폐경 여성에서 체질량지수에 따른 복부비만과 골밀도의 관계
Relationship between Bone Mineral Density and Abdominal Obesity According to BMI in Postmenopausal Women
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연구배경 골다공증은 골의 강도가 감소하는 골격계질환으로 결과적으로 골절의 위험이 높아지며 우리나라에서 유병률이 증가하고 있다. 체중은 골밀도와 양의 상관관계가 있는 것으로 알려져 있지만, 지방 분포의 지표인 복부비만과 골밀도의 관계에 대해서는 아직까지 명확한 결론이 내려져 있지 않다. 방 법 서울대병원 헬스케어시스템 강남센터에서 건강검진을 받은 건강한 폐경 여성 1628명을 대상으로 연구를 시행하였다. 골밀도에 영향을 줄수 있는 질병을 가졌거나, 약물을 복용중인 사람들을 제외한 957명을 분석하였고, 생활습관으로 음주, 운동을 함께 고려하였다. 허리둘레 85cm를 기준으로 복부비만여부에 따른 골감소증 혹은 골다공증의 교차위험비를 체질량지수에 따라 분석하였다. 결 과 연령, 신장, 체중, 운동, 음주의 영향을 통제하고, 체질량지수에 따라서 층화 분석한 결과 체질량지수 23kg/m2 미만인 군에서 복부비만이 있을 때 요추부에 골감소증 혹은 골다공증에 대한 교차위험비가 2.51(95% C.I 1.48-4.24)로 증가하였으며, 대퇴골의 경우 교차비가 1.38(95% C.I 0.77-2.49)로 증가하였으며, 요추부와 대퇴골 모두 체질량지수가 감소함에 따라 교차위험비가 증가하는 경향이 보였다. 결 론 폐경 여성 중 체질량지수 23 kg/m2 미만군에서 복부비만이 있을 때 요추부 골밀도가 상대적으로 낮은 것으로 나타나 이의 관련성에 대해 기전을 밝히는 연구가 뒤따라야 할 것이다.
Abstract
Background Osteoporosis is a musculoskeletal disease characterized by decrease of bone strength and become more and more prevalent in Korea. Body weight is positively related with bone mineral density but relationship between waist circumference which reflects the amount of visceral fat and bone mineral density remains unclear. Methods We performed cross sectional study on healthy menopausal women who took annual health exam at the Seoul National University Hospital Healthcare System Gangnam Center. We excluded those who have medical disease or take medication that can affect bone mineral density(BMD), and finally analysed the data of 957 healthy postmenopausal women. We considered alcohol and exercise as lifestyle factors affecting BMD. We calculated odds ratio of abdominal obesity over BMD according to body mass index(BMI). Results When adjusted for age, height, weight, drinking and exercise, The odds ratio of having abnormal BMD was 2.51(95% CI 1.48-4.24) for lumbar vertebrae and 1.35(95% CI 0.77-2.49) for hip bone among women with abdominal obesity in normal or underweight group(BMI<23 kg/m2). Also there was tendency of increasing odds ratio with decreasing BMI. Conclusions There seems to be increased risk of having abnormal lumbar BMD among postmenopausal women with abdominal obesity in normal or underweight group(BMI<23 kg/m2). Following study on the mechanism of this observation is necessary.
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