• Journal of Nutrition and Health
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• v.35 no.4
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• pp.473-479
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• 2002

This study investigated associations between calcium intake, exercise behaviors, lumbar bona mineral density (BMD), and bone mineral content (BMC) among 79 premenopausal women (mean age = 41yr). The BMD and BMC of the lumbar spine (L$_2$-L$_4$) were measured by dual energy x-ray absorptiometry. Nutrient intake was estimated by the convenient method and a quantitative food frequency questionnaire was designed for this study that included the most commonly consumed floods sources of Ca. Participants were asked to identify all activities of exercise they had participated in including estimation of number of years of participation, number of weeks per year, number of times per week, and the number of hours per session. Participants were then categorized into the exercise group or nonexercise group (control). To meet the criteria for inclusion in the exercise group, the subjects participated more than 3 sessions per week and more than 30 minutes per session and the length of the exercise participation was at least more then 6 months. The participants were also grouped by calcium intake. The total calcium intake of all participants was estimated by dietary calcium intake and then the subjects were divided into quartiles to assess the lumbar BMD and BMC of the upper 25% (average calcium intake = 910 mg) and the lower 25% (average calcium intake = 414 mg). Results indicated that there were no significant differences in energy and calcium intake, and that there were no significant differences in lumbar BMD and BMC between participants in exercise group and the nonexercising control group. However, the exercise group had significantly lower ALP concentration than the nonexercise group. The upper 25% calcium intake group had significantly greater lumbar bone mineral density and bone mineral content than the lower 25% calcium intake group. Also the upper 25% calcium intake group had significantly lower ALP concentration than the lower 25% calcium intake group. Correlation analysis revealed that the spinal BMB was positively associated with body weight, while calcium intake was negatively associated with ALP concentration in nonexercising women. However, neither body weight nor dietary calcium intake were associated with both spinal BMD or ALP concentration in exercising women. These results suggest that calcium intake positively influence bone mineral density and bone mineral content in nonexercisulg premenopausal women. Exercise group did not affected by body weight and dietary calcium, but decreased ALP concentration than nonexercising group. Both exercise and calcium intake positively influence bone mineral density and bone mineral content in premenopausal women.

• Journal of Nutrition and Health
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• v.35 no.4
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• pp.464-472
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• 2002

This study was conducted to investigate dietary and other factors affecting bone mineral density in young Korean collage women. Thirty subjects were recruited; the mean age was 22.1 years and the mean age at menarche was 12.6 years. Bone mineral density (BMD) was measured in the spine (LS), femoral neck (FN), ward's triangle (WT), and femoral trochanter (FT) by Dual Energy X-ray Absorptiometry (DEXA), and physical activity was assessed by a questionnaire. Dietary intake data were obtained 8 times by using a 24 hour recall method to evaluate the subjects' usual diet. Bone mineral densities of lumbar spine, femoral neck, ward's triangle and femoral trochanter were 1.149 g/$\textrm{cm}^2$, 0.980 g/$\textrm{cm}^2$, 0.936 g/$\textrm{cm}^2$ and 0.759 g/$\textrm{cm}^2$ respectively. The met energy intake of subjects was 1,790 kcal, and calcium and iron intakes were found to be inadequate compared to the Korean RDA. The BMD of the lumbar spine was significantly and positively related to the BMI and intake of vitamin C, carbohydrate, potatoes, fruits and plant food. The BMD of the femur (FN, WT, FT) was positively related to the BMI, to carbohydrate and fruit intake, and to the percentage of plant food in total food intake. Multiple recession analysis showed that fruit intake was significantly related to the BMD of the LS. The subjects'ages and fruit intakes were significantly related to the BMD of the femur (FN, WT, FT). These results indicate that higher fruit intakes may have a beneficial effect on bone mineral density.

• Korean Journal of Community Nutrition
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• v.7 no.1
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• pp.121-129
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• 2002

Osteoporosis, the typical metabolic bone disease of the elderly, is characterized by a reduction in bone mineral density (BMD) and increased fracture risk. Genetic and environmental factors are known to play a key role in bone metabolism, and diet is also considered to be one of the important factors. The purpose of the present study was to investigate the relationship among the factors affecting BMD, including stature, body weight, age, time period since onset of menopause, and biochemical markers of bone turnover in postmenopausal women. Seventy-eight postmenopausal women who visited health promotion center for health examinations volunteered to participate in this study and they were divided into two groups according to the time period since onset of menopause : women with a time period since onset of menopause of less than 5 years (Group 1) and women with a time period since onset of menopause of 5 years or more (Group 2). The demographic characteristics and dietary intake were surveyed using a questionnaire. BMDs of the lumbar spine and femoral neck of subjects were measured by dual energy X-ray absorptiometry. Serum levels of 25-hydroxy-vitamin D and parathyroid hormone (PTH), known to be indicators of bone related hormone status, were anlyzed. Serum samples were measured for calcium, phosphorus, alkaline phosphatase, and osteocalcin as bone formation indicators, and urine was analysed for deoxypyridinoline, creatinine, calcium, and sodium as bone resorption indicators. The results are as follow : The mean BMDs of the lumbar spin and femoral neck were $1.02 \pm 0.02 g/cm^2 and 0.81 \pm 0.02 g/cm^2 respectively, and the BMD level of Group 2 was significantly lower than tat of Group 1 (p<0.01, p<0.05, respectively). The mean daily intake of energy was 1838 $\pm$ 55 kcal. When nutrient intake was compared with the recommended dietary allowances (RDA) of the subjects, only calcium, vitamin A and riboflavin intake showed means lower than the RDA. The nutrient intake did not show any significant differences between Group 1 and 2 Serum and urine levels of biochemical markers of bone turnover did not show any significant differences between Group 1 and 2, and all were within the normal range. However, the PTH and deoxypyridinoline levels showed a tendency to be higher, and the osteocalcin level to be lower in Group 2 than in Group 1. Although age and years after menopause (YAM) showed negative correlations with lumbar spine bone mineral density (LBMD) (r= -0.38, p<0.001, and r= -0.26, p< 0.05, respectively), no correlation was found with femoral neck bone mineral density (NBMD). While height, body weight and body mass index (BMI) showed a positive correlation with LBMD (r= 0.32, p<0.001, r= 0.38, p<0.001, r= 0.22, p= 0.05, respectively), only body weight and BMI showed a positive correlation with NBMD (r= 0.30, p<0.01, and r= 0.27, p<0.05, respectivley). There was no significant corealtion between BMDs and the nutrient intake of subjects, except in the case of carbohydrates (r= 0.22, p<0.05). Also, serum and urine levels of bone turnover markers showed no significant correlation with nutrient intake. On the other hand, serum osteocalcin had a positive correlation with vitamin C intake (r= 0.22, p= 0.05), and urine deoxypyridinolin showed a negative correlation with niacin intake (r= -0.22, p= 0.05). Urinary na was negatively correlated with protein intake(r= -0.23, p= 0.05). The results suggested that it is difficult to prevent the decrease in bone mass among postmenopausal women eating the usual Korean diet. However, the BMDs of the lumbar spine and femoral neck were positively related to body weight ad BMI in postmenopausal women. Therefore, this study confirmed that one of the most effective ways to minimize bone loss in postmenopausal women would be to maintain an adequate body weight with balanced nutrient intake and activity in the pre-and postmenopausal periods.

• Journal of radiological science and technology
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• v.31 no.4
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• pp.367-377
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• 2008

We studied the change of bone mineral density (BMD) by age, body mass index (BMI), coffee, carbonated drink, alcohol, smoking, and exercise in adults who checked in health center. The number of study subjects was total 268 persons (women of 136 persons and men of 132 persons). The BMD was determined in lumbar spine and femoral neck by dual energy x-ray absorptiometry. And we got some results as below : 1. In women, mean body height was $155.8{\pm}6.0cm$, mean body weight was $56.8{\pm}7.9kg$, and mean BMI was $23.4{\pm}3.1kg/m^2$. In men, mean body height was $169.1{\pm}6.0cm$, mean body weight was $69.0{\pm}9.5kg$, and mean BMI was $24.1{\pm}2.7kg/m^2$. 2. BMD decreased as age increased, and the age was the most determinant factor for BMD (p<0.01). Women's BMD decreased rapidly in the groups aged $\geq$50s, while men's BMD decreased gradually with age. In addition, for both sex, lower BMD was measured in lumbar spine than in femoral neck. 3. BMD increased in high BMI, and BMD with BMI increased distinctly in the group aged 50s. But their relationship was not significant. 4. In view of the distribution by three BMD categories, women's BMD was mostly normal in the groups aged $\geq$40s, but the rate of osteopenia and osteoporosis was similar in the group aged 50s, and the rate of osteoporosis was the highest in the groups aged 60s and 70s. Men's BMD was mostly normal through all groups except the group aged 70s. 5. Coffee and carbonated drink were not influenced in BMD. But alcohol-drinking group showed higher BMD than non-drinking group, and alcohol was statistically significant determinant for BMD (p<0.05). Smoking and exercise were not statistically significant determinant of BMD.

• Journal of the Korean Society of Food Science and Nutrition
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• v.33 no.2
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• pp.339-348
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• 2004

This study was peformed to assess the relationships among bone mineral density (BMD), Physiological characteristics and lifestyle factors in 61 premenopausal working women aged 30∼49 y in Busan. The BMDs of the lumbar spines (Ll∼L4), femoral necks (FN), ward's triangles (WT) and trochanters (TC) were measured by dual energy X-ray absorptiometry. Data for physiological characteristics and physical activity was assessed by questionnaire and usual intakes of coffee, green tea, alcohol, Coca cola by food frequency questionnaire. The BMDs of L14, FN, WT and TC were 1.02 g/$\textrm{cm}^2$, 0.76 g/$\textrm{cm}^2$,0.69 g/$\textrm{cm}^2$ and 0.66 g/$\textrm{cm}^2$respectively The BMD of FN was assessed as osteopenia by T-score. The BMD of WT was positively correlated with age of monarch (p<0.05) and the BMD of Ll4 was positively correlated with delivery number (p<0.05). The BMD of Ll4 was positively correlated with hours of outdoor activity per weekend and week (p<0.05, p<0.05). The BMDs of FN and WT (p<0.05, p<0.05) were positively correlated with intake of green tea per month and the BMD of FN (p<0.05) was positively correlated with intake of wine per month. But the BMD of Ll (p<0.05) was negatively correlated with intake of Coca cola per month. So nutritional education for increasing hours of outdoor activity and decreasing intake frequency of beverage contributing to diminishment of bone mineral density is needed for premenopausal working women to prevent osteoporosis.

• Tuberculosis and Respiratory Diseases
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• v.47 no.1
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• pp.90-96
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• 1999

Background : Osteoporosis has been reported in patients with chronic obstructive pulmonary disease, but this association is not well established. This study was undertaken to determine whether the prevalence of osteoporosis was increased in patients with chronic obstructive pulmonary disease and we examined the relationship of corticosteroid administration with osteoporosis. Method: Subjects were 23 patients with chronic obstructive pulmonary disease and 20 control patients. We reviewed hospital records and measured bone mineral density using dual-energy x-ray absorptiometry(Lunar. USA). Results: Mean bone mineral density(BMD) of spine in COPD group was $0.683{\pm}0.154 g/cm^2$ and $0.971{\pm}0.212g/cm^2$ in controls(p<0.01). But there was no significant difference in femoral neck BMD. There were seventeen cases of osteoporosis and six cases of osteopenia in COPD group and three patients of osteoporosis and one case of osteopenia in controls. But, there was no significant correlation between disease duration of COPD and spinal T score(r=-0.395, p>0.05). Ten patients were received corticosteroid in COPD group. Spinal T score in steroid receiving patients were $-3.82{\pm}0.94(SD)$ and $-2.82{\pm}0.97(SD)$ in not having steroid patients(p<0.01). Cumulative dose of corticosteroid was associated with spinal T score(r=-0.424, p<0.05) and duration of corticosteroid administration also associated with spinal T score(r=-0.457. p<0.05). Spinal BMD of patients not having corticosteroid in COPD group(n=13) were significantly lower than that of controls($0.71{\pm}0.13 g/cm^2$ and $0.97{\pm}0.21 g/cm^2$, p<0.01). Conclusion : Prevalence of osteoporosis is increased in patients with chronic obstructive pulmonary disease. Especially patients who are receiving corticosteroid have high risk of osteoporosis or osteopenia and need for preventive management.

• Clinical and Experimental Pediatrics
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• v.48 no.5
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• pp.527-533
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• 2005

Purpose : Long-term administration of anticonvulsants in children with epilepsy may cause short stature, hypocalcemia and low bone mineral density. This study was performed for the early detection of abnormal bone metabolism in children with epilepsy on taking anticonvulsants. Methods : Thirty children aged 5 to 16 years who were diagnosed with epilepsy were enrolled in this study. All had taken anticonvulsants for more than one year. Bone mineral density of lumbar vertebra was measured by dual-energy X-ray absorptiometry. Serum calcium, phosphorous, alkaline phosphatase, 25-hydroxycholecalciferol[$25(OH)D_3$], parathyroid hormone, and urine deoxypyridinoline were measured as biochemical bone markers. Bone age and body mass index were also calculated. Results : Bone minreal density, body mass index, bone age, and height were significantly decreased in two female patients who had taken two antiepileptic drugs for more than four years and they also had chronic diseases such as cerebral palsy with microcephaly, encephalomalacia, and microcephaly with atrial septal defect. Bone mineral density had significant positive correlations with body mass index(P<0.01) and bone age(P<0.01). Conclusion : This study showed chronic medication of anticonvulsants in children may cause low bone mineral density and short stature. Bone age and body mass index could be the important surrogate markers to find the population at risk. More studies, including a large study population and long term cohort study, will be required.

• Journal of Nutrition and Health
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• v.40 no.8
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• pp.719-727
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• 2007

To elucidate the relationship among the levels of nutrients intake, bone mineral density(BMD) and the urinary biochemical markers of bone metabolism, this survey is conducted with 225 postmenopausal women over 50 years of age. The urinary biochemical markers including deoxypyridinoline(DPD) and Ca excretion were measured. Bone mineral densities of lumbar spine(L2-L4), femoral neck, ward's triangle and trochanter were measured with dual-energy X-ray absorptiometry and the nutrient intake data obtained by 24 hr recall method. Mean age of all subjects was 64.8 years old, and the BMDs of the subjects were $0.86g/cm^2$(lumbar spine), $0.60g/cm^2$(femoral neck), $0.49g/cm^2$(trochanter), and $0.41g/cm^2$(ward's triangle). The results were compared among 3 groups with different nutrient intake levels classified by the percentage of Dietary Reference Intakes(DRIs) for Koreans as follows: low < 75% DRIs, 75% DRI $\leq$ adequate < 125% DRIs, high $\geq$ 125% DRIs. Bone mineral density of adequate protein intake group was significantly higher than those of low and high protein intake groups(p<0.05). Urinary DPD excretion was lowest in protein and calcium adequate intake groups(p<0.05, p<0.05), respectively. In relation to urinary Ca excretion, it is revealed to be considerably lower in the groups taking protein and vitamin C adequate intake(p<0.05, p<0.05). The percent DRI of protein and calcium were positively correlated with the BMD of the femoral neck after adjusted age(p<0.05, p<0.05). These results showed that there are probably some relationships between nutrient intake levels and urinary biochemical markers. For postmenopausal women with adequate nutrition expecially protein, calcium and vitamin C, has an important role to postpone bone resorption and to prevent the decrease of bone density.

• Journal of Nutrition and Health
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• v.40 no.6
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• pp.517-525
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• 2007

This study was performed to assess the effects of physiological factors and lifestyles on bone mineral density (BMD) in 64 postmenopausal women. Sixty four subjects were selected out of 223 postmenopausal women in Seoul and Kyunggido. The BMD of the lumbar spine (L2 ${\rightarrow}$ L4) and femoral neck were measured dual energy X-ray absorptiometry (DEXA). Subjects were assigned to one of three groups such as normal (T-score > -1, n = 20), osteopenia (-2.5 < Tscore ${\leq}$ -1, n = 24), and osteoporosis (T-score ${\leq}$ -2.5, n = 20). Anthropometric measurements and questionares were administered to these women. The mean age, height, weight and BMI were 62.09 yrs, 153.78 cm, 56.09 kg and 23.70 $kg/m^2$ respectively. The BMDs of lumbar spines (L2 ${\rightarrow}$ L4), femoral neck were 0.84 $g/cm^2$, 0.71 $g/cm^2$ respectively. Years after menopause and age of last delivery of the osteoporosis and osteopenia group were significantly longer than the normal group (p < 0.05). The hours of exercise and outdoor activity of the normal group were longer than the osteoporosis and osteopenia group, but there were no significant differences among the three groups. The BMDs of these two sites were positively correlated with weight, BMI, hip and body fat and negatively correlated with LBM, TBW. These results show there are no consistent effects on bone mineral density, adjusting for age and BMI, of physiological factors and lifestyles in postmenopausal women. Therefore. this study confirmed that one of the most effective ways to minimize bone loss in postmenopausal women would be to maintain an adequate body weight.

• Childhood Kidney Diseases
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• v.6 no.2
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• pp.209-217
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• 2002

Purpose : Corticosteroid has been used as the mainstay therapy of childhood NS. But SIO is one of the serious complications of long-term steroid therapy, especially in growing children. Recently calcium, calcitonin, PTH, vitamin D and bisphosphonate has been used to treat or prevent SIO in adult, which is rare in children with NS. We studied the effect of $1{\alpha}-(OH)D_3$ and Pamidronate on SIO using dual energy X-ray absorptiometry (DEXA). Patients and methods : We studied thirty patients who admitted in the Dept. of Pediatrics of Kyung Hee Medical Hospital with NS. All patients was received longterm steroid therapy. There was no history of bone, liver, or endocrine disease. The samples, serum protein, albumin, BUN, creatinine, calcium, phosphorus, and BMD were obtained before and the six months after the dose of $1{\alpha}-(OH)D_3$ and Pamidronate, respectively Results : The mean age was $6.9{\pm}3.3\;and\;6.5{\pm}2.5$ years old. The mean duration of steroid therapy was $28.8{\pm}1.8\;and\;27.6{\pm}1.0$ months. The changes of serum protein, albumin, BUN, creatinine, calcium and phosphorus level between pre-treatment and post-treatment did not show statistical significance in both $1{\alpha}-(OH)D_3$ and Pamidronate treatment group. However, BMD was increased in both from $0.472{\pm}0.12\;and\;0.457{\pm}0.10\;g/cm^2\;to\;0.533{\pm}0.12$ and $0.529{\pm}0.09\;g/cm^2$ after treatment. (P<0.05) Conclusion : Both $1{\alpha}-(OH)D_3$ and Pamidronate appears to be effective in treating and preventing SIO in children with nephrotic syndrome requiring long-term steroid therapy.