• Nutrition Research and Practice
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• 제16권6호
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• pp.775-788
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• 2022

BACKGROUND/OBJECTIVES: The prevalence of vitamin D deficiency in Koreans is quite high; however, until recently, Korean National Health and Nutrition Survey (KNHANES) had not analyzed the vitamin D intake among Koreans. Additionally, the Korean Dietary Reference Intake for vitamin D was established based on insufficient evidence. Therefore, we investigated vitamin D intake and its relationship with bone mineral density (BMD) in Korean adults using the combined data from the 2009-2011 KNHANES. MATERIALS AND METHODS: This study was conducted in 11,949 healthy adults. Vitamin D intake was assessed using a 24-h recall method, and the BMD was measured using dual-energy X-ray absorptiometry. RESULTS: The prevalence of vitamin D deficiency (< 20 ng/mL) was 64% in men and 77% in women. In women aged ≥ 50 yrs and men aged < 50 yrs, there was a significant positive correlation between vitamin D intake and serum 25-hydroxyvitamin D level after sun exposure adjustment. The BMD of postmenopausal women aged ≥ 50 yrs with a vitamin D intake of 5 ㎍/day or more was significantly higher than that of women with intake less than 5 ㎍/day. After adjusting for age, energy, and calcium intake, the vitamin D intake of the osteoporotic group was significantly lower than that of the osteopenia group in women. CONCLUSIONS: Since the relationship between vitamin D intake and BMD was observed in women aged ≥ 50 yrs, further research is needed to clarify these findings using cohort or randomized controlled trials.

• 대한방사선기술학회지:방사선기술과학
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• 제31권1호
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• pp.25-31
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• 2008

목적: 이중 에너지 X선 흡수 계측(DEXA, Dual Energy X-ray Absorptiometry)을 이용한 골다공증 진단 시 부위 별로 골다공증에 대한 진단 불일치도를 파악하고, 연령의 증가에 따른 골다공증 진단 일치 여부를 조사하여 골절 예방과 치료에 대한 기초 자료를 제공하고자 하였다. 연구대상 및 방법: 골절 및 정형외과적 수술이 없는 여성 220명을 대상으로 요추부 $1{\sim}4$번과 고관절의 대퇴경부, Ward's triangle 그리고 전완부의 Ultra digital 부위의 골밀도를 측정하였다. 요추부와 대퇴경부, 전완부의 진단 일치 여부를 위해 각 부위 별 골감소증, 골다공증을 구별하여 분석하였고, 연령의 증가에 따른 진단의 불일치도를 파악하였다. 통계처리는 전완부와 대퇴 경부, 요추부 골밀도의 상관분석을 하였고, 각 부위 T-score 비교는 $x^2$-test를 사용하여 유의성 검정을 하였고, p < 0.05인 경우를 유의한 차이로 판정하였다. 결과: 대상자의 요추부 골밀도는 정상이 57명(25.9%), 골감소증군 86명(39.1%), 골다공증군은 77명(35.0%)이었다. 요추 4번에서는 골다공증군이 78명(35.5%)이었고, Ward's triangle은 126명(57.3%)에서 골다공증으로 진단되어 Ward's triangle에서 골밀도가 가장 낮았다. 요추부와 대퇴경부의 진단불일치율은 57%였고, 요추부와 전완은 43%, 전완과 대퇴경부는 51%로 나타났다. 정상군, 골감소증군, 골다공증군의 진단불일치율은 각각 39%, 63%, 42%로 나타나, 골감소증군에서 진단불일치율이 가장 높았다. 요추부가 정상일 때 불일치도는 30대, 40대, 50대, 60대, 70대에서 각각 25%, 23%, 11%, 65%, 86%로 나타나 60대 이후 불일치도가 급격히 높아졌다. 요추부가 골감소증이나 골다공증일 때는 30대, 40대, 50대, 60대, 70대에서 각각 62%, 55%, 36%, 20%, 9%로 나타나 연령이 높아질수록 불일치도는 낮아졌다. 결론: 골밀도는 연령증가에 따라 변화되고 부위에 따라 서로 차이가 있으므로 골밀도 검사는 요추와 대퇴경부, 전완을 각각 측정하여 차이를 살펴보는 것이 바람직하다. 진단의 불일치 정도가 60대와 70대, 그리고 골다공증군에서 가장 현저하였으며, 이는 두 부위 이상에서 불일치가 일어날 가능성이 있으므로 골절 위험 한계치의 측정에 각 부위별 골밀도 측정이 필요할 것으로 사료된다.

• Childhood Kidney Diseases
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• 제8권1호
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• pp.43-50
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• 2004

목 적 : 신 사구체 질환을 포함한 여러 질환에서 스테로이드가 장기간 투여되고 있다. 스테로이드의 장기간에 걸친 복용은 여러 가지의 부작용을 초래한다. 그중 골다공증은 성장기의 어린이들에는 심각한 부작용 중에 하나이다. 저자들은 신 사구체 질환으로 지속적인 스테로이드 투여를 진행하면서 위약과 pamidronate를 복용시켜 pamidronate의 골다공증 예방효과를 알아보고자 하였다. 이중 에너지 X선 흡수법(dual energy X-ray absorptiometry, DEXA)과 골대사의 생화학적 지표들을 이용하여 연구하였다. 방 법 : 본 연구는 혈뇨와 단백뇨가 동반되어 2003년 8월부터 2004년 2월 사이에 경희대학교 의과대학 부속병원 소아과에서 지속적인 스테로이드 투여를 3개월 이상 시행 중인 44명(M : F=25: 19)의 환아들을 대상으로 하였다. 대상 환아 44명 모두에게는 하루 500 mg의 칼슘제재가 공급되었고, 이 가운데 16명에게는 pamidronate(125 mg/cap)를 하루 1 cap씩 투여하였고, 다른 28명에게는 위약을 3개월간 투여하였다. 지속적인 스테로이드 투여를 시행 중 3개월 사이의 AST, ALT, 요소 질소, 크레아티닌, 칼슘과 인의 농도의 변화를 측정하였다. 골밀도의 변화는 이중 에너지 X-선 흡수법을 이용하여 측정하였고, 부갑상선 호르몬(PTH), 혈중 osteocalcin, 요중 dipyridinoline의 변화를 조사하였다. 결 과 : 골밀도 검사 상 대조군에서는 $0.754{\pm}0.211(g/cm^2)$에서 3개월 동안의 스테로이드 치료 후 $0.728{\pm}0.208(g/cm^2)$로 통계상 유의한 정도의 골밀도 감소를 보였다(P=0.0004). 반면 pamidronate를 투여한 그룹에서는 지속적인 스테로이드 치료를 받은 3개월 동안 골밀도가 $0.652{\pm}0.194(g/cm^2)$에서 $0.658{\pm}0.226(g/cm^2)$로 증가하였다. 비록 통계학적으로 유의한 증가 소견은 보이지 않았지만 대조군에 비해 스테로이드 치료에 의한 골밀도의 지속적인 저하를 예방하는 효과가 있음을 보여주었다. 결 론 : 장기 스테로이드 치료요법을 시행받는 환아에서 pamidronate 같은 biphosphonates 제재가 골밀도 저하를 예방하는데 유용하게 사용될 수 있을 것으로 사료된다.

• 한국식품영양학회지
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• 제24권4호
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• pp.786-796
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• 2011

The purpose of this study was to investigate the relationship between bone mineral density(BMD), body composition and life styles of female college students. The subjects were 334 students with a mean age of 21.0 years. BMDs of forearm and calcaneus were measured by dual energy X-ray absorptiometry, and body composition was measured by bioelectrical impedence analysis. The means for weight, height, and body mass index(BMI) of the subjects were 55.7 kg, 161.0 cm, 21.5 kg/$m^2$, respectively. Grouping by the BMI, 13.2% of the subjects were classified as overweight, and 11.1% of the subjects as obese group. BMD in the forearm and calcaneus were 0.390 g/$cm^2$, 0.514 g/$cm^2$. In the forearm, 58.1% and 9.6% of the subjects were classified as osteopenia and osteoporosis, respectively, and in the calcaneus, 12.0% and 0.3% of the subjects were classified as osteopenia and osteoporosis, respectively. Body weight, skeletal muscle mass, lean body mass, fat mass and BMI were positively correlated with BMDs in the forearm and calcaneus($r$=0.180~0.495, $p$ <0.01~0.001), and height, % body fat and waist-hip ratio(WHR) were positively correlated with BMDs in the calcaneus($r$=0.213~0.239, $p$ <0.001), but not in the forearm. The factors such as beginning age of cigarette smoking and alcohol drinking and exercise had significant influence on BMD($p$ <0.05; p<0.001), whereas sleeping hours, activity level, frequency of exercise, meal times, frequency of snack and fried food intake, breakfast skipping and amount of meal had not significant influence on BMD. Therefore, the acquisition of balanced body composition is necessary through the increase of fat free mass and muscle mass, not through the increase of fat mass among female college students.

• 한국식품영양학회지
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• 제24권4호
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• pp.630-638
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• 2011

This study was performed to assess the relationships among bone mineral density, anthropometric measurements, maternal factors and exercise in premenopausal and postmenopausal women. Anthropometric measurements were taken by a trained practitioner and the maternal factors of the 78 subjects in Gyeonggi-do were acquired by an interview questionnare. The BMD of the lumbar spine(L2~L4), femoral neck, Ward's triangles and trochanters were measured by dual energy X-ray absorptiometry. The mean age of the premenopausal women was 45.23 years and that of the postmenopausal women whose ase of menopause was 49.37 years was 61.27 years. The age, waist and waist to hip ratio of postmenopausal women were significantly higher than those of premenopausal women. BMD of the lumbar spine(L2~L4) in postmenopausal women was significantly higher than that of premenopausal women. Number of children and age at last delivery were significantly higher in postmenopausal women than those in premenopausal women. The BMDs of the lumbar spine and femoral neck of premenopausal women was positively correlated with weight, body mass index, waist and WHR and the BMDs of these two sites in postmenopausal women were positively correlated with height, and weight. In postmenopausal women, BMD of the lumbar spine was negatively correlated with duration time after menopause and BMD of the femoral neck was positively correlated with age at last delivery. These results suggest that it is necessary to maintain adequate body weight. Health management and education about performing more exercise are recommended for postmenopausal women to prevent osteoporosis.

• 대한간호학회지
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• 제33권3호
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• pp.312-320
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• 2003

Purpose: To investigate body compositons and bone mineral density(BMD) in college women and to find the relationship between them. Method: From January to March of 2001, BMD at four parts(forearm, lumbar, femur and whole body), body mass index(BMI), body fat mass(BFM), lean body mass(LBM) and body fat percentage(%Fat) were measured with the Dual Energy X-ray Absorptiometry. Other physical characteristics were measured with a scale, a height measurer, and questionnaires. Result: Grouping by the BMI, 43.2% showed low weight, and 5% over weight. When applying the percent Fat, 43.8 % was diagnosed as obesity group. The fact indicate that a majority of college women have unbalanced body composition with high percent Fat, compared to their body weight. Assessing the BMD with the WHO standards, 91.4～95.7% of the BMD of forearm and whole body was normal. But, 40.3% and 33.1～43.9% showed osteopenia at lumbar and femur, and 104 %, 0.7～7.2% showed osteoporosis. The BMD at all parts showed significant correlation each other(r=.29～.89, p=.001～.000). Body weight and BMI showed correlations to with BMDs at all parts of the body(r=.19～46, p=.025～.000; r=18～.45, p=.039～.000). But the percent Fat had a correlation with only femur neck BMD(r=.19, p=.024). Conclusion: This study showed a majority of healthy college women were exposed to the risk for osteoporosis. Additional study is required to develop nursing interventions to remove the risk factors of osteoporosis. In particular, the acquisition of balanced body composition is necessary, increasing body weight and BMI through the increase of LBM, not through the quantitative increase of BFM.

• Journal of Nutrition and Health
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• 제38권3호
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• pp.242-250
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• 2005

This study was conducted to assess the bone mineral density (BMD) and the anthropometric measurements, life style, and other environmental factors affecting BMD in Korean adolescents. Subjects were 167 high school students (83 male students, 84 female students) in Seoul. BMD was measured in the lumbar spine (LS), femoral neck (FN), femoral trochanter (FT), and Ward's triangle (WT) by dual energy x-ray absorptiometry (DEXA). The questionnaire was used to assess the anthropometric measurements, life style, and other environmental factors. Bone mineral density of LS, FN, FT and WT were 0.967, 0.960, 0.795, $0.761 g/{\cal}cm^2$. The BMD of LS was not different by sex but the male students's BMD of FN, FT and WT were higher significantly than the female students (LS: 0.976 vs. 0.958, FN: 1.040 vs. 0.880, FT: 0.842 vs. 0.749, WT: 0.827 vs. $0.695 g/{\cal}cm^2$) Female students's BMD of LS, FN, WT, and FT was positively correlated with weight but male students's BMD of WT was not correlated with weight. The factors such as the life style, activity and exercise have significant influence on BMD. This study confirms that the major factor affecting BMD was body weight and the factors such as the life style, activity and exercise is related to accumulation of BMD. The classification of sexual characteristics is needed for further studies on BMD of adolescents.

• Journal of Preventive Medicine and Public Health
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• 제37권1호
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• pp.72-79
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• 2004

Objectives : This cross-sectional study aimed to quantify the relationship between the bone mineral density at the os calcis and the body mass composition in healthy children. Methods : The areal bone mineral density was measured at the os calcis with peripheral dual energy X-ray absorptiometry. The fat free mass, fat mass and percentage fat mass were measured using bioelectric impedance, in 237 Korean children, aged 9 to 12 years. The sexual maturity was determined by self assessment, using standardized series of the 5 Tanner stage drawings, accompanied by explanatory text. Results : From multiple linear regression models, adjusted for age, sexual maturity and height, the fat free mass was found to be the best predictor of the calcaneal bone mineral density in both sexes. About 15 and 20% variabilities were found in the calcaneal bone mineral densities of the boys and girls, respectively, which can be explained by the fat free mass. After weight adjustment, the percentage fat mass was negatively associated with the calcaneal bone mineral density in both sexes. Conclusions : The findings of this study suggest that the fat free mass, among the body compositions, is the major determinant of bone mineral density at the os calcis in Korean children aged 9 to 12 years. Obesity, defined as the percentage fat mass, is assumed to have a negative effect on the calcaneal bone density in children of the same weight.

• 한국운동역학회지
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• 제21권3호
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• pp.297-308
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• 2011

The purpose of this study was to investigate the relationship among isometric and isokinetic muscle strength, lean body mass(LBM) and bone mineral density(BMD) in the elderly. Eleven males(age, 70.27${\pm}$5.78yr; height, 167.36${\pm}$6.68 cm; weight, 68.34${\pm}$8.23 kg) and thirteen female(age, 69.77${\pm}$4.13yr; height, 152.80${\pm}$4.45 cm; weight, 56.86${\pm}$7.40 kg) participated in this study. In all subjects, LBM and BMD segments was measured by using Dual-energy x-ray absorptiometry(DEXA, Lunar DPS-DM, U.S.A.). Maximum isometric and isokinetic muscle strength of flexion and extension at the knee and elbow, ankle, trunk joints were measured by using an isokinetic dynamometer(CON-TREX(R) Multi Joint Testing Module, Switzerland). The results of this study showed that isometric and isokinetic muscle strength was significantly higher in extension than flexion. In the male and female, hamstring to quadriceps strength ratio(H:Q ratio) was increased as contraction velocity increased. BMD was correlated significantly with trunk extension in the male, but not in the female. LBM was correlated significantly in the male and female with knee extension strength. This study suggests that in the elderly muscle strength training program should put more weight on extensor muscles of the body.

• Nutrition Research and Practice
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• 제4권2호
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• pp.128-135
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• 2010

Obesity was characterized in Korean elementary students using different obesity assessment tests on 103 overweight elementary students from three schools of Jeonbuk Province. The body mass index (BMI) and obesity index (OI) were compared, and the data using DEXA and CT were compared with the data using BIA and a tape measure. The results of this study are as follows: first, 27 students who were classified as obese by OI were classified as overweight by BMI, and 3 students who were classified as standard weight by BMI were classified as overweight by OI. Secondly, by DEXA and BIA measurements, there was 1.51% difference in body fat percentage (boys 1.66%, girls 1.17%) and the difference in body fat mass between boys and girls was 0.77 kg (boys 0.85 kg, girls 0.59 kg), but those differences in body fat percentage and mass were not statistically significant. Thirdly, the average total abdominal fat (TAF) measured by CT scans of obese children was more significantly related with subcutaneous fat (r = 0.983, P < 0.01) than visceral fat (r = 0.640, P < 0.01). Also, TAF were highest significant with waist circumference by a tape measure (r = 0.744, P < 0.01). In summary, as there are some differences of assessment results between two obesity test methods (BMI, OI), we need more definite standards to determine the degree of obesity. The BIA seems to be the most simple and effective way to measure body fat mass, whereas waist/hip ratio (WHR) using a tape measurer is considered to be the most effective method for assessing abdominal fat in elementary students.