Journal of Preventive Medicine and Public Health

  • 제54권4호
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  • Pages.284-292
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  • 2021
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  • 1975-8375(pISSN)
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  • 2233-4521(eISSN)
대한예방의학회 (The Korean Society for Preventive Medicine)
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Association Between Parity and Low Bone Density Among Postmenopausal Korean Women

  • Seo, Eunsun (Department of Preventive Medicine, Yonsei University College of Medicine) ;
  • Lee, Yongrong (Department of Preventive Medicine, Yonsei University College of Medicine) ;
  • Kim, Hyeon Chang (Department of Preventive Medicine, Yonsei University College of Medicine)
  • 투고 : 2021.03.26
  • 심사 : 2021.06.10
  • 발행 : 2021.07.31
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초록

Objectives: Low bone density (LBD) in the postmenopausal period has long been a pervasive public health concern; however, the association between parity and LBD has yet to be fully elucidated. Thus, we investigated the association between parity and LBD in postmenopausal Korean women. Methods: This study used baseline data from 1287 Korean postmenopausal women aged 40 years or older enrolled in the Cardiovascular and Metabolic Diseases Etiology Research Center community-based cohort study conducted in Korea from 2013 to 2017. The main exposure was parity (nullipara, 1, 2, 3+). The main outcome was LBD, including osteopenia and osteoporosis, based on bone mineral density measured using quantitative computed tomography of the lumbar spine (L1-2). Results: The mean age of participants was 57.1 years, and the median parity was 2. Of the 1287 participants, 594 (46.2%) had osteopenia and 147 (11.4%) had osteoporosis. No significant difference in the prevalence of LBD was found between nullipara and parous women, whereas higher parity was associated with a higher risk of LBD among parous women; the adjusted odds ratio (95% confidence interval) for the presence of LBD was 1.40 (0.97 to 2.02) for a parity of 2 and 1.95 (1.23 to 3.09) for a parity of 3 relative to a parity of 1. Conclusions: Women who have given birth multiple times may be at greater risk of bone loss after menopause; therefore, they should be a major target population for osteoporosis prevention.

키워드

과제정보

This study was supported by a grant (HI13C0715) from the Korea Health Technology R&D Project, funded by the Ministry of Health and Welfare of the Republic of Korea.

참고문헌

  1. Yan G, Huang Y, Cao H, Wu J, Jiang N, Cao X. Association of breastfeeding and postmenopausal osteoporosis in Chinese women: a community-based retrospective study. BMC Womens Health 2019;19(1):110. https://doi.org/10.1186/s12905-019-0808-0
  2. Park EJ, Joo IW, Jang MJ, Kim YT, Oh K, Oh HJ. Prevalence of osteoporosis in the Korean population based on Korea National Health and Nutrition Examination Survey (KNHANES), 2008-2011. Yonsei Med J 2014;55(4):1049-1057. https://doi.org/10.3349/ymj.2014.55.4.1049
  3. Pasco JA, Seeman E, Henry MJ, Merriman EN, Nicholson GC, Kotowicz MA. The population burden of fractures originates in women with osteopenia, not osteoporosis. Osteoporos Int 2006;17(9):1404-1409. https://doi.org/10.1007/s00198-006-0135-9
  4. Park C, Ha YC, Jang S, Jang S, Yoon HK, Lee YK. The incidence and residual lifetime risk of osteoporosis-related fractures in Korea. J Bone Miner Metab 2011;29(6):744-751. https://doi.org/10.1007/s00774-011-0279-3
  5. Hwang IR, Choi YK, Lee WK, Kim JG, Lee IK, Kim SW, et al. Association between prolonged breastfeeding and bone mineral density and osteoporosis in postmenopausal women: KNHANES 2010-2011. Osteoporos Int 2016;27(1):257-265. https://doi.org/10.1007/s00198-015-3292-x
  6. Lee EN. Effects of parity and breastfeeding duration on bone density in postmenopausal women. Asian Nurs Res (Korean Soc Nurs Sci) 2019;13(2):161-167. https://doi.org/10.1016/j.anr.2019.04.002
  7. Cooke-Hubley S, Kirby BJ, Valcour JE, Mugford G, Adachi JD, Kovacs CS. Spine bone mineral density increases after 6 months of exclusive lactation, even in women who keep breastfeeding. Arch Osteoporos 2017;12(1):73. https://doi.org/10.1007/s11657-017-0368-6
  8. More C, Bettembuk P, Bhattoa HP, Balogh A. The effects of pregnancy and lactation on bone mineral density. Osteoporos Int 2001;12(9):732-737. https://doi.org/10.1007/s001980170048
  9. Crandall CJ, Liu J, Cauley J, Newcomb PA, Manson JE, Vitolins MZ, et al. Associations of parity, breastfeeding, and fractures in the Women's Health Observational Study. Obstet Gynecol 2017;130(1):171-180. https://doi.org/10.1097/aog.0000000000002096
  10. Wang Q, Huang Q, Zeng Y, Liang JJ, Liu SY, Gu X, et al. Parity and osteoporotic fracture risk in postmenopausal women: a dose-response meta-analysis of prospective studies. Osteoporos Int 2016;27(1):319-330. https://doi.org/10.1007/s00198-015-3351-3
  11. Song SY, Kim Y, Park H, Kim YJ, Kang W, Kim EY. Effect of parity on bone mineral density: a systematic review and meta-analysis. Bone 2017;101:70-76. https://doi.org/10.1016/j.bone.2017.04.013
  12. Ma XH, Zhang W, Wang Y, Xue P, Li YK. Comparison of the spine and hip BMD assessments derived from quantitative computed tomography. Int J Endocrinol 2015;2015:675340.
  13. Li N, Li XM, Xu L, Sun WJ, Cheng XG, Tian W. Comparison of QCT and DXA: osteoporosis detection rates in postmenopausal women. Int J Endocrinol 2013;2013:895474. https://doi.org/10.1155/2013/895474
  14. American College of Radiology. ACR-SPR-SSR practice parameter for the performance of musculoskeletal quantitative computed tomography (QCT); 2018 [cited 2021 Mar 1]. Available from: https://www.acr.org/-/media/ACR/Files/PracticeParameters/qct.pdf.
  15. Allali F, Maaroufi H, Aichaoui SE, Khazani H, Saoud B, Benyahya B, et al. Influence of parity on bone mineral density and peripheral fracture risk in Moroccan postmenopausal women. Maturitas 2007;57(4):392-398. https://doi.org/10.1016/j.maturitas.2007.04.006
  16. Peker N, Tosun OC. Is grand multiparity a risk factor for the development of postmenopausal osteoporosis? Clin Interv Aging 2018;13:505-508. https://doi.org/10.2147/CIA.S155793
  17. Kritz-Silverstein D, Barrett-Connor E, Hollenbach KA. Pregnancy and lactation as determinants of bone mineral density in postmenopausal women. Am J Epidemiol 1992;136(9):1052-1059. https://doi.org/10.1093/oxfordjournals.aje.a116570
  18. Kalkwarf HJ, Specker BL. Bone mineral loss during lactation and recovery after weaning. Obstet Gynecol 1995;86(1):26-32. https://doi.org/10.1016/0029-7844(95)00083-4
  19. Lopez JM, Gonzalez G, Reyes V, Campino C, Diaz S. Bone turnover and density in healthy women during breastfeeding and after weaning. Osteoporos Int 1996;6(2):153-159. https://doi.org/10.1007/BF01623940
  20. Reid IR, Bristow SM, Bolland MJ. Calcium supplements: benefits and risks. J Intern Med 2015;278(4):354-368. https://doi.org/10.1111/joim.12394