한국 폐경 전후 여성에서 요추골밀도 예측인자
Predictors for lumbar bone mineral density in premenopausal tmenopausal women in Korea
2
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Objective: The need for early and correct prescription for bone densitometry led to the research for decision model useful for clinicians to address women to bone densitometry. there are few studies that have focused on both pre- and postmenopausal groups simultaneously in healthy pre-and postmenopausal Korean women. Methods: The authors analyzed the easily obtained biometrical variables such as factors used at clinical decision rules for BMD testing and evaluated predictive values and robustness of a decision model for prediction of lumbar BMD in total , pre-and postmenopausal Korean women. Results: After stepwise multiple regression analysis, Lumbar BMD in total population is 1.083-0.153 (status of menopause)-0.007 (age of menopause)+0.0039 (body weight) (R2=0.52). Postmenopausal women is 0.563-0.0077 (duration after menopause)+0.0054 (body weight) (R2=0.30) and premenopausal women is 0.23+0.0048 (height) (R2=0.05). Although its validity (52%) in total population was sufficiently high for the prediction of lumbar BMD in clinical settings, In postmenopausal women only 30% of the decision model can be explained by the predictors of bone demineralization which is not completely satisfactory in determining lumbar BMD and in premenopausal women 5% is the very low explanatory value which is necessary for identifying possible factors influencing BMD. Conclusions: Because of difference in underlying risk, as well as differences in the distribution of different risk factors according to menopausal status, this study present different robustness of prediction models according to menopausal status and suggest that it be need to design prediction models divided by menopausal status. More research is needed for computer-based screening aids useful to clinician which overcome some limitation of our study.
Abstract
Objective: The need for early and correct prescription for bone densitometry led to the research for decision model useful for clinicians to address women to bone densitometry. there are few studies that have focused on both pre- and postmenopausal groups simultaneously in healthy pre-and postmenopausal Korean women. Methods: The authors analyzed the easily obtained biometrical variables such as factors used at clinical decision rules for BMD testing and evaluated predictive values and robustness of a decision model for prediction of lumbar BMD in total , pre-and postmenopausal Korean women. Results: After stepwise multiple regression analysis, Lumbar BMD in total population is 1.083-0.153 (status of menopause)-0.007 (age of menopause)+0.0039 (body weight) (R2=0.52). Postmenopausal women is 0.563-0.0077 (duration after menopause)+0.0054 (body weight) (R2=0.30) and premenopausal women is 0.23+0.0048 (height) (R2=0.05). Although its validity (52%) in total population was sufficiently high for the prediction of lumbar BMD in clinical settings, In postmenopausal women only 30% of the decision model can be explained by the predictors of bone demineralization which is not completely satisfactory in determining lumbar BMD and in premenopausal women 5% is the very low explanatory value which is necessary for identifying possible factors influencing BMD. Conclusions: Because of difference in underlying risk, as well as differences in the distribution of different risk factors according to menopausal status, this study present different robustness of prediction models according to menopausal status and suggest that it be need to design prediction models divided by menopausal status. More research is needed for computer-based screening aids useful to clinician which overcome some limitation of our study.
참고문헌 (35)
- Assessment of fracture risk and its application to screening for postmenopausal osteoporosis, "World Health Organization", ~, pp.Technical Report Series No. 843 (1994)
- Cummings SR, "Risk factors for hip fracture in white women. Study of Osteoporotic Fractures Research Group", N Engl J Med, 332, pp.767~773 (1995)
- [URL]
- "Consensus Development Conference: diagnosis, prophylaxis, and treatment of osteoporosis", Am J Med, 94, pp.646~650 (1993)
- Boyle P, "Epidemiology of osteoporosis", J Epidemiol Biostat, 6, pp.185~192 (2001)
- Kanis JA, "Diagnosis of osteoporosis and assessment of fracture risk", Lancet, 359, pp.1929~1936 (2002)
- "Osteoporosis prevention, diagnosis and therapy", NIH Consensus Statement, 17, pp.1~45 (2000)
- Fulton JP, "New guidelines for the prevention and treatment of osteoporosis. National Osteoporosis Foundation", Med Health R I, 82, pp.110~111 (1999)
- Stevenson JC, "Determinants of bone density in normal women: risk factors for future osteoporosis?", Br Med J, 298, pp.924~928 (1989)
- Sowers MR, "Menopause: its epidemiology and potential association with chronic disease", Epidemiol Rev, 17, pp.287~302 (1995)
- Sedrine WB, "Development and assessment of the Osteoporosis Index of Risk (OSIRIS) to facilitate selection of women for bone densitometry", Gynecol Endocrinol, 16, pp.245~250 (2002)
- Richy F, "Primary prevention of osteoporosis: mass screening scenario or prescreening with questionnaires?", An economic perspective J Bone Miner Res, 19, pp.1955~1960 (2004)
- Richy F, "Validation and comparative evaluation of the osteoporosis self-assessment tool (OST) in a Caucasian population from Belgium", QJM, 97, pp.39~46 (2004)
- Cadarette SM, "Development and validation of the Osteoporosis Risk Assessment Instrument to facilitate selection of women for bone densitometry", CMAJ, 162, pp.1289~1294 (2000)
- Nakamura K, "Correlations between bone mineral density and demographic, lifestyle, and biochemical variables in community- dwelling Japanese women 69 years of age and over", Osteoporos Int, 17, pp.1202~1207 (2006)
- Dargent-Molina P, "In elderly women weight is the best predictor of a very low bone mineral density: evidence from the EPIDOS study", Osteoporos Int, 11, pp.881~888 (2000)
- D’Amelio P, "Effects of Lifestyle and Risk Factors on Bone Mineral Density in a Cohort of Italian Women: Suggestion for a New Decision Rule", Calcif Tissue Int, 77, pp.72~78 (2005)
- Knoke JD, "Weight loss: a determinant of hip bone loss in older men and women. The Rancho Bernardo Study", Am J Epidemiol, 158, pp.1132~1138 (2003)
- López-Caudana AE, "Predictors of bone mineral density in female workers in Morelos State, Mexico", Arch Med Res, 35, pp.172~180 (2004)
- Jones G, "Low bone mass in premenopausal parous women: identification and the effect of an information and bone density feedback program", J Clin Densitom, 2, pp.109~115 (1999)
- Jamal SA, "Bone mineral density testing and osteoporosis education improve lifestyle behaviors in premenopausal women: a prospective study", J Bone Miner Res, 14, pp.2143~2149 (1999)
- Hawker GA, "A Clinical Prediction Rule to Identify Premenopausal Women with Low Bone Mass", Osteoporos Int, 13, pp.400~406 (2002)
- Khan A, "Premenopausal women and low bone density", Can Fam Physician, 52, pp.743~747 (2006)
- Kritz-Silverstein D, "Pregnancy and lactation as determinants of bone mineral density in postmenopausal women", Am J Epidemiol, 136, pp.1052~1059 (1992)
- Hopkinson JM, "Lactation delays postpartum bone mineral accretion and temporarily alters its regional distribution in women", J Nutr, 130, pp.777~783 (2000)
- Laskey MA, "Bone mineral changes during and after lactation", Obstet Gynecol, 94, pp.608~615 (1999)
- Parra-Cabrera S, "Exercise and reproductive factors as predictors of bone density among osteoporotic women in Mexico City", Calcif Tissue Int, 59, pp.89~94 (1996)
- Lloyd T, "Long-term oral contraceptive use does not affect trabecular bone density", Am J Obstet Gynecol, 160, pp.402~404 (1989)
- Rosenthal DI, "Age and bone mass in premenopausal women", J Bone Miner Res, 4, pp.533~538 (1989)
- Nordin BE, "Relative contributions of years since menopause, age, and weight to vertebral density in postmenopausal women", J Clin Endocrinol Metab, 74, pp.20~23 (1992)
- Kolle E, "Bone mineral density in Norwegian premenopausal women", Osteoporos Int, 16, pp.914~920 (2005)
- Sowers MR, "Epidemiology of bone mass in premenopausal women", Epidemiol Rev, 15, pp.374~398 (1993)
- Khan K, "Physical activity and bone health" (2001), Human kinetics
- Bjertness E, "Osteoporosis: from mechanisms and risk factors to prevention", Proceedings from a symposium held at the Norwegian Academy of Science and Letters (2003)
- Johnston CC Jr, "Determinants of peak bone mass", Osteoporos Int, 3, pp.54~55 (1993)