폐경 전.후 여성의 골밀도 및 골대사 지표에 영향을 미치는 요인

The purpose of this study was to examine the association among bone mineral density (BMD), biochemical bone markers, nutrients, and salt intake in premenopausal and postmenopausal women. We evaluated 431 subjects who visited a health promotion center of a university hospital between January 2008 and July 2009. We excluded those who were taking medications or who had an endocrine disorder affecting osteoporosis. The subjects were divided into premenopausal (n = 283) and postmenopausal (n = 143) women. We evaluated the correlation among BMD of the lumbar spine, femoral neck, and total femoral, as well as biochemical bone markers, hormone, serum profiles, general characteristics, nutrient intakes, and food intake frequencies. From a stepwise multiple regression analysis, lumbar spine BMD was positively correlated with weight (p < 0.001) and negatively correlated with osteocalcin (OC)(p < 0.001), Femoral neck BMD was positively correlated with weight (p < 0.001) and negatively correlated with C-telopeptide (CTx) and alkaline phosphatase (ALP)(p < 0.001, p < 0.05). In premenopausal women, femoral total BMD was positively correlated with BMI (p < 0.001) and negatively correlated with CTx (p < 0.001). In postmenopausal women, lumbar spine BMD was positively correlated with calcium intake (p < 0.01) and negatively correlated with sodium intake (p < 0.01). Femoral neck and femoral total BMD were both positively correlated with weight (p < 0.001), and femoral neck BMD was negatively correlated with age and ALP (p < 0.001, p < 0.05). Femoral total BMD was negatively correlated with age and OC (p < 0.001, p < 0.01). These results suggest that reducing sodium intake may play an important role delaying bone resorption and preventing a decrease in BMD. 본 연구는 서울 소재 대학병원에서 건강검진을 한 폐경 전 (283명)과 폐경 후 (143명) 여성 총 431명을 대상으로 골밀도, 골대사지표, 여성호르몬 및 영양소와의 관련성에 대해 알아보고자 실시하였으며 그 결과를 요약하면 다음과 같다. 연구 대상자의 평균 나이는 48.4세였고, 폐경 후 여성의 평균 폐경 나이는 50.3세였으며, 폐경 후 경과기간은 5.17년 이었다. 대상자의 평균 신장 체중 허리둘레 체질량지수 체지 방률은 각각 159.2 cm, 55.6 kg, 74.4 cm, $21.9\;kg/m^2$, 29.1% 이었으며, 폐경 후 여성의 나이, 신장, 허리둘레, BMI, 체지방률이 폐경 전 여성보다 유의하게 높았다 (p < 0.001, p < 0.001, p < 0.001, p < 0.01, p < 0.001). 평균 수축기혈압과 이완기혈압은 각각 113.5 mmHg, 69.4 mmHg었으며 폐경 후 여성에서 유의적으로 높았다 (p < 0.001, p < 0.01). 연구 대상자의 골 밀도를 살펴본 결과 폐경 후 여성이 폐경 전 여성보다 요추, 대퇴경부, 대퇴전체 골 밀도가 유의하게 감소되어 있었고 (p < 0.001) OC, CTx, ALP 지표는 폐경 전 여성보다 폐경 후 여성이 유의하게 높은 것으로 나타났다 (p < 0.001). 평균 열량 섭취량은 폐경 전 여성 1,679.4 kcal, 폐경 후 여성 1,621 kcal로 권장량의 93.2%, 90.05%이었으며 탄수화물,