Association Between Parity and Low Bone Density Among Postmenopausal Women
2
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Objectives: Low bone density (LBD) in the postmenopausal period has long been a pervasive public health concern; however, the association between parity and LBD has yet to be fully elucidated. Thus, we investigated the association between parity and LBD in postmenopausal Korean women. Methods: This study used baseline data from 1287 Korean postmenopausal women aged 40 years or older enrolled in the Cardiovascular and Metabolic Diseases Etiology Research Center community-based cohort study conducted in Korea from 2013 to 2017. The main exposure was parity (nullipara, 1, 2, 3+). The main outcome was LBD, including osteopenia and osteoporosis, based on bone mineral density measured using quantitative computed tomography of the lumbar spine (L1-2). Results: The mean age of participants was 57.1 years, and the median parity was 2. Of the 1287 participants, 594 (46.2%) had osteopenia and 147 (11.4%) had osteoporosis. No significant difference in the prevalence of LBD was found between nullipara and parous women, whereas higher parity was associated with a higher risk of LBD among parous women; the adjusted odds ratio (95% confidence interval) for the presence of LBD was 1.40 (0.97 to 2.02) for a parity of 2 and 1.95 (1.23 to 3.09) for a parity of 3 relative to a parity of 1. Conclusions: Women who have given birth multiple times may be at greater risk of bone loss after menopause; therefore, they should be a major target population for osteoporosis prevention.
Abstract
Objectives: Low bone density (LBD) in the postmenopausal period has long been a pervasive public health concern; however, the association between parity and LBD has yet to be fully elucidated. Thus, we investigated the association between parity and LBD in postmenopausal Korean women. Methods: This study used baseline data from 1287 Korean postmenopausal women aged 40 years or older enrolled in the Cardiovascular and Metabolic Diseases Etiology Research Center community-based cohort study conducted in Korea from 2013 to 2017. The main exposure was parity (nullipara, 1, 2, 3+). The main outcome was LBD, including osteopenia and osteoporosis, based on bone mineral density measured using quantitative computed tomography of the lumbar spine (L1-2). Results: The mean age of participants was 57.1 years, and the median parity was 2. Of the 1287 participants, 594 (46.2%) had osteopenia and 147 (11.4%) had osteoporosis. No significant difference in the prevalence of LBD was found between nullipara and parous women, whereas higher parity was associated with a higher risk of LBD among parous women; the adjusted odds ratio (95% confidence interval) for the presence of LBD was 1.40 (0.97 to 2.02) for a parity of 2 and 1.95 (1.23 to 3.09) for a parity of 3 relative to a parity of 1. Conclusions: Women who have given birth multiple times may be at greater risk of bone loss after menopause; therefore, they should be a major target population for osteoporosis prevention.
참고문헌 (20)
- Yan G, "Association of breastfeeding and postmenopausal osteoporosis in Chinese women : a community-based retrospective study", BMC Womens Health, 19(1), pp.110~ (2019)
- 박은정, "Prevalence of Osteoporosis in the Korean Population Based on Korea National Health and Nutrition Examination Survey (KNHANES), 2008--2011", Yonsei Medical Journal, 55(4), pp.1049~1057 (2014), 연세대학교의과대학[DOI]
- Pasco JA, "The population burden of fractures originates in women with osteopenia, not osteoporosis", Osteoporos Int, 17(9), pp.1404~1409 (2006)
- Park C, "The incidence and residual lifetime risk of osteoporosis-related fractures in Korea", J Bone Miner Metab, 29(6), pp.744~751 (2011)
- Hwang IR, "Association between prolonged breastfeeding and bone mineral density and osteoporosis in postmenopausal women : KNHANES 2010-2011", Osteoporos Int, 27(1), pp.257~265 (2016)
- 이은남, "Effects of Parity and Breastfeeding Duration on Bone Density in Postmenopausal Women", Asian Nursing Research, 13(2), pp.161~167 (2019), 한국간호과학회[DOI]
- Cooke-Hubley S, "Spine bone mineral density increases after 6 months of exclusive lactation, even in women who keep breastfeeding", Arch Osteoporos, 12(1), pp.73~ (2017)
- More C, "The effects of pregnancy and lactation on bone mineral density", Osteoporos Int, 12(9), pp.732~737 (2001)
- Crandall CJ, "Associations of parity, breastfeeding, and fractures in the Women’s Health Observational Study", Obstet Gynecol, 130(1), pp.171~180 (2017)
- Wang Q, "Parity and osteoporotic fracture risk in postmenopausal women : a dose-response meta-analysis of prospective studies", Osteoporos Int, 27(1), pp.319~330 (2016)
- Song SY, "Effect of parity on bone mineral density : a systematic review and meta-analysis", Bone, 101, pp.70~76 (2017)
- Ma XH, "Comparison of the spine and hip BMD assessments derived from quantitative computed tomography", Int J Endocrinol, 2015, pp.675340~ (2015)
- Li N, "Comparison of QCT and DXA : osteoporosis detection rates in postmenopausal women", Int J Endocrinol, 2013, pp.895474~ (2013)
- "ACR–SPR–SSR practice parameter for the performance of musculoskeletal quantitative computed tomography (QCT)" (2018)[URL]
- Allali F, "Influence of parity on bone mineral density and peripheral fracture risk in Moroccan postmenopausal women", Maturitas, 57(4), pp.392~398 (2007)
- Peker N, "Is grand multiparity a risk factor for the development of postmenopausal osteoporosis?", Clin Interv Aging, 13, pp.505~508 (2018)
- Kritz-Silverstein D, "Pregnancy and lactation as determinants of bone mineral density in postmenopausal women", Am J Epidemiol, 136(9), pp.1052~1059 (1992)
- Kalkwarf HJ, "Bone mineral loss during lactation and recovery after weaning", Obstet Gynecol, 86(1), pp.26~32 (1995)
- López JM, "Bone turnover and density in healthy women during breastfeeding and after weaning", Osteoporos Int, 6(2), pp.153~159 (1996)
- Reid IR, "Calcium supplements : benefits and risks", J Intern Med, 278(4), pp.354~368 (2015)