• Journal of Preventive Medicine and Public Health
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• v.39 no.5
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• pp.389-396
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• 2006

Objectives: A community-based, cross-sectional survey was conducted to determine theprevalence of osteoporosis and to evaluate the effects of body composition, health behaviors and reproductive history on bone density in postmenopausal women. Methods: The study subjects were 362 postmenopausal women, aged 45 years old or over, who were invited to the hospital. Information on their socio-demographic characteristics and the potential risk factors such as their past medical history, smoking, alcohol intake, exercise, diet and menstrual/reproductive histories were collected by trained interviewers. Weight, height, the body mass index ($kg/m^{2}$), and body composition variables were measured. Bone mineral density of the lumbar spine was measured by dual energy X-ray absorptiometry (DXA). Results: The prevalence of osteoporosis was 30.6% in the $45{\sim}64$ years old women, 52.5% in the elderly women aged $65{\sim}74$, and 68.7% in the women aged 75 years or over. After adjustment for the effect of potential covariates, those women in the highest 25% (4th quartile) of the lean body mass are less likely to have osteoporosis (aOR=0.31, 95% CI=0.12-0.76), compared with the lowest quartile group. More parity also had significantly detrimental effects on osteoporosis. Conclusions: These findings suggest that the prevalence of osteoporosis in postmenopausal women increased with age from 46.3% of those aged 45-64 to 68.7% for those aged 75 and over. Lean body mass and parity appeared significant contributor to bone mineral density in postmenopausal women in this population.

• Korean Journal of Community Nutrition
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• v.9 no.1
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• pp.66-72
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• 2004

There is some evidence that phytostrogen plays an important role in bone metabolism in postmenopausal women. In this study, we investigated the phytoestrogen intake levels and the relation between dietary phytoestrogens intake and bone mineral density of vegetarian (n = 77) and omnivore postmenopausal women (n = 122 . Vegetarian women, all of them were seven day adventists, who had been on vegetarian diet (almost lacto-ovo vegetarians;a few vegans) oyer 20 yrs. The average age of vegetarians and omnivores were 62.3 yrs and 60.2 yrs, respectively and, there was no significant difference. However, body weight (p < 0.001), body mass index (p < 0.001) of vegetarians were significantly lower than those of omnivores. The mean daily energy intake of vegetarians and omnivores were 1386.1 kcal (76.3% of RDA) and 1424.5 kcal (76.9% of RDA), respectively. The mean calcium intake of vegetarians (456.7 mg, 66.3 % of RDA) was not significantly different from that of omnivores (453.5 mg, 65.2 % of RDA). The mean daily isoflavones (daidzein +genistein) intake of vegetarians and omnivore were 33.9 mg and 23.9 mg, respectively. The vegetarians consumed significantly greater quantities of isoflavones (p < 0.05) and lignans precursor (p < 0.05). In the vegetarians, intake of isoflavones was significantly positively correlated with BMD of femoral neck, after adjusted for age and BMI. Also lignan precursor intake of vegetarians was significantly positively correlated with BMD of spine, after adjusted for age and BMI. In conclusion, in omnivore post menopausal women, intake of phytoestrogen such as isoflavones and lignans was little low, and it is not clear that positive association with bone mineral density. But in vegetarian postmenopausal women, phytoestrogen intakes be important factors related to bone mineral density.

• Korean Journal of Community Nutrition
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• v.9 no.1
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• pp.73-80
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• 2004

Bone mineral density (BMD) focus one's attention on prevention effects of osteoporosis. This study was conducted to investigate BMD (lumbar spin : L2- L4, femur neck : m, femur trochanter TR, femur ward's triangle : WT, wrist) and look into the factors that affect BMD by menopause in 89 nonsmoking healthy Korean women (40-60 yr). Anthropometric index and body composition, nutrient intakes, osteocalcin and total protein, albumin, total cholesterol, triacylglycerol and calcium in serum were determined. Body fat mass, diastolic blood pressure and serum cholesterol concentration of postmenopausal women were significantly higher than those of premenopausal women. FN, TR, WT, wrist BMD of postmenopausal women were not different from those of premenopausal women. However L2- L4 BMD of postmenopausal women was lower than that of premenopausal women. Significant positive correlations were found between L2-L4, FN, TR, WT and weight (r = 0.44, r = 0.64, r = 0.58, r = 0.57) and significant positive correlations were found between FN, TR, WT and BMI (r =: 0.54, r = 0.41, r = 0.54) of premenopausal women. Whereas significant positive correlation was only found between TR BMD and weight. BMI (r = 0.38, r = 0.29) of postmenopausal women. FN BMD and WC (waist circumstance) of premenopausal women were found significant positive correlation (r = 0.35) whereas L2-L4 BMD and WC of postmenopausal women was found significant negative correlation (r = -0.31) . In premenopausal women. differences of bone BMD were not shown by exercise and alcohol drinking, but in postmenopausal women, significant difference of FN BMD was shown by exercise and alcohol drinking. These results suggested that by menopause, effects of weight, BMI, WC, exercise and alcohol drinking on bone BMD were different. Therefore, by menopause, we should consider the different ways to increase the bone BMD according to different factors.

• Journal of Nutrition and Health
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• v.36 no.5
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• pp.476-482
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• 2003

We studied the effects of soy isoflavone supplements on bone metabolism marker (serum osteocalcin, urinary deoxypyridinoline) and urinary mineral excretion (urinary Ca, Mg, Zn) in 47 postmenopausal women. There were 24 participants in the treatment group and 23 in the control group. The treatment group consumed isoflavone extract capsules daily (which contained 90 mg of soy isoflavones) for 12 weeks. The study compared before and after isoflavone intake in the following areas: Physical examination, diet survey, bone metabolism marker and urinary mineral excretion. The average age of the treatment group was 64.6 years and that of the control group was 66.5 years. There were no significant differences between the two groups in terms of height, weight and body mass index. Both groups maintained a regular diet pattern in terms of their average daily nutrient intake. There were no significant differences between the treatment group (23.9 mg) and the control group (25.4 mg) in terms of daily isoflavone intake based on diet. The analysis of bone metabolism marker changes in the treatment group after 12 weeks of taking the isoflavone supplements demonstrated significant differences in the following: Serum osteocalcin (13.7 ng/mL in befor versus 6.8 ng/mL in after) and urinary deoxypyridinoline (5.9 nmol/mmol Cr in befor versus 4.5 nmol/mmol Cr in after). The subjects in the treatment group showed no significant difference in urinary Ca excretion. But the subjects showed a significant difference in urinary Mg (131.9 mg/day in befor versus 115.6 mg/day in after) and Zn (400.5 $\mu\textrm{g}$/day in befor versus 310.2 $\mu\textrm{g}$/day in after) excretion in the isoflavone treatment group at the levels of p<0.001, p<0.01, respectively. No changes were made in the intake of minerals. The composition of serum osteocalcin and urinary deoxypyridinoline, and indicators of bone metabolism, including the excretion Mg and Zn, significantly decreased. As a result, bone mineral loss was lessened. (Korean J Nutrition 36(5): 476~482, 2003)

• Journal of Nutrition and Health
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• v.39 no.5
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• pp.476-484
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• 2006

To elucidate the relationship between blood parameters related bone metabolism and antioxidant enzyme activity in postmenopausal period 60 women residing in Iksan area were recruited. Food and nutrient intake of each individual subject were estimated by 24-hour recalls of 3 non-consecutive days. The biochemical markers including total protein, albumin, osteocalcin (intact bone gla protein; BOP), calcium, phosphorus and hemoglobin were measured in fasting blood. In addition, parameters of antioxidative capacity including the activities of superoxide dismutase (SOD), glutathione peroxidase (GPx) , catalase (CAT) and total antioxidant capacity (TA) were monitored in blood, also. The mean age, height, weight, and BM! of subjects were 64.8 years, 151.1 em, 59.5 kg $26.0\;kg/m^2$, respectively. The mean SOD, GPx, and CAT activities were 138.5 U/ml, 1,273.8 U/ml and 314.3 kU/l respectively, and TA was 1.16 mmol/l without significant difference among different age groups. BMI was positively correlated with SOD activity (p < 0.01). SOD activity and CAT activity showed positive correlation with serum albumin (p < 0.05) and hemoglobin (p < 0.01). In conclusion, this study revealed that antioxidant enzyme activity holds a significant relationship with the blood parameters like as serum albumin and hemoglobin in postmenopausal women and further systematic research is needed to investigate the their relation mechanism.

• Journal of Nutrition and Health
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• v.39 no.8
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• pp.801-807
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• 2006

To elucidate the effect of soy isoflavone supplementation on bone mineral density and antioxidant enzyme activity in 60 postmenopausal women residing in Iksan area were recruited. There were 31 participants in the treatment group and 29 in the control group. The treatment group consumed isoflavone extract capsules daily (which contained 90 mg of soy isoflavones) for 12 weeks. The study compared before and after isoflavone intake in the following areas. Physical examination, diet survey, bone mineral density (BMD) and antioxidant enzyme activity (superoxide dismutase (SOD), glutathione peroxidase (GPx), catalase (CAT) and total antioxidant capacity (TA)). The average age of the treatment group was 64.6 years and that of the control group was 66.5 years. There were no significant differences between the two groups in terms of height, weight and body mass index. Both groups maintained a regular diet pattern in terms of their average daily nutrient intake. There were no significant differences between the treatment group (23.3 mg) and the control group (24.0 mg) in terms of daily isoflavone intake based on diet. Isoflavone supplementation of 12 weeks did not resulted in any significant changes in BMD or parameters of antioxidant enzyme activity, implying the necessity of more intensive intervention for a substantial change. In conclusion, this study revealed that antioxidant enzyme activity holds a significant relationship with the bone mineral density in postmenopausal women and further systematic research on dose and period of isoflavone supplementation is needed to clearify the positive effect of isoflavone on BMD and/or blood antioxidant capacity in postmenopausal women.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.26 no.5
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• pp.519-526
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• 2000

Osteoporosis has recently been recognized as a major health problem in the elderly population. The disorder is manifested as a loss of bone mass accompanied by structural alteration of bone and increased incidence of fracture. Mandible also may be affected. So, I evaluated panoramic views of 66 postmenopausal women for finding the possibility of useful diagnostic mandibular parmeters of osteoporosis. To know the correlationship between skeleton and mandible, the average of the bone mineral density of lumbar from 2nd to 4th by the dual energy X-ray absorptiometry(DEXA, LUNAR DPZ. USA), and age and mandibular parameters, that is, the number of residual teeth, alveolar ridge resorption ratio, panoramic mandibular index (PMI), mandibular cortical width (MCW), angular cortical thickness (ACT), ramus cortical thickness (RCT), morphology of mandibular inferior cortical (MIC) were compared. And I divided the all tested women to the osteoporotic group and non-osteoporotic group by the use of T-score -2.0, which was derived from skeletal bone mineral density (BMD). To find the correlationship of the each group with mandibular parameters, t-test and discriminant analysis were done. The results of the t-test were that all parameters were highly related with 2 groups (p<0.05). Especially ACT, MIC, age have had even higher correlationship than others (p<0.001). The results of the discriminant analysis by the use of these ACT, MIC and age were that the discriminant function was Z = -2.973+(-1.447)$\times$(ACT)+1.131$\times$(MIC score)+(0.052)$\times$(age), the cutting score was 0.257 and the classification accuracy was 84.8%. Therefore I suggest that the consideration of the angular cortical thickness (ACT), the age of patient and the morphology of mandibular inferior cortical(MIC) may help find the osteoporosis.

• Journal of the Korean Society of Food Science and Nutrition
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• v.30 no.1
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• pp.159-167
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• 2001

The objective of this study is to examine the factors affecting bone mineral density in pre- and postmenopausal women. The subject were 30 Korean premenopausal women with mean ages of 33.6 years, and 30 Korean post menopausal women with mean ages of 63.3 years without diagnosed diseases. Data for food and nutrient intake were obtained by the24-hour recall method. BMD of lumbar spine and femoral neck were measured by the dual-energy X-ray absorptiometry (DEXA). Anthropometric measurement were made, and a blood sample was taken for assay osteocalcin. The results are summarized as follows: 16.67% of the subjects in the premenopausal women and 87.33% of the subjects in the postmenopausal women was less than the korean RDA level exceping phosphorus and vitamin C. In the premenopausal women, BMD of lumbar spine is correlated significantly with anthropometric measurement such as weight, waist circumference, BMI, and body fat mass BMD of femoral neck for the premenopausal women is correlated significantly with weight, BMI, waist circumference, body fat mass, hip circumference, and BMDs of both site are negatively correlated with lean body mass, total body water, but they are not related with intake of nutrients in this study. In the postmenopausal women group, BMDs of both site are not significantly correlated with anthropometric measurement, but BMD of lumbar spine showed positive relation with intake of energy, protein, and carbohydrate. In conclusion, adequate nutrient intake, especially energy, protein have been suggested to prevent the loss of bone mineral density in the postmenopausal women. Also, adequate body weight and BMI have been suggested in the premenopausal women.

• The Korean Journal of Food And Nutrition
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• v.20 no.4
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• pp.450-459
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• 2007

This study was performed to assess the relationships between bone mineral density(BMD), anthropometric measurements, and maternal factors in postmenopausal women. The anthropometric measurements were taken by a trained practitioner, and the maternal factors of the 85 subjects in Chungnam were acquired by an interview questionaire. The BMDs of the lumbar $spines(L_2-L_4)$, femoral necks(FN), ward's triangles(WT), and trochanters(TR) were measured by dual energy X-ray absorptiometry(DEXA). The BMDs(T-score) for $L_2-L_4$, FN, and WT were 0.996 $g/cm^2$(-1.601), 0.697 $g/cm^2(-1.657)$, and 0.793 $g/cm^2(-1.512)$ respectively, which were assessed as osteopenia by the T-score ; TR was noma1 at 0.718 $g/cm^2(-0.675)$. The 85 subjects in Chungnam were divided into three groups according to their BMD measurements for $L_2-L_4$ and FN, assessed by the T-score. The percentages in the osteoporosis, osteopenia, and normal groups were 32.9%, 42.4, and 24.7%, respectively. The average age was significantly the highest in the osteoporosis group than in the other two osteopenia and normal group(p<0.001). The subjects' BMDs were positively correlated with weight, height, BMI, waist, WHR, OBR and hip circumference, and negatively correlated with the age, duration time after menopause, lactation, the age of last delivery, menarche age, and number of children. The average age at menopause was 48.8. The osteoporosis group's average age at menopause was lower than those of the other groups. However, the BMD of the lumbar spine positively correlated with duration time after menopause and the BMD of the femoral neck with lactation, last delivery, menarch age, number of children. Therefore, researches are needed to find out the effective way to minimize the effect of age and other physiological conditions on the decrease of bone mass density.

• 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.