• Korean Journal of Clinical Pharmacy
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• v.30 no.3
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• pp.196-205
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• 2020

Background: The indication of denosumab for osteoporosis was expanded from second-line to first-line therapy in 2019. The aim of this study was to evaluate the efficacy of denosumab as both first- and second-line therapy in postmenopausal women with osteoporosis and osteopenia with risk factors by using the Fracture Risk Assessment Tool (FRAX). Methods: We conducted a medication use evaluation of denosumab in 98 patients who had been treated three or more times for osteoporosis or osteopenia at Chungnam National University Hospital from July 1^st, 2017 to January 31^st, 2020. Risk factors were identified using quantitative N-gram analyses of FRAX estimations. Patient information, including menopause status and results of bone mineral density tests (T-score), was obtained from electronic medical records. Results: Age, body mass index (BMI), prior medication use, and T-score were identified as risk factors and were included as variables in the evaluation of denosumab use. Since no significant differences were detected between groups, denosumab is likely effective regardless of age or BMI. In addition, no significant difference was detected in T-scores following denosumab treatment, between groups who took bisphosphonates and selective estrogen receptor modulators (SERMs) with denosumab as first-line therapy for postmenopausal osteoporosis. Denosumab may, therefore, be effective as second-line therapy. Conclusion: Efficacy of denosumab was evaluated in postmenopausal women with osteoporosis. Denosumab may be used as first- and second-line therapy regardless of age, BMI, and prior use of bisphosphonates and SERMs.

• Journal of the Korean Society of Food Culture
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• v.24 no.6
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• pp.588-596
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• 2009

To determine the relationships between soybean food intake, dietary isoflavone intake, and osteoporosis incidence, questionnaire surveys, bone mineral density measurements, and dietary surveys by food record were performed with 19 postmenopausal women ($57.6{\pm}7.3$ yrs of age) in Daejeon city. The subjects were divided into two groups: an 'osteoporosis group' (OG, n=10) and a 'normal group' (NG, n=9). Mean age, height, and body weight were similar between the two groups but BMI was higher in OG than in NG. Mean age at menarche was not different between the two groups. However, mean number of childbirths was greater in OG than in NG and mean total period of lactation was shorter in OG. Mean exercise time per week was similar between the two groups, and mean time of sunlight exposure tended to be shorter in OG. Mean daily intake of calcium was lower in OG whereas sodium intake was higher in OG. Mean daily intakes of total soybean food (OG: $203.8{\pm}84.6\;g/d$, NG: $285.0{\pm}146.3\;g/d$) and total dietary isoflavone (OG: $29.1{\pm}14.3\;mg/d$, NG: $38.3{\pm}23.1\;mg/d$) were not different between the two groups. However, greater intakes of soybean food and dietary isoflavone were associated with higher bone mineral density, respectively. The above results indicate that osteoporosis incidence tends to be influenced by BMI, maternal factors, dietary nutrient intakes, soybean food intakes, and dietary isoflavone intakes in postmenopausal women; although no significant differences in soybean food and dietary isoflavone intake were found between the two groups. This tendency implies that greater intakes of soybean food and dietary isoflavone lead to lower incidence of osteoporosis in postmenopausal women.

• Korean Journal of Adult Nursing
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• v.21 no.3
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• pp.303-313
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• 2009

Purpose: The purpose of this study was to investigate bone mineral density(BMD) and identify risk factors of osteoporosis in Korean postmenopausal women. Methods: The subjects consisted of 328 women. The BMD of the calcaneus were measured with peripheral dual energy x-ray absorptiometry. The risk factors were collected by a self-report standardized questionnaire. The differences among the osteoporosis, osteopenia, and normal group were compared by one way analysis of variance test, Scheffe's multiple comparison tests and Logistic regression. Results: The average age was 65 years old and the average T-score was 28.7% with osteoporosis. The Risk factors of osteoporosis were inclined by 24% in age (OR = 1.24, CI = 1.16 ~ 1.31), 53% in menarchal age (OR = 1.53, CI = 1.24 ~ 1.88), 3.5 times in vegetarian (OR = 3.52, CI = 1.66 ~ 7.47), 2 times in small-bowel disease (OR = 2.01, CI= 1.03 ~ 3.94), 5.3 times in arthritis (OR = 5.33, CI = 1.61 ~ 17.67), 5.5 times in eating disorder (OR = 5.50, CI = 1.43 ~ 21.17), 6 times in health perception (OR = 6.08, CI = 2.30 ~ 16.06). The Risk factors of osteoporosis were reduced by 10% in weight (OR = 0.90. CI = 0.83 ~ 0.97), and 10% in menopausal age (OR = 0.90. CI = 0.84 ~ 0.98). Conclusion: The risk factors of osteoporosis were in the general characteristics, menstrual history, history of disease, life style & diet, and health perception. Eating disorder and health perception are highest on the risk factor of osteoporosis in Korean postmenopausal women.

• Journal of Nutrition and Health
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• v.29 no.9
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• pp.1013-1020
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• 1996

The purpose of this study was to investigate nutrient intake and bone status in rural postmenopausal women in Korea. Ten postmenopausal women in An-Sung area participated in this study and they were divided into two groups ; women in group I had been postmenopausal for 4 years or less and those in group II had been postmenopausal for 5 years or more before the present study began. Their environmental factors and dietary intakes were surveyed through the personal interviews. Serum levels of calcium, phosphorus, parathyroid hormone(PTH), estradiol and urinary Ca, P, creatinine, hydroxyproline levels were measured from December 4 to December 27 in 1993. The reults of this study are summarized as follows : Average ages of group I and II were 54.8 and 57.2 years. Average menopausal ages of group I and II were 50.8 and 47.3 years. The nutrient intakes of subjects were higher than recommended dietary allowances(RDA) except calorie, protein, calcium, and vitamin A. The nutrient status did not show any significant difference between group I and II. Serum levels of Ca, P, PTH, estradiol and urinary P, creatinine excretion did not show any significant difference between group I and II, and all levels were in normal range. Urinary Ca excretion(p<0.05) and hydroxyproline excretion(p<0.01) were significantly lower in group I than in group II. Urinary Ca/creatinine(Ca/cr) and hydroxyproline/creatinine(Hpr/cr) rations were significantly higher in group II than in group I(p<0.01. And Hpr/cr levels of group I were in normal range, but most of subjects in group II were higher than 0.017 indicating sign of osteoporosis. Correlations between parameters showed that serum PTH adn urinary Ca, Ca/cr levels were positive related (p<0.01), and the years of the after menopausal year and urinary Hpr/cr was also positive related(p<0.05). The present results suggests that it is difficult to protect postmenopausal women's bone destruction having Korean usual diets. Therefore, to prevent osteoporosis with aging, minimizing the hormonal changes in postmenopausal women is needed as well as Ca supplementation and proper exercise before menopause begins.

• Nutritional Sciences
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• v.9 no.1
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• pp.42-47
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• 2006

It has been reported that taking a proper amount of calcium and vitamin D helps to increase bone mineral density (BMD) and is effective in decreasing the risk of osteoporosis. This study investigated the supplementary effects of calcium and vitamin D on postmenopausal women who had osteoporosis and used calcium and vitamin D supplements. The study subjects consisted of osteoporotic postmenopausal women who were recruited from the Department of Orthopedics in a university-affiliated hospital. Sixty-seven study subjects were orally administrated 1,000 mg of calcium (calcium carbonate) and 2.5 mg of active vitamin D (1-$\alpha$ hydroxyvitamin D) (cholecalciferol 250 IU) twice a day for a year and a half. BMD and biochemical markers were evaluated and repeated every six months. One year after the intervention test, the bone mineral density of the lumbar spine was significantly increased as compared to the baseline. Six months after supplement administration, the level of serum alkaline phosphatase began to decrease, and afterwards a significant difference was maintained Concentration of 1, 25-dihydroxy-vitamin D at 1.5 years was higher than that of the baseline. In comparison with that of the baseline, the level of urinary hydroxyproline in the study subjects over six months was significantly decreased This study continued that effects such as BMD improvement and changes in biochemical markers appeared at least one year after administration of supplements.

• Imaging Science in Dentistry
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• v.42 no.4
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• pp.231-235
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• 2012

Purpose: This study was performed to evaluate the trabecular pattern on panoramic radiographs to predict age-related osteoporosis in postmenopausal women. Materials and Methods: Thirty-one postmenopausal osteoporotic women and 25 postmenopausal healthy women between the ages of 50 and 88 were enrolled in this study. The bone mineral density (BMD) of the lumbar vertebrae and femur were calculated using dual-energy X-ray absorptiometry (DXA), and panoramic radiographs were obtained. Fractal dimension (FD) was measured using the box counting method from 560 regions of interest ($51{\times}51$ pixels) in 6 sites on the panoramic radiographs. The relationships between age and BMD and between FD and BMD were assessed, and the intraobserver agreement was determined. Results: There was a significant difference in the FD values between the osteoporotic and normal groups (p<0.05). There was a significant difference in the FD values at three sites in the jaws (p<0.05). Age was significantly correlated with the BMD measurements, with an odds ratio of 1.25. However, the FD values were not significantly correlated with the BMD measurements, with an odds ratio of 0.000. The intraobserver agreement showed relatively higher correlation coefficients at the upper premolar, lower premolar, and lower anterior regions than the other sites. Conclusion: Age was an important risk factor for predicting the presence of osteoporosis in postmenopausal women. The lower premolar region was the most appropriate site for evaluating the FD value on panoramic radiographs. However, further investigation might be needed to predict osteoporosis using an FD value on panoramic radiographs.

• Research in Community and Public Health Nursing
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• v.17 no.1
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• pp.46-55
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• 2006

Objective: This study is to examine the physical function, psychological well-being, and subjective symptom of postmenopausal osteoporotic women. Methods: Data used for this study was collected from 397 women who had experienced one years or longer menopause and visited a hospital in Seoul, Korea during the period from May to December 2005. Results: The level of physical function of the fracture osteoporosis group was significantly lower than the other three groups. The psychological well-being of the fracture osteoporosis group was significantly lower than the other three groups. Subjective symptom of the fracture osteoporosis group was significantly higher than the other three groups. The level of physical function was positively correlated with psychological well-being and negatively with subjective symptom. Psychological well-being was also negatively correlated with the level of subjective symptom. Based on the results, it is recommended that the prevention of vertebral fracture in osteoporotic woman is important, and nursing intervention is necessary for the physical function, psychological well-being, and subjective symptom care.

• Journal of Yeungnam Medical Science
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• v.13 no.2
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• pp.261-271
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• 1996

Introduction: Osteoporosis, the most common metabolic bone disorder, is a condition of reduced bone density and increased susceptibility to fractures. Osteoporosis is a major public health problem and a significant cause of morbidity in postmenopausal women. Therefore family physicians as primary care physicians are in a key position for preventing and treating this disorder. So we studied the factors affecting to bone mineral density in postmenopausal women. Materials and Methods: A total of 136 spontaneous postmenopausal women were participated in the study. They have measured spinal bone mineral density by dual energy x-ray absorptiometry from January 1992 to June 1995 at Yeungnam University Hospital. Age, height, weight, age at menarche and menopause, number of child and breast feeding child, history of oral pill ingestion, family history of osteoporosis, amount of milk and coffee ingestion, consumption of tobacco and alcohol and physical activity were assessed by qustionnaire and medical records. Results: The mean age is 55.2 and mean age at menopause is 47.9. Height, weight and physical activity were significantly positive correlated to bone mineral density. But age, duration after menopause and number of child were significantly negative correlated. Also age, height, weight, physical activity and duration after menopause were significantly correlated to % age-matched bone mineral density. In multiple regression analysis, which dependent variable is bone mineral density, duration after menopause, physical activity and weight were significant contributors. Duration after menopause is most the largest contributor. In multiple regression analysis, which dependent variable is % age-matched bone mineral density to adjust the age effect, physical activity and weight were significant contributors. Physical activity is most the largest contributor. Conclusions: Among factors affecting to BMD in postmenopausal women, physical activity and weight were more important factors. Therefore continuous physical activity is significant factor to prevent osteoporosis in postmenopausal women.

• The Korean Journal of Rehabilitation Nursing
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• v.2 no.2
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• pp.193-205
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• 1999

This study was carried out to identify the important risk factors for reduced bone mass of postmenopausal RA patients and to develop discriminant function which can classify postmenopausal RA patients with either reduced or normal bone mass. Through the literature review, individual characteristics such as age, body weight, height, age of menarche, duration of menopause, gravity, parity, and breast feeding period and factors of life style such as milk consumption exercise habit, alcohol intake, cigarette smoking, coffee consumpt ion , disease activity, corticosteroid therapy were identified as influencing factors of reduced bone mass in RA patients Sixty eight postmenopausal women with rheumatoid arthritis aged between 42 and 76 were selected among those who checked bone mineral density in lumbar spine and femur from october, 1998 to Apr il, 1999 at Dong-a university hospital in Pusan. Assessment of disease activity, duration of disease and corticosteroid therapy were made by the same rheumatologist and included Ritchie articular index, erythrocyte sedimentation rate, and C-reactive protein on measuring bone mineral density. Cumulative steroid dosage was calculated from the daily dosage multiplied by t h e number of days received. The information of other risk factor including health assessment score, individual characteristics and life style factors were collected by questionnaire. Bone mineral density(BMD) was measured using DXA at lumbar spine and femoral Ward's triangle. Discriminant function(regression equation) was developed for estimating the likelihood of the presence or absence of reduced bone mass. The results are as follows: Among the subjects, thirteen(19.1%) exhibited osteoporosis in lumbar spine and twenty four(35.3%) exhibited osteoporosis in femoral Ward's triangle. For lumbar spine, the variables significant were age, body weight, health assessment score, while for femoral Ward's triangle, age, body weight, duration of disease. But disease activity and corticosteroid therapy were not signigicant to distinguish reduced bone mass from normal bone mass. When the discriminant function was evaluated by comparing the observed out come with predicted out come, the discriminant function correctly classified 85.4% of patients with reduce bone mass and 63.0% of patients with normal bone mass in the lumbar spine and 100% of patients with reduced bone mass and 9.1% of patients with normal bone mass in the femoral Ward's triangle. In summary, we found that osteoporosis in postmenopausal women with RA is more evident at the femur than the lumbar spine. Also the important discriminant factors of reduced bone mass postmenopausal women with RA were age, body weight , duration of disease and health disability. In nursing situation, the efforts to improve of functional capacity of postmenopausal women with rheumatoid arthritis should be considered to prevent osteoporosis and fractures. Also we recommend those postmenopausal women with RA who are classified as a group of the reduced bone mass in the discriminant function should examine the bone mineral density to further examine the usefulness of this discriminant function.

• Journal of the East Asian Society of Dietary Life
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• v.16 no.4
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• pp.421-428
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• 2006

This study assessed the effects of daily isoflavone intake on urinary excretion of deoxypyridinoline(DPD), Ca and Zn excretion as an index of bone resorption rates in 162 postmenopausal osteoporotic women. There were 87 participants in the osteoporosis group and 75 in the control group. The average age in the osteoporosis group was 62.97 years and that of the control group was 63.67 years. There were no significant differences between the two groups in height, weight and body mass index. The osteoporosis group consumed significantly lower amounts of soy foods compared to the control group(p<0.00l). Daily isoflavone intake was significantly different between the osteoporosis group(29.19 mg) and the control group(48.56 mg). The average urinary excretion of deoxypyridinoline in the osteoporosis and control groups were 5.71 nmol/mmol Cr and 5.15 nmol/mmol Cr, respectively and these values were significantly different(p<0.05). In addition, the subjects in the osteoporosis group and control group exhibited significant difference in urinary excretion of Ca(200.16 mg/day, 177.05 mg/day respectively) and Zn(333.32 $\mu$g/day, 303.68 $\mu$g/day respectively) at the levels of p<0.0l and p<0.05, respectively. There were no significant differences between the two groups in mineral intake. Thus, daily isoflavone intakes may contribute to decreases in the rates of urinary excretion of deoxypyridinoline, Ca and Zn in postmenopausal subjects.