• Journal of Korean Medical Science
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• v.33 no.48
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• pp.311.1-311.10
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• 2018

Background: In postmenopausal women, there is rapid bone loss due to estrogen depletion. In women, reproductive factors such as age at menarche, breastfeeding, and parity are considered risk factors of osteoporosis. Many reports suggest that obesity is associated with a reduced risk of osteoporosis. This nationwide, population-based study aims to identify the association between maternal age and osteoporosis risk in postmenopausal women of different obesity classifications. Methods: We assessed data from the Korean National Health and Nutrition Examination Survey 2010-2012. The study included 1,328 postmenopausal women, after excluding women with missing data for reproductive history among 4,546 postmenopausal women in the survey. Multivariate regression was used to identify the association between childbirth age and postmenopausal bone mineral density after adjustments for confounding factors. Results: The prevalence of postmenopausal osteoporosis was 35.24% (n = 468). After dividing the subjects into obese and non-obese groups based on body mass index (BMI) and waist circumference, there were significant differences between non-osteoporosis and osteoporosis groups with regard to age at first childbirth, age at last childbirth, and parity in the BMI-based general obesity group. The prevalence of osteoporosis was highest in women older than 35 years old at last childbirth. The prevalence of osteoporosis was also greater in women with parity ${\geq}4$ compared to those with lower parity levels. Conclusion: Postmenopausal women of older age at last childbirth and higher parity were at increased risk of osteoporosis in the BMI-based non-general obesity group.

• Research in Community and Public Health Nursing
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• v.14 no.2
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• pp.253-262
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• 2003

Purpose: This study was carried out to identify factors influencing osteoporosis in women at pre- and post-menopausal state. Methods: The subjects of this study were 52 pre-menopausal and 125 post-menopausal women who were assessed of bone density in one general hospital. The data were collected through review of clinical records and telephone interviews using a questionnaire. Results: In the pre-menopausal women, the factors influencing osteoporosis were regular exercise (protective factor) and age (risk factor). Regression analysis showed that the factors attributable to osteoporosis included educational level, weight, age and number of pregnancy, accounted for 41.89% of the total variance. In the post-menopausal women. the factors influencing osteoporosis were age (risk factor), low educational level (risk factor), low economical state (risk factor), high parity (risk factor), and intake of coffee (protective factor). Regression analysis also showed that factors attributable to their osteoporosis included age, educational level, number of delivery, intake of the coffee, regular exercise, number of pregnancy and duration of oral pill intake, accounted for 37.41 % of the total variance. Conclusion: In pre-menopausal women, regular exercise was one of the most powerful determinant of their bone mass. Therefore, it is necessary to participate in a regular exercise program to maintain peak bone mass density prior to the onset of menopause. In post-menopausal women, increased age was the most influencing factor of their bone mass. Therefore, it is essential to establish early diagnosis and management of osteoporosis after menopause.

• Journal of muscle and joint health
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• v.6 no.1
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• pp.37-50
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• 1999

The purpose of this study was to identify the risk factors of osteoporosis. The data were collected from women who visited Physical Examination Center of a university hospital located in Taejon during the period of September 1997-August 1998. The sample was divided into two groups(the osteoporosis group of 44 cases and the control group of 66 cases). The results were summarized as follows ; 1. Sociodemographic characteristics(education and family income) and BMI showed no significant difference between the osteoporosis group and the control group. 2. There was no significant difference in coffee, unbalanced diet, diet method and meal habit between the osteoporosis group and the control group. 3. The osteoporosis group reported more incidence of operative menopause due to hysterectomy and oophorectomy, but this was not statistically significant. There was no significant difference in use of oral pill use, past disease and family history of fracture between the osteoporosis group and the control group, but the odds ratio(OR 3.11, 95% CI : 1.30-7.41) of present illness was statistically significant in the osteoporosis group. 4. There was no significant difference in the reproductive history including number of delivery and abortion and feeding method between the osteoporosis group and the control group. 5. The osteoporosis group showed significant results of lower menopausal age, shorter duration of menstruation and longer duration after menopause compared to the control group. 6. The osteoporosis group reported significantly lower level of physical activity in such variables as work activity and walking time. 7. A logistic analysis showed that shorter period of menstruation, lower level of physical activity, non-alcohol drinking group, and presence of disease were related to the possibility of occurring of osteoporosis.

• Nutrition Research and Practice
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• v.7 no.5
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• pp.409-417
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• 2013

This study was performed to determine the effects of dietary calcium (Ca) intake, milk and dairy product intake, and serum vitamin D level on bone mineral density. The survey data from the 2008-2009 Korea National Health and Nutrition Examination Survey (KNHANES) for adults (3,819 males, 5,625 females) aged > 20 years were examined; osteoporosis was defined according to the standards for Asian populations (T-score < -2.5). The risk for osteoporosis significantly decreased as Ca intake increased; this effect persisted (quartile 4 vs. quartile 1 of Ca intake: odds ratio [OR] 0.66; 95% confidence interval [CI]: 0.50-0.87) even after adjustment for gender, age, and other factors (body mass index, serum vitamin D, menstruation, female hormone intake, menopausal status, and the number of days per week of muscular strength exercise). Additionally, the risk for osteoporosis significantly decreased as the Ca/P ratio increased (quartile 4 vs. quartile 1: OR 0.76; 95% CI: 0.58-0.98). The degree of risk was 0.96 (0.66-1.38) in those who consumed < 1 portion of milk or dairy products daily, and 0.71 (0.53-0.96) in those who consumed > 1 portion per day, compared with those who had zero intake. The risk for osteoporosis significantly decreased as the serum 25(OH) vitamin D level increased. From these results, we advocate an increase in Ca, milk, and dairy product intake, and that serum 25(OH) vitamin D levels be maintained within the normal range, for the maintenance of bone health and the prevention of osteoporosis in adults.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.8
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• pp.3377-3381
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• 2014

Background: The incidence of colorectal cancer increases with vitamin D deficiency as shown in recently published studies. In addition, prospective investigations have indicated that low vitamin D levels may be associated with increased mortality of colorectal cancer, especially in stage III and IV cases. However, the exact incidence of vitamin D deficiency and the relation between vitamin D deficiency and osteopenia/osteporosis is still not known. The aim of this study is to identify severity of vitamin D deficiency and absolute risk factors of osteopenia/osteoporosis in colorectal cancer survivors. Materials and Methods: A total of 113 colorectal cancer survivors treated with surgery and/or chemotherapy ${\pm}$ radiotherapy were recruited from medical oncology outpatient clinics during routine follow-up visits in 2012-2013. Bone mineral densitometry (BMD) was performed, and serum 25-OH vitamin D levels were also checked on the same day of the questionnaire. The patients was divided into 2 groups, group A with normal BMD and group B with osteopenia/osteoporosis. Results: The median age of the study population was 58 (40-76). Thirty (30.0%) were female, whereas 79 (70.0%) were male. The median follow-up was 48 months (14-120 months). Vitamin D deficiency was found in 109 (96.5%); mild deficiency (20-30 ng/ml) in 19 (16.8%), moderate deficiency (10-20 ng/ml) in 54 (47.8%) and severe deficiency (<10 ng/ml) in 36 (31.9%). Osteopenia was evident in 58 (51.4%) patients whereas osteoporosis was noted in 17 (15.0%). Normal BMD was observed in 38 (33.6%). No apparent effects of type of surgery, presence of stoma, chemotherapy, radiotherapy and TNM stage were found regarding the risk of osteopenia and osteoporosis. Also, the severity of the vitamin D deficiency had no effect in the risk of osteopenia and osteporosis (p=0.93). In female patients, osteopenia/osteoporosis were observed in 79.5% patients as compared to 60.7% of male patients (p=0.04). Conclusions: In our study, vitamin D deficiency and osteopenia/osteoporosis was observed in 96.5% and 66.4% of colorectal cancer survivors, respectively. There is no defined absolute risk factor of osteopenia and osteoporosis in colorectal cancer survivors. To our knowledge, in the literature, our study is the first to evaluateall the risk factors of osteopenia and osteoporosis in colorectal cancer survivors.

• Korean Journal of Adult Nursing
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• v.21 no.2
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• pp.257-267
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• 2009

Purpose: The purpose of this study was to identify risk factors of fall and to examine its results among patients aged 60 and over diagnosed with osteoporosis. Methods: A retrospective descriptive survey was conducted with 91 patients admitted in a university hospital in a city. Data were collected using an interview method with a structured questionnaire, and were analyzed using descriptive statistics and multiple logistic regression. Results: In patients with osteoporosis, the intrinsic risk factors of falls were aging (OR = 3.742), gait disturbance (OR = 12.565), taking one or fewer medicine (OR = 7.873), and having two or more diseases (OR = 5.173). The extrinsic risk factors included the use of a bed (OR = 3.093), slippery floors (OR = 12.130), bathroom mat without anti-slip rubber backing (OR = 3.564), and presence of a night light on the passage from the bedroom to the bathroom (OR = 2.980). Conclusion: For the elderly aged over 70 who are most vulnerable to falls, screening tests such as bone mineral density (BMD) should be conducted in health examinations and the risk of fracture caused by osteoporosis should be communicated to the vulnerable elderly. Besides, development of new exercise programs combining weightbearing exercise is needed to prevent bone loss and increase functional activities.

• International Journal of Oral Biology
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• v.44 no.1
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• pp.1-7
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• 2019

Osteoporosis is a common disease characterized by bone mass reduction, leading to an increased risk of bone fracture, and it is caused by an imbalance of osteoblastic bone formation and osteoclastic bone resorption. Current osteoporosis drugs aim to reduce the risk of bone fracture, either by increasing osteoblastic bone formation or decreasing osteoclastic bone resorption. However, osteoblasts and osteoclasts are closely coupled, such that any reagent altering the differentiation or activity of one eventually affects the other. This tight coupling between osteoblasts and osteoclasts not only limits the therapeutic efficacy but also threatens the safety of osteoporosis drugs. This review will discuss the biological mechanisms of action of currently approved medications for osteoporosis treatment, focusing on the osteoblast-osteoclast coupling.

• Tuberculosis and Respiratory Diseases
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• v.66 no.3
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• pp.186-191
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• 2009

Background: Osteoporosis is a significant comorbidity in patients with chronic obstructive pulmonary disease (COPD). This study examined the prevalence and risk factors associated with osteoporosis in patients with COPD. Methods: The bone mineral densities (BMDs) of the lumbar spine and femoral bone were measured in 53 patients with clinically stable COPD and 41 age- and gender-matched control subjects showing a normal lung function. Osteoporosis was defined as a T-score $\leq$-2.5. The subjects' clinical characteristics and laboratory data were reviewed, and multiple logistic regression analysis was used to identify the risk factors associated with osteoporosis in COPD patients. Results: The prevalence of osteoporosis was 47% and 32% in the COPD patients and controls, respectively. In particular, using the femoral neck T-score, the prevalence of osteoporosis in COPD patients was higher than that in the controls (26% vs. 5%; p=0.006). The average T-score of the lumbar spine (p=0.025) and femoral neck of COPD patients were significantly lower than those of the controls (p=0.001). The forced expiratory volume in the 1 second ($FEV_1$) % predicted (p=0.019; odds ratio [OR], 0.955; 95% confidence interval [CI], 0.919-0.993) and age (p=0.024; OR, 1.144; 95% CI, 1.018-1.287) were independently associated with osteoporosis in patients with COPD. Conclusion: Using the femoral neck T-score, the prevalence of osteoporosis in patients with COPD was higher than the age-and gender-matched controls. A lower $FEV_1$ and older age further increase the risk of osteoporosis in patients with COPD.

• Nutrition Research and Practice
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• v.12 no.5
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• pp.436-442
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• 2018

BACKGROUND/OBJECTIVES: The aim of this study was to identify the effect of dairy products, milk and yogurt on osteoporosis incidence among Korean postmenopausal women using prospective cohort data. MATERIALS/METHODS: Between 2001 and 2003, 10,038 participants were recruited in rural and urban areas for a baseline examination of a community-based cohort study. Of those, 1,573 postmenopausal women (aged 40-69 years at baseline) were eligible for the present study. Intakes of dairy products, milk, and yogurt were assessed using a validated semi-quantitative food frequency questionnaire. The speed of sound at the radius and tibia were measured using a quantitative ultrasound device and osteoporosis was defined based on the WHO criteria (T-score ${\leq}-2.5$). RESULTS: During the 4-years follow-up study, the cumulative incidence of osteoporosis was 18.4% (273 cases) in the radius and 33.6% (407 cases) in the tibia. The subjects with higher frequency of dairy product consumption showed a decreased risk of radius osteoporosis after adjusting for potential confounders [hazard ratio (HR) = 0.51, 95% confidence interval (CI): 0.33-0.80 for >1 time/day vs. non consumer; P for trend = 0.0027]. Similarly, high frequency of milk and yogurt consumption had a protective effect on radius osteoporosis risk [milk: HR = 0.60, 95% CI: 0.42-0.87 for > 5-6 times/week vs. non consumer (P for trend = 0.0130), yogurt: HR = 0.51, 95% CI: 0.30-0.85 for > 5-6 times/week vs. non consumer (P for trend = 0.0167)]. However, high dairy products consumption was not related with tibia osteoporosis. CONCLUSIONS: This study suggests that daily intake of dairy products could potentially reduce radius osteoporosis incidence among Korean postmenopausal women.

• 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.