, Boonen S, Greenspan S et al. Obesity is not protective against fracture in postmenopausal women: GLOW. Am J Med 2011; 124(11): 1043-1050. https://doi.org/10.1016/j.amjmed.2011.06.013
  13. Hu FB. Dietary pattern analysis: a new direction in nutritional epidemiology. Curr Opin Lipidol 2002; 13(1): 3-9. https://doi.org/10.1097/00041433-200202000-00002
  14. Kim S, Haines PS, Siega-Riz AM, Popkin BM. The Diet Quality Index-International (DQI-I) provides an effective tool for crossnational comparison of diet quality as illustrated by China and the United States. J Nutr 2003; 133(11): 3476-3484. https://doi.org/10.1093/jn/133.11.3476
  15. Sipila S, Narici M, Kjaer M, Pollanen E, Atkinson RA, Hansen M et al. Sex hormones and skeletal muscle weakness. Biogerontology 2013; 14(3): 231-245. https://doi.org/10.1007/s10522-013-9425-8
  16. Czarkowska-Paczek B, Milczarczyk S. Age-related muscle mass loss. Przegl Lek 2006; 63(8): 658-661.
  17. Christenson RH. Biochemical markers of bone metabolism: an overview. Clin Biochem 1997; 30(8): 573-593. https://doi.org/10.1016/S0009-9120(97)00113-6
  18. Ho-Pham LT, Nguyen ND, Lai TQ, Nguyen TV. Contributions of lean mass and fat mass to bone mineral density: a study in postmenopausal women. BMC Musculoskelet Disord 2010; DOI:10.1186/1471-2474-11-59.
  19. Ijuin M, Douchi T, Matsuo T, Yamamoto S, Uto H, Nagata Y. Difference in the effects of body composition on bone mineral density between pre- and postmenopausal women. Maturitas 2002; 43(4): 239-244. https://doi.org/10.1016/S0378-5122(02)00273-6
  20. Reid IR, Ames R, Evans MC, Sharpe S, Gamble G, France JT et al. Determinants of total body and regional bone mineral density in normal postmenopausal women-a key role for fat mass. J Clin Endocrinol Metab 1992; 75(1): 45-51. https://doi.org/10.1210/jc.75.1.45
  21. Hsu YH, Venners SA, Terwedow HA, Feng Y, Niu T, Li Z et al. Relation of body composition, fat mass, and serum lipids to osteoporotic fractures and bone mineral density in Chinese men and women. Am J Clin Nutr 2006; 83(1): 146-154. https://doi.org/10.1093/ajcn/83.1.146
  22. Park SJ, Ahn YJ, Min HS, Oh KS, Park C, Cho NH et al. Osteoporosis prevalence of radius and tibia and related factors using multiple bone sites quantitative ultrasound measurement of the Korean health and genome study cohort women. Korean J Community Nutr 2005; 10(4): 536-545.
  23. Koo JO, Park SY. Analysis of BMI menopose, blood pressure and dietary habits affecting born mineral density of 30-60 years women. Korean J Community Nutr 2010; 15(3): 403-414.
  24. Ducy P, Amling M, Takeda S, Priemel M, Schilling AF, Beil FT et al. Leptin inhibits bone formation through a hypothalamic relay: a central control of bone mass. Cell 2000; 100(2): 197-207. https://doi.org/10.1016/S0092-8674(00)81558-5
  25. Burguera B, Hofbauer LC, Thomas T, Gori F, Evans GL, Khosla S et al. Leptin reduces ovariectomy-induced bone loss in rats. Endocrinology 2001; 142(8): 3546-3553. https://doi.org/10.1210/endo.142.8.8346
  26. Holloway WR, Collier FM, Aitken CJ, Myers DE, Hodge JM, Malakellis M et al. Leptin inhibits osteoclast generation. J Bone Miner Res 2002; 17(2): 200-209. https://doi.org/10.1359/jbmr.2002.17.2.200
  27. Lee MY, Kim JH. Comparison of serum insulin, leptin, adiponectin and high sensitivity C-reactive protein levels according to body mass index and their associations in adult women. Korean J Community Nutr 2011; 16(1): 126-135. https://doi.org/10.5720/kjcn.2011.16.1.126
  28. Yeo JK, Lee SJ, Joo IW, Kim JA, Oh HJ. Age-related changes of serum bone turnover marker (osteocalcin, bone specific alkaline phosphatase and cross-linked C telopeptides of type I collagen) and the relationship with bone mineral density in Korean women. Osteoporosis 2008; 6(1): 43-50.
  29. Yang R, Ma X, Pan X, Wang F, Luo Y, Gu C et al. Serum osteocalcin levels in relation to metabolic syndrome in Chinese postmenopausal women. Menopause 2013; 20(5): 548-553.
  30. Bae SJ, Choe JW, Chung YE, Kim BJ, Lee SH, Kim HY et al. The association between serum osteocalcin levels and metabolic syndrome in Koreans. Osteoporos Int 2011; 22(11): 2837-2846. https://doi.org/10.1007/s00198-010-1504-y
  31. Zeng FF, Xue WQ, Cao WT, Wu BH, Xie HL, Fan F et al. Diet-quality scores and risk of hip fractures in elderly urban Chinese in Guangdong, China: a case-control study. Osteoporos Int 2014; 25(8): 2131-2141. https://doi.org/10.1007/s00198-014-2741-2
  32. Yamaguchi T, Sugimoto T, Yano S, Yamauchi M, Sowa H, Chen Q et al. Plasma lipids and osteoporosis in postmenopausal women. Endocr J 2002; 49(2): 211-217. https://doi.org/10.1507/endocrj.49.211
  33. Cui LH, Shin MH, Chung EK, Lee YH, Kweon SS, Park KS et al. Association between bone mineral densities and serum lipid profiles of pre- and post-menopausal rural women in South Korea. Osteoporos Int 2005; 16(12): 1975-1981. https://doi.org/10.1007/s00198-005-1977-2
  34. Luegmayr E, Glantschnig H, Wesolowski GA, Gentile MA, Fisher JE, Rodan GA et al. Osteoclast formation, survival and morphology are highly dependent on exogenous cholesterol/lipoproteins. Cell Death Differ 2004; 11(Suppl 1): S108-118. https://doi.org/10.1038/sj.cdd.4401399
  35. Parhami F, Demer LL. Arterial calcification in face of osteoporosis in ageing: can we blame oxidized lipids? Curr Opin Lipidol 1997; 8(5): 312-314. https://doi.org/10.1097/00041433-199710000-00010