Journal of Preventive Medicine and Public Health

Original Articles

Association Between Parity and Low Bone Density Among Postmenopausal Korean Women: Eunsun Seo, Yongrong Lee, Hyeon Chang Kim; J Prev Med Public Health. 2021;54(4):284-292. Published online June 24, 2021; DOI: https://doi.org/10.3961/jpmph.21.162

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Abstract Summary PDF Supplementary Material

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.

Summary

Korean summary
40-64세 폐경 여성 1287명을 대상으로 과거 출산 횟수와 골밀도의 관련성을 평가하였다. 정량적 전산화 단층촬영(QCT)으로 L1-L2의 평균 골무기질밀도(bone mineral density, BMD)를 측정하였으며, 그 값이 120mg/cm3 미만이면 골밀도 감소가 있는 것으로 정의하였다. 나이, 비만도, 폐경후기간, 직업, 소득, 교육, 결혼, 흡연, 음주, 신체활동, 질병력 등을 보정하여도, 출산횟수가 많을수록 평균 골밀도는 낮고 골밀도감소의 빈도는 높은 경향이 관찰되었다.

Citations

Citations to this article as recorded by

The Heterogeneity of Post-Menopausal Disease Risk: Could the Basis for Why Only Subsets of Females Are Affected Be Due to a Reversible Epigenetic Modification System Associated with Puberty, Menstrual Cycles, Pregnancy and Lactation, and, Ultimately, Meno
David A. Hart
International Journal of Molecular Sciences.2024; 25(7): 3866. CrossRef
Bridging the Gap: Pregnancy—And Lactation—Associated Osteoporosis
Mara Carsote, Maria Roxana Turturea, Ana Valea, Cristian Buescu, Claudiu Nistor, Ionut Florin Turturea
Diagnostics.2023; 13(9): 1615. CrossRef
Associations of breastfeeding duration and the total number of children breastfed with self-reported osteoarthritis in Korea women 50 years and older: a cross-sectional study
Dajeong Ham, Sanghyuk Bae
Epidemiology and Health.2023; 45: e2023044. CrossRef
Association between parity and bone mineral density in postmenopausal women
Yimei Yang, Shanshan Wang, Hui Cong
BMC Women's Health.2022;[Epub] CrossRef

Relationship Between Non-alcoholic Fatty Liver Disease and Decreased Bone Mineral Density: A Retrospective Cohort Study in Korea: Jisun Sung, Seungho Ryu, Yun-Mi Song, Hae-Kwan Cheong; J Prev Med Public Health. 2020;53(5):342-352. Published online July 17, 2020; DOI: https://doi.org/10.3961/jpmph.20.089

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Abstract PDF

Objectives
The aim of this retrospective cohort study was to investigate whether non-alcoholic fatty liver disease (NAFLD) was associated with incident bone mineral density (BMD) decrease.
Methods
This study included 4536 subjects with normal BMD at baseline. NAFLD was defined as the presence of fatty liver on abdominal ultrasonography without significant alcohol consumption or other causes. Decreased BMD was defined as a diagnosis of osteopenia, osteoporosis, or BMD below the expected range for the patient’s age based on dual-energy X-ray absorptiometry. Cox proportional hazards models were used to estimate the hazard ratio of incident BMD decrease in subjects with or without NAFLD. Subgroup analyses were conducted according to the relevant factors.
Results
Across 13 354 person-years of total follow-up, decreased BMD was observed in 606 subjects, corresponding to an incidence of 45.4 cases per 1000 person-years (median follow-up duration, 2.1 years). In the model adjusted for age and sex, the hazard ratio was 0.65 (95% confidence interval, 0.51 to 0.82), and statistical significance disappeared after adjustment for body mass index (BMI) and cardiometabolic factors. In the subgroup analyses, NAFLD was associated with a lower risk of incident BMD decrease in females even after adjustment for confounders. The direction of the effect of NAFLD on the risk of BMD decrease changed depending on BMI category and body fat percentage, although the impact was statistically insignificant.
Conclusions
NAFLD had a significant protective effect on BMD in females. However, the effects may vary depending on BMI category or body fat percentage.

Summary

Citations

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Anti-osteoporotic treatments in the era of non-alcoholic fatty liver disease: friend or foe
Maria Eleni Chondrogianni, Ioannis Kyrou, Theodoros Androutsakos, Christina-Maria Flessa, Evangelos Menenakos, Kamaljit Kaur Chatha, Yekaterina Aranan, Athanasios G. Papavassiliou, Eva Kassi, Harpal S. Randeva
Frontiers in Endocrinology.2024;[Epub] CrossRef
Association between body fat and bone mineral density in Korean adults: a cohort study
Hyunjung Yoon, Eunju Sung, Jae-Heon Kang, Cheol-Hwan Kim, Hocheol Shin, Eunsol Yoo, Minyoung Kim, Mi Yeon Lee, Sujeong Shin
Scientific Reports.2023;[Epub] CrossRef
Liver fibrosis is associated with impaired bone mineralization and microstructure in obese individuals with non-alcoholic fatty liver disease
Ilaria Barchetta, Carla Lubrano, Flavia Agata Cimini, Sara Dule, Giulia Passarella, Arianna Dellanno, Alberto Di Biasio, Frida Leonetti, Gianfranco Silecchia, Andrea Lenzi, Maria Gisella Cavallo
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Nonalcoholic Fatty Liver Disease Is Associated With Decreased Bone Mineral Density in Adults: A Systematic Review and Meta‐Analysis
Ying‐Hao Su, Kuo‐Liong Chien, Shu‐Hua Yang, Wei‐Tso Chia, Jen‐Hau Chen, Yen‐Ching Chen
Journal of Bone and Mineral Research.2023; 38(8): 1092. CrossRef
The National Consensus statement on the management of adult patients with non-alcoholic fatty liver disease and main comorbidities
Marina V. Maevskaya, Yulia V. Kotovskaya, Vladimir T. Ivashkin, Olga N. Tkacheva, Ekaterina A. Troshina, Marina V. Shestakova, Valeriy V. Breder, Natalia I. Geyvandova, Vladimir L. Doshchitsin, Ekaterina N. Dudinskaya, Ekaterina V. Ershova, Khava B. Kodzo
Terapevticheskii arkhiv.2022; 94(2): 216. CrossRef
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Ilias D. Vachliotis, Athanasios D. Anastasilakis, Antonis Goulas, Dimitrios G. Goulis, Stergios A. Polyzos
Diabetes, Obesity and Metabolism.2022; 24(9): 1702. CrossRef
Hepatic fibrosis is associated with an increased rate of decline in bone mineral density in men with nonalcoholic fatty liver disease
Ji Won Yoon, Min Joo Kim, Goh-Eun Chung, Jong In Yang, Jeong Yoon Yim, Jin Ju Kim, Sun Mie Kim, Min-Sun Kwak
Hepatology International.2021; 15(6): 1347. CrossRef
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Physical Activity in Adolescence Has a Positive Effect on Bone Mineral Density in Young Men: Jinhyun Kim, Moonki Jung, Yeon-pyo Hong, Jung-Duck Park, Byung-Sun Choi; J Prev Med Public Health. 2013;46(2):89-95. Published online March 28, 2013; DOI: https://doi.org/10.3961/jpmph.2013.46.2.89

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Abstract PDF

Objectives

Little is yet known about the determinants of bone mineral density (BMD) in young adults. Thus, in this study, we aimed to determine the factors that have an impact on BMD in young men.

Methods

Questionnaires were sent out to 111 male medical students. Information on age, socio-economic status, medical history, lifestyle, physical activity during adolescence, school club participation, current physical activity, and dietary intake were collected by the survey. Height, weight, percent body fat and muscle mass were estimated by bioelectrical impedance, and BMD was obtained using calcaneal quantitative ultrasound. Using the Poisson regression model, prevalence ratios (PRs) were used to estimate the degree of association between risk factors and osteopenia.

Results

The height and current physical activity showed a correlation to the Osteoporosis Index. Among the categorized variables, past physical activity during adolescence (p=0.002) showed a positive effect on the bone mineral content. In the multivariate model, past physical activity (≥1 time/wk) had a protective effect on osteopenia (PR, 0.37; 95% confidence interval [CI], 0.18 to 0.75) and present physical activity (1000 metabolic equivalent of task-min/wk) decreased the risk of osteopenia (PR, 0.64; 95% CI, 0.44 to 0.91).

Conclusions

Past physical activity during adolescence is as important as physical activity in the present for BMD in young men.

Summary

Citations

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Chang-Sook Han, Hyo-Kyung Kim, Suhee Kim
International Journal of Environmental Research and Public Health.2021; 18(11): 6170. CrossRef
A Review of Knowledge, Belief and Practice Regarding Osteoporosis among Adolescents and Young Adults
Chin Chan, Norazlina Mohamed, Soelaiman Ima-Nirwana, Kok-Yong Chin
International Journal of Environmental Research and Public Health.2018; 15(8): 1727. CrossRef
Relationship between total and segmental bone mineral density and different domains of physical activity among children and adolescents: cross-sectional study
Tiego Aparecido Diniz, Ricardo Ribeiro Agostinete, Paulo Costa Junior, Bruna Thamyres Ciccotti Saraiva, Diego Kanashiro Sonvenso, Ismael Forte Freitas Junior, Rômulo Araujo Fernandes, Diego Giulliano Destro Christofaro
Sao Paulo Medical Journal.2017; 135(5): 444. CrossRef
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Alessandra Madia Mantovani, Manoel Carlos Spiguel Lima, Ricardo Ribeiro Agostinete, Igor Hideki Ito, Jamile Sanches Codogno, Kyle Robinson Lynch, Rômulo Araújo Fernandes
Motriz: Revista de Educação Física.2016; 22(4): 335. CrossRef
Bone Mineral Density and Response to Treatment in Men Younger Than 50 Years with Testosterone Deficiency and Sexual Dysfunction or Infertility
Ravi Kacker, William Conners, John Zade, Abraham Morgentaler
Journal of Urology.2014; 191(4): 1072. CrossRef
Comparison of Musculoskeletal Characteristics and Bone Mineral Density Related Factors between Male and Female University Students
Seung-Hye Choi, Haeyoung Lee, MiJeong Park, Seungmi Park
Journal of muscle and joint health.2013; 20(3): 161. CrossRef

The Association between Bone Density at Os Calcis and Body Composition in Healthy Children Aged 9-12 Years.: Eun Kyung Shin, Ki Suk Kim, Hee Young Kim, In Sook Lee, Hyo Jee Joung, Sung Il Cho; J Prev Med Public Health. 2004;37(1):72-79.

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Abstract PDF: OBJECTIVE
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.; Summary

English Abstract

Distribution of Calcaneal Bone Density According to the Mechanical Strain of Exercise and Calcium Intake in Premenarcheal Girls.: Eun Kyung Shin, Ki Suk Kim, Hee Young Kim, In Sook Lee, Hyo Jee Joung, Sung Il Cho; J Prev Med Public Health. 2005;38(3):291-297.

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Abstract PDF: OBJECTIVE
The effects of exercise on bone density have been found to be inconsistent in previous studies. We conducted a cross-sectional study in premenarcheal girls to test two hypotheses to explain these inconsistencies. Firstly, "the intensity of mechanical strain, in terms of the ground reaction force (GRF), has more important effects on the bone mass at a weight-bearing site", and secondly, "calcium intake modifies the bone response to exercise". METHODS: The areal bone mineral density was measured at the Os calcis, using peripheral dual energy X-ray absorptiometry, in 91 premenarcheal girls aged between 9 and 12 years. The intensity of mechanical strain of exercise was assessed by a self-report questionnaire and scored by the GRF as multiples of body weight, irrespective of the frequency and duration of exercise. The energy and calcium intake were calculated from the 24-hour dietary recall. An analysis of covariance (ANCOVA) was used to determine the interaction and main effects of exercise and calcium on the bone density, after adjusting for age, weight, height and energy intake. RESULTS: The difference in the bone density between moderate and low impact exercise was more pronounced in the high than low calcium intake group. The bone density for moderate impact exercise and high calcium intake was significantly higher than that for low impact exercise (p=0.046) and low calcium intake, after adjusting for age, weight, height and energy intake. CONCLUSIONS: Our study suggests that the bone density at a weight-bearing site is positively related to the intensity of mechanical loading exercise, and the calcium intake may modify the bone response to exercise at the loaded site in premenarcheal girls.; Summary

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