Son-Ok Mun; Jihye Kim; Yoon Jung Yang

doi:10.5720/kjcn.2013.18.2.177

Articles

Page Path: HOME > Korean J Community Nutr > Volume 18(2); 2013 > Article

Original Article
Factors Associated with Bone Mineral Density in Korean Postmenopausal Women Aged 50 Years and Above: Using 2008-2010 Korean National Health and Nutrition Examination Survey: Son-Ok Mun, Jihye Kim, Yoon Jung Yang; Korean Journal of Community Nutrition 2013;18(2):177-186.
DOI: https://doi.org/10.5720/kjcn.2013.18.2.177
Published online: April 30, 2013

Department of Obesity Management, Dongduk Women's University, Seoul, Korea.

¹Department of Clinical Nutrition, Dongduk Women's University, Seoul, Korea.

²Department of Food & Nutrition, Dongduk Women's University, Seoul, Korea.

Corresponding author: Yoon Jung Yang, Department of Food and Nutrition, Dongduk Women's University, Seoul 136-714, Korea. Tel: (02) 940-4465, Fax: (02) 940-4193, yjyang@dongduk.ac.kr

• Received: January 16, 2013 • Revised: February 13, 2013 • Accepted: March 28, 2013

354 Views
2 Download
16 Crossref

Full Article

Download PDF

Abstract
REFERENCES

Abstract

The purpose of this study was to investigate factors associated with Bone Mineral Density (BMD) in Korean postmenopausal women. The data from 2008-2010 Korean National Health and Nutrition Examination Survey (KNHANES) were used for data analysis. Subjects were 2,701 postmenopausal women aged ≥ 50 years. BMDs at whole body, total femur, femoral neck, and lumbar spine were measured by Dual-energy X-ray absorptiometry (DXA). Dietary data from 24-hour dietary recall and a food frequency questionnaire containing 63 food items were used. The proportions of osteopenia at total femur, femoral neck, and lumbar spine were 37.4%, 54.5%, and 45.4%, respectively. The proportions of osteoporosis at total femur, femoral neck, and lumbar spine were 6.2%, 25.6%, and 34.3%, respectively. Age, anthropometric index including height, weight, and Body Mass Index (BMI), parathyroid hormone, and physical activity were related to BMD, but the relationships were site specific. Total femur BMD was explained by age, weight, parathyroid hormone and intakes of carbohydrate and fruits. Femoral neck BMD was related to age, weight, parathyroid hormone and intakes of riboflavin and fruits. Lumbar spine BMD was associated with age, weight, milk and dairy products, calcium intake, and exercise. These results indicated that adequate intakes of milk and dairy products, fruits, carbohydrate, calcium, riboflavin and exercise as well as weight maintenance might play an important role in maintaining optimum bone health in Korean postmenopausal women.
Keywords: Bone mineral density; osteoporosis; osteopenia; postmenopausal women; dietary factor

REFERENCES

1. Basu S, Michaelsson K, Olofsson H, Johansson S, Melhus H. Association between oxidative stress and bone mineral density. Biochem Biophys Res Commun. 2001; 288(1): 275-279.Article PubMed
2. Chae JW, Kim IH, Kwon WS, Lee KM, Jung SP, Moon Y. The relationship between body composition and bone mineral density in postmenopausal women. Yeungnam Univ J Med. 2003; 20(1): 53-61.Article
3. Cheng XG, Yang DZ, Zhou Q, Zhuo TJ, Zhang HC, Xiang J, Wang HF, Ou PZ, Liu JL, Xu L, Huang GY, Huang QR, Barden HS, Weynand LS, Faulkner KG, Meng XW. Age-related bone mineral density, bone loss rate, prevalence of osteoporosis, and reference database of women at multiple centers in China. J Clin Densitom. 2007; 10(3): 276-284.Article PubMed
4. Choe HJ, Lee DJ. Age-related change of spinal bone mineral density and accumulated bone loss rate in women. J Korean Soc Menopause. 2003; 9(2): 171-176.
5. Chung YS. The medical treatment of osteoporosis. Korean J Med. 2010; 79(3): 250-253.
6. Dalsky GP, Stocke KS, Ehsani AA, Slatopolsky E, Lee WC, Birge SJ. Weight-bearing exercise training and lumbar bone mineral content in postmenopausal women. Ann Intern Med. 1988; 108(6): 824-828.Article PubMed
7. Dawson-Hughes B, Dalal GE, Krall EA, Sadowski L, Sahyoun N, Tannenbaum S. A controlled trial of the effect of calcium supplementation on bone density in postmenopausal women. N Engl J Med. 1990; 323(13): 878-883.Article PubMed
8. Douchi T, Yamamoto S, Oki T. Difference in the effect of adiposity on bone density between pre and postmenopausal women. Maturitas. 2000; 34(3): 261-266.Article PubMed
9. El Maghraoui A, Guerboub AA, Achemlal L, Mounach A, Nouijai A, Ghazi M, Bezza A, Tazi MA. Bone mineral density of the spine and femur in healthy Moroccan women. J Clin Densitom. 2006; 9(4): 454-460.Article PubMed
10. Finkelstein JS, Lee ML, Sowers M, Ettinger B, Neer RM, Kelsey JL, Cauley JA, Huang MH, Greendale GA. Ethnic variation in bone density in premenopausal and early perimenopausal women: Effects of anthropometric and lifestyle factors. J Clin Endocrinol Metab. 2002; 87(7): 3057-3067.Article PubMed
11. Garnero P, Delmas PD. New developments in biochemical markers for osteoporosis. Calcif Tissue Int. 1996; 59: Suppl 1. S2-S9.Article PubMed PDF
12. Garnero P, Munoz F, Sornay-Rendu E, Delmas PD. Associations of vitamin D status with bone mineral density, bone turnover, bone loss and fracture risk in healthy postmenopausal women. Bone. 2007; 40(3): 716-722.Article
13. Han IK. Hormone replacement therapy for osteoporosis. J Korean Med Assoc. 1995; 38(1): 42-48.
14. Hwang YC, Ahn HY, Jeong IK, Ahn KJ, Chung HY. Optimal serum concentration of 25-hydroxyvitamin D for bone health in older Korean adults. Calcif Tissue Int. 2013; 92: 68-74.Article PDF
15. Kang BM, Kim MR, Yoon BK, Lee BS, Chung HW, Choi Hoon, Park HM, Kim JU. The influence of exercise on bone mineral density in Korean postmenopausal women. J Korean Soc Menopause. 2007; 13(2): 131-136.
16. Kim HJ. Reserarch on relation of nutrients intake, health status, and bone mineral density in middle-aged women. J Korean Diet Assoc. 2003; 9(4): 307-315.
17. Kim KR, Kim KH, Lee EK, Lee SS. A study on the factors affecting bone mineral density in adult women-based on the mothers of elementary school students. Korean J Nutr. 2000; 33(3): 241-249.
18. Kim JH, Jung JC, Kim SO. Survey on the benefit coverage rate of national health insurance in 2004. 2004; Health Insurance Research Institute.
19. Kim MH, Kim JS, Kim YM. The relationship between bone mineral density and physical, obstetric characteristics in middle-aged women. J Korean Acad Adult Nurs. 2002; 14(4): 532-542.
20. Lau EM, Suriwongpaisal P, Lee JK, Das De S, Festin MR, Saw SM, Khir A, Torralba T, Sham A, Sambrook P. Risk factors for hip fracture in Asian men and women-the Asian Osteoporosis Study (AOS). J Bone Miner Res. 2001; 16(3): 572-580.
21. Lee HJ, Choi MJ, Lee IK. The effect of anthropometric measurement and body composition on bone mineral density of Korean women in Taegu. Korean J Nutr. 1996; 29(7): 778-787.
22. Lim JS, Kim KM, Rhee Y, Lim SK. Gender-dependent skeletal effects of vitamin D deficiency in a younger generation. J Clin Endocrinol Metab. 2012; 97(6): 1995-2004.Article
23. Maalouf G, Salem S, Sandid M, Attallah P, Eid J, Saliba N, Nehmé I, Johnell O. Bone mineral density of the Lebanese reference population. Osteoporos Int. 2000; 11(9): 756-764.Article PDF
24. Meyer HE, Søgaard AJ, Falch JA, Jørgensen L, Emaus N. Weight change over three decades and the risk of osteoporosis in men. Am J Epidemiol. 2008; 168(4): 454-460.
25. Mikhail BI. Reduction of risk factors for osteoporosis among adolescents and young adults. Issues Compr Pediatr Nurs. 1992; 15(4): 271-280.Article
26. Morton DJ, Barrett-Connor E, Kritz-Silverstein D, Wingard DL, Schneider DL. Bone mineral density in postmenopausal Caucasian, Filipina, and Hispanic women. Int J Epidemiol. 2003; 32(1): 150-156.Article
27. Na HB. Factors affecting bone mineral density in Korean women by menopause. Korean J Community Nutr. 2004; 9(1): 73-80.
28. Nam TH, Oh DJ, Han SS, Cha SU, Kim YW. A preliminary research on osteoporosis in women before and after menopause. J Phys Educ Sports Sci. 1997; 13: 227-244.
29. National Institutes of Health. Osteoporosis prevention, diagnosis, and therapy. NIH Consens Statement. 2000; 17: 1-45.
30. NOF Scientifis Statement. NOF'S updated recom-mendations for calcium and vitamin D3 intake. 2012; cited 2012 October 12. Available from http://www.nof.org/files/nof/public/co-ntent/file/218/upload/68.pdf.
31. Oh KW. Diabetes and osteoporosis. Korean Diabetes J. 2009; 33(3): 169-177.Article
32. Okubo H, Sasaki S, Horiguchi H, Oguma E, Miyamoto K, Hosoi Y, Kim MK, Kayama F. Dietary patterns associated with bone mineral density in premenopausal Japanese farmwomen. Am J Clin Nutr. 2006; 83(5): 1185-1192.
33. Park J, Choi M, Lee S, Choi Y, Park Y. 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.Article
34. Park YJ, Koo BS, Kang BS, Chun SH, Yoon JW. The menopausal age and climacteric symptoms and the related factors of Korean women. Korean J Women Health Nurs. 2001; 7(4): 473-485.Article PDF
35. Rikli RE, McManis BG. Effects of exercise on bone mineral content in postmenopausal women. Res Q Exerc Sport. 1990; 61(3): 243-249.Article
36. In: Ross AC, Taylor CL, Yaktine AL, Del Valle HB, editors. Dietary reference Intakes for calcium and vitamin D. 2011; Washington D.C: The National Academies Press.
37. Sadat-Ali M, Al-Habdan IM, Al-Mulhim FA, El-Hassan AY. Bone mineral density among postmeno-pausal Saudi women. Saudi Med J. 2004; 25(11): 1623-1625.
38. Shils ME, Olson JA, Shike M, Ross AC. Modern nutrition in health and disease. 1999; Nine edition. Riverwoods: Lippincott Williams and Wilkins; 1353-1364.
39. Shin A, Lim S, Sung J, Myung S, Kim J. Dietary habit and bone mineral density in Korean postmenopausal women. Osteoporos Int. 2010; 21: 947-955.Article PDF
40. Sung CJ, Baek SK, Lee HS, Kim MH, Choi SH, Lee SY, Lee DH. A study of body anthropometry and dietary factors affecting bone mineral density in Korean pre-and postmenopausal women. J Korean Soc Food Sci Nutr. 2001; 30(1): 159-167.
41. Wardlaw GM, Weese N. Putting calcium into perpective for your clients. Top Clin Nutr. 1995; 11(1): 23-35.
42. Yoon EH, Noh H, Lee HM, Hwang HS, Park HK, Park YS. Bone mineral density and food-frequency in Korean adults: The 2008 and 2009 Korea national health and nutrition examination survey. Korean J Fam Med. 2012; 33: 287-295.Article
43. You MH, Son BS, Park JA, Kim JO, Yang WH. Patterns of bone mineral density of adult women and its causal factors in Suwon Korea. Korean J Sanit. 2004; 19(3): 71-80.
44. Youk JI. Female bone mineral density in an urban area and its relation with contributing factors. 2004; Graduate school of public health, Chungnam National University; 26-30 Master thesis.
45. Yu CH, Lee JS, Lee LH, Kim SH, Lee SS, Kang SA. Nutritional factors related to bone mineral density in the different age group of Korean men. Korean J Nutr. 2004; 37(2): 132-142.

Fig. 1

Distribution of osteopenia and osteoporosis among study subjects.

Table 1

General characteristics of postmenopausal women by bone health status

1) P-values by one-way ANOVA for continuous variables and chi-square test for categorical variables

2) Values with different superscript letters within a row are significantly different means, based on one-way ANOVA followed by Scheffe's post hoc comparison test

Table 2

Pearson correlation coefficients between factors and bone mineral density in each site

1) Pearson correlation coefficient

Table 3

Partial correlation coefficients between nutrient intake and bone mineral density in each site

1) Adjusted for age, weight, exercise, smoking, alcohol drinking and dietary supplements

2) Adjusted for age, weight, exercise, parathyroid hormone, smoking, alcohol drinking and dietary supplements

3) Adjusted for age, weight, smoking, alcohol drinking and dietary supplements

Table 4

Partial correlation coefficients between food consumption frequency and bone mineral density in each site

1) Adjusted for age, weight, exercise, smoking, alcohol drinking and dietary supplements

2) Adjusted for age, weight, exercise, parathyroid hormone, smoking, alcohol drinking and dietary supplements

3) Adjusted for age, weight, smoking, alcohol drinking and dietary supplements

Table 5

Stepwise multiple regression analysis of several variables on bone mineral density in each site¹⁾

1) Dependent variable was bone mineral density in each site. Independent variables were, age, weight, parathyroid hormone, exercise, intakes of energy, protein, carbohydrate, fiber, calcium, phosphorus, potassium, vitamin A, riboflavin, niacin, and MAR, and frequencies of meats and eggs, fruits, milk and dairy products, and fast foods. The entry point of the stepwise method was 0.05, and the removal point was 0.10

Figure & Data

REFERENCES

Citations

Citations to this article as recorded by

Estimation of Bone Mineral Density in the Femoral Neck and Lumbar Spine using Texture Analysis of Chest and Pelvis Computed Tomography Hounsfield Unit
Young-Kyung Min, Dong-Ha Lee, Jae-Heung Yoo, Man-Jun Park, Jung-Wook Huh, MinWoo Kim
Current Medical Imaging Reviews.2023;[Epub] CrossRef
Milk Consumption and Bone Mineral Density in Adults: Using Data from the Korea National Health and Nutrition Examination Survey 2008–2011
Ji Soo Kim, Seung-Won Oh, Jiwoo Kim
Korean Journal of Family Medicine.2021; 42(4): 327. CrossRef
Dietary behaviors and nutritional status according to the bone mineral density status among adult female North Korean refugees in South Korea
Su-Hyeon Kim, Soo-Kyung Lee, Sin-Gon Kim
Journal of Nutrition and Health.2019; 52(5): 449. CrossRef
Nutrient Intake in Postmenopausal Rheumatoid Arthritis Women with Osteoporosis: Results from the Korean National Health and Nutrition Examination Survey
Yeon Soo Baik, Jee Won Park, Jihye Kim, Won Gyoung Kim, Sohee Oh, Sung-il Cho, Yeong Wook Song, Kichul Shin
Journal of Rheumatic Diseases.2017; 24(1): 35. CrossRef
Association between Hemoglobin Level and Bone Mineral Density in Korean Adults
Yun Hwan Oh, Ji Hyun Moon, Belong Cho
Journal of Bone Metabolism.2017; 24(3): 161. CrossRef
Association of serum vitamin D with osteosarcopenic obesity: Korea National Health and Nutrition Examination Survey 2008–2010
Jinhee Kim, Yunhwan Lee, Seunghee Kye, Yoon‐Sok Chung, Okhee Lee
Journal of Cachexia, Sarcopenia and Muscle.2017; 8(2): 259. CrossRef
The Factors Influencing the Bone Mineral Density in Korean Adult Men : Based on Korea National Health and Nutrition Examination Survey 2010~2011 Data
Hye-Sang Lee
Korean Journal of Community Nutrition.2017; 22(2): 136. CrossRef
Prevalence of Osteopenia/Osteoporosis and Related Risk Factors of Men Aged 50 Years and Older: Korea National Health and Nutrition Examination Survey 2010~2011 Data
Hye-Sang Lee
Journal of the Korean Dietetic Association.2016; 22(2): 106. CrossRef
Bone mineral density and nutritional state according to milk consumption in Korean postmenopausal women who drink coffee: Using the 2008~2009 Korea National Health and Nutrition Examination Survey
Sun-Hyoung Ryu, Yoon Suk Suh
Journal of Nutrition and Health.2016; 49(5): 347. CrossRef
Sex- and age group-specific associations between intakes of dairy foods and pulses and bone health in Koreans aged 50 years and older: Based on 2008~2011 Korea National Health and Nutrition Examination Survey
Hyun-Bi Seo, Young-Sun Choi
Journal of Nutrition and Health.2016; 49(3): 165. CrossRef
Nutrition Diagnostic Analysis for Nutrition Care Process Model in Adults of a Health Screening & Promotion Center
Hye Seung Lee, Ji Ho Chang, Hyeon Jeong Lee, So Jeong Park, Eun Hee Kang
Korean Journal of Community Nutrition.2015; 20(1): 61. CrossRef
Problems with Bone Health and the Influencing Factors of Bone Mineral Density in Women across the Life Cycle
Nami Chun, Hyunju Chae
Korean Journal of Women Health Nursing.2015; 21(1): 43. CrossRef
A Study on the Correlation between Menopausal Rating Scale and Bone Mineral Density for Menopausal Osteoporosis Patients※
Kyu In Kwak, Jae Hui Kang, Yun Joo Kim, Hyun Lee
The Acupuncture.2014; 31(3): 25. CrossRef
Various Factors Affecting the Bone Mineral Density in Korean Young Adult Women: Data from the Fifth Korea National Health and Nutrition Examination Survey (KNHANES V), 2010~2011
Kwang-Hyun Jho, Soon-Nam Choi, Nam-Yong Chung
Journal of the Korean Dietetic Association.2014; 20(2): 110. CrossRef
Association of Anthropometric and Biochemical Factors with Bone Mineral Density in Korean Adult Women Data from the Fourth (2008~2009) and Fifth (2010~2011) Korea National Health and Nutrition Examination Surveys (KNHANES IV & V)
Soon-Nam Choi, Kwang-Hyun Jho, Nam-Yong Chung
Journal of the Korean Dietetic Association.2014; 20(3): 157. CrossRef
Analysis of Bone Mineral Density, Biochemical Index and Nutrient Intakes of 30-70 Years Old Women: Based on 2011 KNHANES
Jae Ok Koo, Myung Sook Kim
Korean Journal of Community Nutrition.2014; 19(4): 328. CrossRef

PubReader

Cite

CITE: export Copy Download Format; Close

Download Citation

Download a citation file in RIS format that can be imported by all major citation management software, including EndNote, ProCite, RefWorks, and Reference Manager.

Format:

RIS — For EndNote, ProCite, RefWorks, and most other reference management software
BibTeX — For JabRef, BibDesk, and other BibTeX-specific software

Include:

Citation for the content below
Citation and abstract for the content below

Factors Associated with Bone Mineral Density in Korean Postmenopausal Women Aged 50 Years and Above: Using 2008-2010 Korean National Health and Nutrition Examination Survey

Korean J Community Nutr. 2013;18(2):177-186. Published online April 30, 2013

DOI: https://doi.org/10.5720/kjcn.2013.18.2.177

XML Download

Figure

We recommend

Related articles

Factors Associated with Bone Mineral Density in Korean Postmenopausal Women Aged 50 Years and Above: Using 2008-2010 Korean National Health and Nutrition Examination Survey

Fig. 1 Distribution of osteopenia and osteoporosis among study subjects.

Fig. 1

Factors Associated with Bone Mineral Density in Korean Postmenopausal Women Aged 50 Years and Above: Using 2008-2010 Korean National Health and Nutrition Examination Survey

Table 1

General characteristics of postmenopausal women by bone health status

1) P-values by one-way ANOVA for continuous variables and chi-square test for categorical variables

2) Values with different superscript letters within a row are significantly different means, based on one-way ANOVA followed by Scheffe's post hoc comparison test

Table 2

Pearson correlation coefficients between factors and bone mineral density in each site

1) Pearson correlation coefficient

Table 3

Partial correlation coefficients between nutrient intake and bone mineral density in each site

1) Adjusted for age, weight, exercise, smoking, alcohol drinking and dietary supplements

2) Adjusted for age, weight, exercise, parathyroid hormone, smoking, alcohol drinking and dietary supplements

3) Adjusted for age, weight, smoking, alcohol drinking and dietary supplements

Table 4

Partial correlation coefficients between food consumption frequency and bone mineral density in each site

1) Adjusted for age, weight, exercise, smoking, alcohol drinking and dietary supplements

2) Adjusted for age, weight, exercise, parathyroid hormone, smoking, alcohol drinking and dietary supplements

3) Adjusted for age, weight, smoking, alcohol drinking and dietary supplements

Table 5

Stepwise multiple regression analysis of several variables on bone mineral density in each site¹⁾

Table 1 General characteristics of postmenopausal women by bone health status

1) P-values by one-way ANOVA for continuous variables and chi-square test for categorical variables

2) Values with different superscript letters within a row are significantly different means, based on one-way ANOVA followed by Scheffe's post hoc comparison test

Table 2 Pearson correlation coefficients between factors and bone mineral density in each site

1) Pearson correlation coefficient

Table 3 Partial correlation coefficients between nutrient intake and bone mineral density in each site

1) Adjusted for age, weight, exercise, smoking, alcohol drinking and dietary supplements

2) Adjusted for age, weight, exercise, parathyroid hormone, smoking, alcohol drinking and dietary supplements

3) Adjusted for age, weight, smoking, alcohol drinking and dietary supplements

Table 4 Partial correlation coefficients between food consumption frequency and bone mineral density in each site

1) Adjusted for age, weight, exercise, smoking, alcohol drinking and dietary supplements

2) Adjusted for age, weight, exercise, parathyroid hormone, smoking, alcohol drinking and dietary supplements

3) Adjusted for age, weight, smoking, alcohol drinking and dietary supplements

Table 5 Stepwise multiple regression analysis of several variables on bone mineral density in each site1)