65세 미만 폐경 여성의 골밀도 관련 요인
Factors Related to Bone Mineral Density in Menopausal Women Younger than 65 Years
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연구배경: 국내외적으로 65세 미만 여성에서의 골밀도선별검사 가이드라인이 일관되게 제시되지 못하고 있다. 65세 미만 여성에서 골밀도검사를 적절히 선별해서 시행하는 데 도움이 되고자 65세 미만 폐경 여성을 대상으로골밀도 관련 요인을 조사해보았다. 방법: 2007년 1월부터 6월까지 일개 대학 병원 가정의학과와 산부인과 외래를 방문하여 골밀도검사를 시행한65세 미만 폐경 여성 108명을 대상으로 하였다. 자기기입식 설문지를 이용하여 사회인구학적 요인, 초경 및 폐경연령, 흡연력, 음주력, 운동력, 과거골절력, 식이습관 등을조사하고 키, 체중을 측정하였다. 골밀도는 이중 에너지방사선 골밀도 측정기로 요추 및 대퇴골에서 측정하였다. 각각의 위험요인들과 요추 및 대퇴부 골밀도의 연관성을상관계수와 분산분석을 통하여 검증하였다. 각각의 단변량 분석에서 유의한 결과를 보인 변수들을 모아 다중 선형회귀분석을 시행하였다. 결과: 65세 미만 폐경 여성에서 요추와 대퇴부에서 공통적으로 연령이 증가함에 따라 골밀도가 감소하고(P<0.001), 체중이 증가함에 따라 골밀도는 증가하였다(P<0.001). 요추부에서는 가임기간이 길수록 골밀도가 높았고(P=0.005), 대퇴부에서는 40세 이후 가벼운 충격에 의한 골절력이 있는 경우 골밀도가 낮았으며(P=0.004) 적정음주군에서 요추부 대퇴부 모두 골밀도가 높았다(P=0.031, P=0.005). 결론: 65세 미만 폐경 여성에서 연령과 체중이 골밀도의 가장 주요한 결정 요인이나 이 둘만으로 골밀도검사 대상을 선별해 내기 어려우므로 부가적인 위험요인을 고려해야 한다. 그 위험요인으로서 요추 골밀도는 가임기간,대퇴 골밀도는 과거골절력을 들 수 있겠고, 적정음주는 골밀도를 보호하는 효과가 있으므로 고려해 볼 수 있겠다.
Abstract
Background: Bone mineral density (BMD) screening guidelines for women younger than 65 years are inconsistent. We investigated BMD-related factors in postmenopausal women younger than 65 years to help clinicians identify which women in this age group should undergo this investigation. Methods: The study subjects included 108 postmenopausal women, younger than 65 years, who visited one university hospital from January to June 2007 and had a BMD by DEXA. Information on socio-demographic characteristics, menarche, menopause, smoking, alcohol use, past history of fracture and diet were gathered using a self-reported questionnaire. Height and weight were measured. The association between each risk factor and BMD was assessed using Pearson’s correlation and ANOVA test. Finally, multiple regression analysis was done, using the model including significant variables of baseline analysis. Results: In our subjects, age was negatively and body weight was positively correlated with BMD of lumbar spine and femur. The reproductive years was positively correlated with BMD of lumbar spine and past history of fragility fracture was negatively associated with BMD of femur. Moderate alcohol users had higher BMDs of lumbar spine and femur. Conclusions: In postmenopausal women younger than 65 years, age and body weight are major determinants of BMD of lumbar spine and femur, negatively and positively, respectively. Our data suggest women younger than 65 years with low lean body mass, past history of fracture, and premature menopause could be good candidates for BMD.
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