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젊은 성인여성에서 낮은 골밀도의 위험요인과 평가

Risk Factors and Assessment of Low Bone Mass in the Young Adult Female

최희정
대한가정의학회 (The Korean Academy Of Family Medicine)|2009.12|Korean Journal of Family Medicine|제30권 제12호|pp. 924-933

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참고문헌

키워드

골다공증Osteoporosis폐경 전 여성Premenopausal Women최대골량낮은 골밀도Low Bone MassPeak Bone Mass
주제분류가정의학

초록

골다공증은 주로 폐경 후 여성에게 발생하지만 젊은 여성에 서도 골밀도가 낮거나 뼈 소실이 빠르게 일어나면 폐경 전이 라도 낮은 골밀도를 보일 수 있다. 실제 폐경 전 젊은 여성 중 일부는 골다공증의 위험이 있음에도 불구하고 젊은 여성에서 낮은 골밀도와 관련된 위험을 평가하고 관리하기 위한 지침 이 나와 있지 않기 때문에 임상에서 이를 다루기가 쉽지 않다. 젊은 여성에서 낮은 골밀도는 획득한 최대골밀도가 낮거나, 최대골밀도를 획득한 후 점진적으로 뼈 소실이 일어나 생긴 결과일 수 있다. 초기 뼈 건강은 향후 골다공증의 발생을 결정 짓는 중요한 요인이 되므로 젊은 성인기에 뼈 획득을 최적화 하고 폐경 전까지 뼈 소실을 최소화하는 것은 중요한 예방 전 략이 될 수 있다. 젊은 여성에서 낮은 골량은 지속적인 무월경, 신경성식욕부진, 장기간의 글루코코르티코이드치료, 칼슘과 비타민 D 대사에 영향을 주는 질환이나 약물치료와 관련이 있 으며, 흡연이나 체중감량, 칼슘섭취 부족, 운동 부족과 같은 환 경적 요인은 뼈 소실과 연관이 있다. 이 종설에서는 낮은 골량 과 관련된 위험인자를 리뷰하고, 골밀도가 낮은 젊은 성인여 성의 선별검사와 평가, 관리방법을 정리하였다.

Abstract

Although low bone mass and accelerated bone loss can occur early in life, osteoporosis is usually considered a disorder of postmenopausal women. However, some premenopausal women are also at risk for osteoporosis. Because of a lack of knowledge and few practice recommendations for premenopausal women, it can be more difficult to determine the potential risk and to manage the low bone mass in these women. Low bone density in the young adult female may refl ect attainment of a lower peak bone mass or be secondary to progressive bone loss following attainment of peak bone density. Early bone health is a key determinant of future osteoporosis, optimizing the bone gain by young adulthood and minimizing the bone loss by menopause is the important preventive strategies. Low bone mass in the young adult female may be associated with prolonged amenorrhea, anorexia nervosa, chronic glucocorticoid therapy and diseases that affect calcium and vitamin D metabolism. Also, bone loss may be associated with common conditions such as smoking, dieting, low calcium intake, and low physical activity. This review addresses peak bone mass accrual, risk factors, screening or evaluation and management of low bone mass in young adult female.

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