• 대한골대사학회지
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• 제25권4호
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• pp.213-217
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• 2018

Patients with gastrointestinal disease (GI) are at risk for osteopenia or osteoporosis, which can lead to fractures. Although these patients may be at risk from a young age, gastroenterologists often overlook this fact in practice. There are well-known GI diseases associated with osteopenia and osteoporosis, such as the post-gastrectomy state, inflammatory bowel disease (IBD), and celiac disease. As there is an increase in the prevalence of IBD patients, newly diagnosed celiac disease in adulthood, and gastric cancer survivors following gastrectomy, bone disease in these patients becomes an important issue. Here, we have discussed osteoporosis and fractures in GI disease, especially in the postgastrectomy state, IBD, and celiac disease. Although the pathogenesis of bone loss in each disease has not been fully identified, we have confirmed that the prevalence of osteoporosis and fractures in each of these diseases is high. There are scarce studies comparing the prevalence of osteoporosis or osteoporotic fractures in GI disease patients with studies in postmenopausal women, and specific guidelines for their management in each disease have not been established. Intensive surveillance and management are needed to ensure that these patients attain peak bone mass for age and sex to prevent fractures.

• 동서간호학연구지
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• 제16권2호
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• pp.172-178
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• 2010

Purpose: We examined the relationship between the health-related issues of elderly women and bone density and identified specific factors that affect the prevalence of osteoporosis to provide basic data for developing a health care program on osteoporosis prevention. Methods: This study is a secondary data analysis of 118,903 66-yr-old women who received a health examination conducted by the National Health Insurance Corporation in 2008. Multiple logistic regression analysis was used to identify factors affecting the prevalence of osteoporosis. Results: The prevalence of osteoporosis was 46.8%, whereas the prevalence of osteopenia was 38.4% among elderly women in this study. Statistically significant differences were observed between the osteoporosis and non-osteoporosis group in terms of smoking (p<.001), exercise (p<.001), obesity (p<.001), waist circumference (p<.001), depression (p<.001), falling experience (p<.05), and the cognitive function risk (p<.05). Based on the multiple logistic regression results, the risk for osteoporosis was high in those who were under-weight, smoked, or were depressed. In contrast, moderate or high level obesity showed a negative relationship with osteoporosis. Conclusion: The prevalence of osteopenia and osteoporosis was 85.2%. Therefore, there is a need to develop health care programs pertaining to osteoporosis intervention and prevention for elderly women. Because smoking, non-exercise, and obesity are main osteoporosis risk factors, it is highly recommended that some sound practical life programs and psychological support programs be considered for this population.

• 한국식생활문화학회지
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• 제21권6호
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• pp.596-605
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• 2006

This study was conducted to investigate factors affecting gone density of university students in Seoul area. Data for food habits, exercise and health-related behaviors were obtained by self administered questionnaires. BQI(bone quality index) of the subjects was measured by an Quantitative Ultrasound(QUS). The results are summarized as follows: The average hight, weight BMI and osteopenia percentage of the male and female student were 173.3cm, 68.6kg, 22.7 and 24.2%; 161.4cm, 54.4kg, 20.9 and 55.5%, respectively. The BQI and Z-score of the subjects were 99.6, -0.3 in male student group, and 82.7, -1.1 in female student group, respectively. Height, weight, fat weight, fat mass and BMI were positively related with BQI in female group. BQI was positively affected by breakfast and frequence exercise in male student group. In female student group, frequency exercise was positively related with BQI. The result of this study revealed that the desirable food habits, dietary behaviors and health-related lifestyles may have a beneficial effect on bone density. They should have practically and systematically organized nutritional education on optimum body weight, good eating habits, weight bearing exercise for higher bone density level.

• 한국식생활문화학회지
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• 제22권6호
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• pp.841-847
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• 2007

This study was conducted to investigate on bone density and nutrient intake of university students in Seoul area. Nutrient intake data were obtained by using the 24-hour recall method to evaluate the usual diet of the subjects. BQI(bone quality index) of the subjects was measured by an Quantitative Ultrasound (QUS). The results are summarized as follows: The average height, weight, BMI of the male and female student were 173.3 cm, 68.5 kg, 22.7; 161.4 cm, 54.2 kg, 20.8, respectively. The BQI and Z-score of the subjects were 99.50, -0.69 in male student group, and 82.6, -1.15 in female student group, respectively. Normal, osteopenia and osteoporosis percentage by bone status were 73.8%, 24.9%, 1.3% in male student group, and 39.8%, 57.6%, 2.6% in female student group, respectively. Energy intake of male and female group were 71.7%, 79.1% of EER(estimated energy requirement) respectively. Fiber, Ca, Vit $B_2$, niacin, folic acid, Vit C intake were less than RI(recommended intake) and protein, phosphorus intake were higher than RI in subjects. Nutrient intake were not significantly related with BQI in male and female groups generally.

• 한국의학물리학회지:의학물리
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• 제21권1호
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• pp.70-77
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• 2010

골다공증 환자를 대상으로 이중 에너지 X선 흡수(DEXA) 방법을 이용한 골밀도 영상에서는 T-score를 측정하고 자기공명영상 기법 중 확산강조영상에서는 신호대 잡음비와 현성 확산 계수를 측정한 다음 T-score변화에 따라 신호대 잡음비와 현성 확산 계수가 어떻게 변화하는지 알아보았다. 골다공증이 없는 건강한 사람 30명과 2009년 1월부터 2009년 12월까지 허리 통증으로 내원한 환자 중 단순 방사선 촬영에서 골다공증 소견이 보이는 환자 30명을 대상으로 Dual Energy X-ray Absorptiometry (DEXA)를 이용하여 척추 L1-L4부위의 T-score를 측정 후 각각의 척추에 대해서 골감소증, 골다공증으로 분류하였다. 1.5T MR scanner를 이용하여 b value를 $400\;s/mm^2$으로 획득한 확산강조영상에서는 L1-L4 네 부위에서 신호 강도(signal intensity)측정을 하였고 현성 확산 계수(apparent diffusion coefficient; ADC) map 영상에서는 현성 확산 계수를 측정하였다. 정량적 분석방법으로 관심영역의 T-score와 신호대 잡음비(signal to noise ratio)와 ADC를 구하고 평균화 하여 관심영역에서 T-score변화에 따른 신호대 잡음비와 현성확산계수의 변화를 비교하였고 T-score에 의해 골감소증, 골다공증으로 분류하여 그룹별로 신호대 잡음비와 현성확산계수의 변화도 비교하였다. 정성적인 분석방법은 육안적으로 건강한 그룹과 골감소증, 골다공증그룹의 T1강조 시상면 영상에서 요추체중 L4 부위에서의 신호강도 차이를 알아보았다. 정량적 분석에서 골감소증 그룹과 골다공증그룹은 T-score가 감소함에 따라 확산강조영상에서의 신호대 잡음비가 감소하여 나타났으며 골다공증 그룹에서 신호대 잡음비가 가장 크게 감소하였다. ADC map영상에서는 골감소증그룹과 골다공증 그룹은 T-score가 감소함에 따라 현성 확산 계수는 감소해서 나타났고 건강한 그룹과 골감소증 및 골다공증 그룹의 경우 현성 확산 계수 차이는 골다공증 그룹에서 현성 확산 계수가 가장 낮게 나타났다. 정성적 분석에서는 건강한 그룹과 골감소증 및 골다공증 그룹에서 L4 부위의 신호강도는 건강한 그룹에서 가장 낮게 나타났고 골다공증그룹에서 높게 나타났다. 골다공증이 진행 될수록 신호대 잡음비와 현성 확산계수는 감소하고 T1강조 영상에서는 신호강도가 증가 하는 결과를 얻었고 자기공명검사가 골다공증 진단에 유용함을 알 수 있었다.

• 대한영양사협회학술지
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• 제11권1호
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• pp.86-94
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• 2005

This study was conducted to examine bone mineral density and factors which effect on bone mineral density such as daily nutrients intake, age, menarch age and physical condition among healthy female college students in Daegu area from April 20, to May 20, 2004. 1. Average age was 20.5$\pm$0.96 years old, average height was 160.9$\pm$4.30㎝, and average weight was 55.9$\pm$7.67㎏. Body mass index was 21.6$\pm$2.91㎏/㎡, body fat was 25.6$\pm$5.79％, menarche age was average 12.5$\pm$1.1 years old and WHR(waist/hip circumference ratio) was 0.8$\pm$0.01㎝/㎝. 2. Average level of bone mineral density(T-score -0.56$\pm$0.91) was in normal range. But, 11 persons(24.4％) are over T-score -1.0, 33 persons(73.4％) were within -1.0 - -2.5 and one person(2.2％) was under -2.5. It is very anxious level for Osteopenia-low bone mass, as research result shows 73.4% of the subject of examine on the level of Osteopenia. 3. Daily calorie intake was 2,550㎉ and each nutrient intake, compared to the seventh recommended dietary allowances for korean, was as follows ; Calorie 112％, protein 123％, calcium 78％, phosphorus 137％, iron 68％, vitamin A 101％, vitamin $B_1$ 141％, vitamin $B_2$ 95％, niacin 107％, vitamin C 128％ and zinc 120％. The ratio of calcium to phosphorus(Ca/P) is 0.66, low compared to RDA, but phosphorus intake is so high compared to RDA that precautions should be taken. The ratio of calcium to protein(Ca/Protein) is 8.55. 4. Menarche age and bone mineral density of calcaneus showed positive correlation and body mass index(BMI) indicated positive correlation. Age, height, weight. WHR and physical activity coefficient all do not indicate any significant correlation with bone mineral density. 5. Intake of Calorie, Ca, Ca/p ratio, carbohydrate and fat intake were positively correlated and, protein was negatively correlated, and Fe, Na, P and cholesterol were negatively correlated with BMD. These results indicate that average bone mineral density of subjects was in normal range, but subjects in the stage of osteopenia-low bone mass are many and bad effects are expected to have on their bone mineral density after menopause. Therefore, in order reach maximal bone mineral density, they should improve the balance between calcium and phosphorus and reduce salt intake. And it is thought that education and profound studies on relevant factors affecting the genesis of bone mineral density should be made.

• 대한지역사회영양학회지
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• 제18권3호
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• pp.213-222
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• 2013

Few studies investigated the effects of nutrition education and exercises in women with osteopenia. This study examined the relationship between changes in dietary intakes and changes in indicators related to bone health in postmenopausal women with osteopenia (-2.5 ${\leq}$ T-score ${\leq}$ 1) after a 12-week intervention. Thirty-one postmenopausal women aged > 50 years residing in Seoul were recruited and participated in nutritional education regarding bone health and general nutrition practices and aerobic exercises (three times a week; 60 min per session). Twenty-five subjects completed the study and were eligible for the analysis. Bone mineral density (BMD) at femoral neck was measured by dual energy x-ray absorptiometry. Serum calcium, osteocalcin, and intact parathyroid hormone (PTH) were also measured. Dietary intake was estimated by using a one-day 24 recall by a clinical dietitian. After 12 weeks, meat consumption increased (P = 0.028) but vegetable intake decreased (P = 0.005). Intakes of animal protein (P = 0.024), vitamin B1 (P = 0.012) and vitamin $B_2$ (P = 0.047) increased, and sodium intake decreased (P = 0.033). Intact PTH (P = 0.002) decreased and osteocalcin (P = 0.000) increased, however, BMD decreased (P = 0.000). Changes in mushroom consumption were positively correlated with femoral neck BMD (r = 0.673, P = 0.003). Changes in animal iron intake were negatively correlated with intact PTH (r = -0.488, P = 0.013) but were positively correlated with osteocalcin (r = 0.541, P = 0.005). These results suggested that the association between animal iron intake and biochemical markers of bone turnover may play an important role in bone metabolism. Further studies are needed to shed light on complicated mechanisms of diet, hormonal levels of bone metabolism, and bone density.

• 대한영양사협회학술지
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• 제16권2호
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• pp.122-132
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• 2010

Elderly people comprise an increasing proportion of the population, and nutritional impairments may contribute to health problems among this group. This study was conducted to evaluate the nutritional status by Mini-Nutritional Assessment (MNA) and to identify relationships among anthropometric measurements, biochemical indicators, bone Mineral Density (BMD) and MNA results among older adults (${\geq}$65 yrs, n=98, 66.7${\pm}$2.5 yrs; M=52, F=46, BMI 24.5${\pm}$2.8 $kg/m^2$) at a Health Care Center. A dietitian administered MNA and collected anthropometric measurements (weight, height, waist circumference), biochemical indicators (albumin, hemoglobin, hematocrit, TLC, glucose, lipids) and the BMD (spine, femur, F=46). Subjects were grouped into a normal nutrition group (0~2 risk factors of malnutrition) and a high risk of malnutrition group (>=3 risk factors of malnutrition) based on their risk factor status for malnutrition. The risk factors for malnutrition include age ${\geq}$65 years, PIBW <90%, albumin <3.5 g/dl, TLC <1,500%, Hgb <14 g/dl (men), Hgb <10 g/dl (women), loss of appetite and weight loss 1~3 kg/last 3 months. In addition, subjects were grouped into a normal, osteopenia and osteoporosis group by BMD. We found that 12% of the subjects were at risk of malnutrition (MNA score, 21.4${\pm}$2.1) and that 88% were well nourished (27.3${\pm}$1.5) according to the MNA. Full-MNA scores were positively and significantly (p<0.05) associated with BMI, mid-arm circumference (MAC), calf circumference (CC), albumin and hemoglobin, respectively. The full-MNA score of the high risk of malnutrition group (23.0${\pm}$3.8) was lower than that of the normal nutrition group (27.0${\pm}$2.1) (p<0.05). In addition, the Full-MNA score was negatively associated with the risk factor of malnutrition (r=－0.35, p=0.0004). We found that 39.1% of the subjects had osteoporosis, 45.7% had osteopenia and 15.2% were normal according to their BMD. The MNA score of osteoporosis group (24.58${\pm}$3.3) was lower than that of the normal (27.4${\pm}$1.1) and osteopenia group (26.9${\pm}$1.5) (p<0.05). These results suggested that MNA can be useful as a nutritional screening tool of older adults in Health Care Centers.

• 대한지역사회영양학회지
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• 제13권4호
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• pp.489-498
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• 2008

This study was carried out to identify bone mineral density(BMD), body composition, lifestyle and dietary habits of young women by physical measurement and questionnaires. The study subjects, 190 young women living in Seoul, were divided into three age groups: $20{\sim}24$ years(93), $25{\sim}29$ years(44) and $30{\sim}39$ years(53). There was no significant difference in mean body muscle mass, protein, mineral, body fat and BMI among the three age groups. The rate of low weight(18%) in 20 years group was higher that of the 30 years(11.3%). The mean BMD and T-score were $0.44g/cm^2$ and -0.66. BMD and T-score of the forearm bone were significantly higher in the $30{\sim}39$ years group. But BMD and T-score of calcanues were not significantly different among the three age groups. The rate of normal, osteopenia and osteoporosis subjects by BMD were 60.5%, 38.4%, 1.1%, respectively. The rate of osteopenia in $20{\sim}24$ years group was significantly higher than the other age groups. The rate of meal irregularity was significantly higher in $20{\sim}24$ years group. The rate of women who walk and are exposed to sunlight more than 1hr per day were significantly higher in $20{\sim}24$ years group than the others. However, the score of food behaviors is significantly higher(bad) in $20{\sim}24$ years group than the others. The relationship between BMD and frequency of food intake showed significant differences in beans, broom, seaweed and rice wine. In conclusion, the risk rate of BMD was very high, 40% of the subjects, and the risk rate of BMD was higher in 20 years group than 30 years group, and the rate of low weight in 20 years group was higher than in 30 years group. The food habits and behaviors were not healthy enough. Therefore, nutrition education is needed for bone health.

• 대한방사선기술학회지:방사선기술과학
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• 제28권3호
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• pp.235-239
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• 2005

청소년기에 형성된 골밀도는 25세에서 35세 전후로 최고치가 되며, 형성된 골밀도는 중년기와 노년기에 감소된다. 골밀도 감소는 골다공증의 발생과 골절 위험성 증가 등을 유발하여 사회적인 건강문제로 대두되고 있다. 골다공증은 사전 예방이 매우 중요하며, 골밀도가 감소되는 중년기 이후보다 골밀도가 형성되고 최고로 발달되는 시기인 청년기에 적극적인 관리와 예방이 중요하다. 따라서 본 연구는 대학생의 골밀도 상태와 생활습관 및 신체활동과의 관계를 파악하여 골밀도 향상을 위한 자료 개발에 도움이 되는 시사점을 도출하고자 일부 대학생 119명을 대상으로 골밀도 측정과 생활습관에 대한 설문을 실시하여 다음과 같은 결론을 도출하였다. 첫째, 대상자의 일반적 골밀도 상태는 정상 88명(73.9%), 골감소증 29명(24.4%), 골다공증 2명(1.7%)으로 정상이 가장 높게 나타났으나 골감소증도 다소 높게 나타났다. 둘째, 성별에 따른 생활습관과의 관계에서는 음주 경험, 흡연경험, 운동 경험이 통계적으로 유의하게 나타났다. 음주경험, 흡연경험, 운동경험이 있는 경우는 남학생 군이 모두 높게 나타났다. 셋째, 일반적 특성에 따른 골다공증 상태와의 관계에서는 성별과 흡연경험이 집단 내에서 통계적으로 유의한 차이를 나타냈다. 성별에서는 남학생에게서는 골감소증이 가장 높게 나타났고, 여학생은 정상이 높게 나타났으며 이는 통계적으로 유의하였다. 흡연경험에 따른 골다공증 상태에서는 흡연경험이 없는 군에서는 정상이 가장 높게 나타났고, 흡연경험이 있는 군에서는 골감소증이 가장 높게 나타났으며 통계적으로 유의하였다.