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Kim E, Lee HW, Kim SS, Yoon E, Jang ES, Chang JI, Cho YY, Seo GH, Kim HJ. Tenofovir disoproxil fumarate versus tenofovir alafenamide on risk of osteoporotic fracture in patients with chronic hepatitis B: A nationwide claims study in South Korea. Aliment Pharmacol Ther 2023; 58:1185-1193. [PMID: 37694558 DOI: 10.1111/apt.17716] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Revised: 05/05/2023] [Accepted: 08/30/2023] [Indexed: 09/12/2023]
Abstract
BACKGROUND As tenofovir disoproxil fumarate (TDF) requires long-term use, a reduction in bone density should be considered a possibility when treating patients with chronic hepatitis B (CHB) with aging and systemic diseases. Patients treated with tenofovir alafenamide (TAF) have improved bone mineral density loss compared to patients treated with TDF. Although improvements in bone density caused by TAF have been reported, studies on the actual reduction of fractures are insufficient. AIM To evaluate the impact of TAF on the risk of osteoporotic fractures in comparison with that of TDF. METHODS Using the national claims data of the Health Insurance Review and Assessment Service, we conducted a retrospective cohort study of 32,582 patients with CHB who had been initially treated with TDF or TAF between November 2017 and December 2020. The numbers of patients treated with TDF and TAF were 20,877 and 11,705, respectively. The annual fracture rate per 100 patients in each group was calculated, and the Cox proportional hazard ratio (HR) was analysed after applying inverse probability treatment weights (IPTW) for both groups. RESULTS Among 32,582 patients, the average age was 47.8 ± 11.2 years, 64.5% were men, and the follow-up period was 24.4 ± 11.6 months. The incidence of osteoporotic fractures was 0.78 and 0.49 per 100 person-years in the TDF and TAF groups, respectively. After application of IPTW, the HR was 0.68 (95% confidence interval 0.55-0.85, p = 0.001). CONCLUSION TAF-treated patients with CHB had a significantly lower risk of osteoporotic fracture than TDF-treated patients.
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Affiliation(s)
- Eunju Kim
- Department of Gastroenterology, Chung-Ang University Gwangmyeong Hospital, Gwangmyeong, Korea
| | - Hyun Woong Lee
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Soon Sun Kim
- Department of Gastroenterology, Ajou University School of Medicine, Suwon, Korea
| | - Eileen Yoon
- Department of Internal Medicine, Hanyang University Hospital, Hanyang University College of Medicine, Seoul, Korea
| | - Eun Sun Jang
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Jong-In Chang
- Department of Gastroenterology, Chung-Ang University Gwangmyeong Hospital, Gwangmyeong, Korea
| | - Young Youn Cho
- Department of Internal Medicine, Chung-Ang University Hospital, Seoul, Korea
| | - Gi Hyeon Seo
- Health Insurance Review and Assessment Service, Seoul, South Korea
| | - Hyung Joon Kim
- Department of Internal Medicine, Chung-Ang University Hospital, Seoul, Korea
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Li R, Qu H, Xu J, Yang H, Chen J, Zhang L, Yan J. Association between dietary intake of α-tocopherol and cadmium related osteoporosis in population ≥ 50 years. J Bone Miner Metab 2023:10.1007/s00774-023-01418-x. [PMID: 37036532 DOI: 10.1007/s00774-023-01418-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 03/01/2023] [Indexed: 04/11/2023]
Abstract
INTRODUCTION To analyze the association between α-tocopherol intake and cadmium (Cd) exposure and osteoporosis in population ≥ 50 years. MATERIALS AND METHODS Sociodemographic data, physical examination, and laboratory indicators including serum Cd level and dietary α-tocopherol intake of 8459 participants were extracted from the National Health and Nutrition Examination Survey (NHANES) database in this cross-sectional study. The associations between α-tocopherol intake, serum Cd levels and osteoporosis were evaluated using univariate and multivariate logistic regression analyses, with the estimated value (β), odds ratios (ORs) and 95% confidence intervals (CIs). We further explored the impact of α-tocopherol intake on Cd exposure and the bone mineral density (BMD) in total femur and femur neck. RESULTS A total of 543 old adults suffered from osteoporosis. The serum Cd level (0.52 μg/L vs. 0.37 μg/L) and α-tocopherol intake (5.28 mg vs. 6.50 mg) were statistical different in osteoporosis group and non-osteoporosis group, respectively. High level of Cd exposure was related to the increased risk of osteoporosis [OR = 1.60, 95% CI (1.15-2.21)]. In the total femur, α-tocopherol intake may improve the loss of BMD that associated with Cd exposure [β = - 0.047, P = 0.037]. Moreover, high α-tocopherol intake combined with low Cd exposure [OR = 0.54, 95% CI (0.36-0.81)] was linked to the decreased risk of osteoporosis comparing with low α-tocopherol intake combined with high Cd exposure. CONCLUSION High α-tocopherol intake may improve the Cd-related osteoporosis and loss of BMD that could provide some dietary reference for prevention of osteoporosis in population ≥ 50 years old.
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Affiliation(s)
- Renjia Li
- Department of Nutrition and Food Safety, West China School of Public Health and West China Fourth Hospital, Sichuan University, No. 16, Section 3, Renmin South Road, Wuhou District, Chengdu, 610041, Sichuan, People's Republic of China.
- Department of Clinical Nutrition, Yan'an Hospital of Kunming City, No. 245 Renmin East Road, Panlong District, Kunming, 650051, Yunnan, People's Republic of China.
| | - Hai Qu
- Department of Intensive Care Unit, Yan'an Hospital of Kunming City, Kunming, 650051, Yunnan, People's Republic of China
| | - Jinwei Xu
- Department of Police Sports and Actual Combat Teaching, Yunnan Police Officer Academy, Kunming, 650223, Yunnan, People's Republic of China
| | - Huiqin Yang
- Department of Orthopedic, Yan'an Hospital of Kunming City, Kunming, 650051, Yunnan, People's Republic of China
| | - Jinyao Chen
- Department of Nutrition and Food Safety, West China School of Public Health and West China Fourth Hospital, Sichuan University, No. 16, Section 3, Renmin South Road, Wuhou District, Chengdu, 610041, Sichuan, People's Republic of China
| | - Lishi Zhang
- Department of Nutrition and Food Safety, West China School of Public Health and West China Fourth Hospital, Sichuan University, No. 16, Section 3, Renmin South Road, Wuhou District, Chengdu, 610041, Sichuan, People's Republic of China
| | - Jiuming Yan
- Department of Clinical Nutrition, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, People's Republic of China
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Jeong HG, Kim MK, Lim HJ, Kim SK. Up-to-Date Knowledge on Osteoporosis Treatment Selection in Postmenopausal Women. J Menopausal Med 2022; 28:85-91. [PMID: 36647271 PMCID: PMC9843036 DOI: 10.6118/jmm.22007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 08/20/2021] [Accepted: 09/12/2021] [Indexed: 11/12/2022] Open
Abstract
The concept of a super-aged society has led to a steady increase in the average lifespan and hence, interest in a healthy life has increased. Aging is a major risk factor for many diseases, including osteoporosis. Osteoporotic fractures have a significant impact on the quality of life of the elderly and hence, it is pivotal to provide effective treatment of osteoporosis after menopause. Osteoporosis requires proper management and the treatment must be centered on long-term goals. New drugs with diverse mechanisms have been developed for treating osteoporosis. Current management of osteoporosis generally focuses on the importance of risk-based strategies to maximize the effectiveness of existing treatments and mitigate potential negative side-effects. Additionally, there is a need for sequential treatment of osteoporosis in the future. This review discusses the dynamic strategies for osteoporosis treatment and the importance of long-term management in postmenopausal women.
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Affiliation(s)
- Hye Gyeong Jeong
- Department of Obstetrics and Gynecology, Korea University Anam Hospital, Seoul, Korea.,Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea
| | - Min Kyung Kim
- Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Hee Jeung Lim
- Department of Obstetrics and Gynecology, Seoul National University Hospital, Seoul, Korea
| | - Seul Ki Kim
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea.,Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, Korea
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Effect of Dosing Interval on Compliance of Osteoporosis Patients on Bisphosphonate Therapy: Observational Study Using Nationwide Insurance Claims Data. J Clin Med 2021; 10:jcm10194350. [PMID: 34640368 PMCID: PMC8509687 DOI: 10.3390/jcm10194350] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 09/11/2021] [Accepted: 09/22/2021] [Indexed: 11/22/2022] Open
Abstract
Only a few studies are available on the effect of the dosing interval of bisphosphonate on drug compliance. We analyzed the data of patients who were newly prescribed bisphosphonate using a national insurance claims database. Drug compliance was assessed by calculating medication possession ratio (MPR) over a minimum of a 1-year follow-up. This analysis included 281,996 new bisphosphonate users with a mean age of 68.9 years (92% women). The patients were divided into daily, weekly, monthly, 3-monthly, and switch groups (who changed the drug to other dosing intervals). The average MPR was the highest in the switch group (66%), and the longer the dosing interval, the higher the compliance (3-monthly, 56% vs. daily, 37%). “Non-compliant” was defined as an MPR under 80%. Various factors which were possibly associated with “non-compliant” MPR were investigated using multiple regression analysis. Multivariate analysis showed that male patients were more likely to be non-compliant with pharmacotherapy than female patients, with as odds ratio of 1.389. Younger patients had a significantly lower likelihood of being non-compliant than older patients for age 60–69 vs. age 80+. Long dosing intervals were recommended to improve compliance and special attention was given to older and male patients.
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Analyses of the relationship between hyperuricemia and osteoporosis. Sci Rep 2021; 11:12080. [PMID: 34103622 PMCID: PMC8187414 DOI: 10.1038/s41598-021-91570-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 05/19/2021] [Indexed: 12/27/2022] Open
Abstract
The aim of the present study was to evaluate the association between hyperuricemia and osteoporosis in a Korean population. Data from participants of the Korean Genome and Epidemiology Study who were ≥ 40 years old were collected from 2004 to 2016. Among 173,209 participants, 11,781 with hyperuricemia (> 7.0 mg/dL in men and > 6.0 mg/dL in women) and 156,580 controls were selected based on serum measurements. Odds ratios (ORs) of osteoporosis between individuals with hyperuricemia and controls were analyzed using a logistic regression model. In the adjusted model, age, sex, income group, body mass index, smoking, alcohol consumption, hypertension, diabetes mellitus, hyperlipidemia history and nutritional intake were adjusted. The adjusted OR (aOR) of osteoporosis was 0.79 [95% confidence interval (CI) = 0.71–0.87, P < 0.001]. In subgroup analyses according to age and sex, statistical significance was observed in men > 60 years old and in women > 50 years old. In another subgroup analysis according to past medical history, significant differences were found according to hypertension (aOR = 0.83, 95% CI = 0.73–0.94, and 0.75, 95% CI = 0.64–0.87), diabetes mellitus (aOR = 0.77, 95% CI = 0.69–0.86), and hyperlipidemia (aOR = 0.74, 95% CI = 0.61–0.89, and 0.81, 95% CI = 0.72–0.91). This study demonstrated that hyperuricemia was associated with a decreased risk of osteoporosis.
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Effects of a health-belief-model-based osteoporosis- and fall-prevention program on women at early old age. Appl Nurs Res 2021; 59:151430. [PMID: 33947516 DOI: 10.1016/j.apnr.2021.151430] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 07/25/2020] [Accepted: 03/28/2021] [Indexed: 01/21/2023]
Abstract
BACKGROUND Elderly women are at high risk of osteoporosis and falls. Lifestyle modifications and regular check-ups are strongly recommended to promote their bone health. However, elderly women tend to perform low preventive behaviors due to physiological changes associated with aging. Education facilitating healthy behaviors is essential for older women. Therefore, the purpose of this study was to determine whether a Health Belief Model (HBM)-based osteoporosis- and fall-prevention program could improve osteoporosis- and fall-prevention knowledge, self-efficacy, and health behaviors among women aged 65 to 74 years. METHODS This study included an untreated control group with a pretest-posttest design. Women (n = 47) in the intervention group received four sessions of an HBM-based program within a 2-month period. Participants (n = 47) in the control group attended usual education sessions. RESULTS Women in the intervention group exhibited greater knowledge in exercise and diet for osteoporosis-prevention (t = 5.473, p < 0.001; t = 6.895, p < 0.001, respectively), fall-prevention knowledge (t = 2.354, p = 0.021), self-efficacy in exercise for osteoporosis-prevention (t = 2.736, p = 0.008), osteoporosis-prevention behavior of exercise, diet, and routine follow-ups (t = 3.019, p = 0.003; t = 2.705, p = 0.008; t = 2.368, p = 0.020, respectively), and fall-prevention behavior (t = 3.879, p < 0.001). CONCLUSION HBM-based osteoporosis- and fall-prevention program exhibited outstanding effectiveness in promoting osteoporosis and fall prevention among women at early old age. Further studies with more rigorous designs are needed to provide further evidence that supports this finding.
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Kim D, Han A, Park Y. Association of Dietary Total Antioxidant Capacity with Bone Mass and Osteoporosis Risk in Korean Women: Analysis of the Korea National Health and Nutrition Examination Survey 2008-2011. Nutrients 2021; 13:1149. [PMID: 33807163 PMCID: PMC8065953 DOI: 10.3390/nu13041149] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 03/25/2021] [Accepted: 03/27/2021] [Indexed: 01/10/2023] Open
Abstract
Antioxidant intake has been suggested to be associated with a reduced osteoporosis risk, but the effect of dietary total antioxidant capacity (TAC) on bone health and the risk of osteoporosis remains unclear. We aimed to assess the hypothesis that dietary TAC is positively associated with bone mass and negatively related to the risk of osteoporosis in Korean women. This cross-sectional study was performed using data from the Korea National Health and Nutrition Examination Survey. Dietary TAC was estimated using task automation and an algorithm with 24-h recall data. In total, 8230 pre- and postmenopausal women were divided into four groups according to quartiles of dietary TAC. Dietary TAC was negatively associated with the risk of osteoporosis (odds ratio, 0.73; 95% confidence interval, 0.54-0.99; p-value = 0.045) in postmenopausal women, but not in premenopausal women. Dietary TAC was positively associated with bone mineral content (BMC) and bone mineral density of the femoral neck and lumbar spine in postmenopausal women and BMC of the total femur and lumbar spine in premenopausal women. Our study suggests that dietary TAC is inversely associated with the risk of osteoporosis in postmenopausal women and positively associated with bone mass in both pre- and postmenopausal women.
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Affiliation(s)
- Donghyun Kim
- Department of Food and Nutrition, Hanyang University, 222 Wangsimni-ro, Seongdong-gu, Seoul 04763, Korea;
| | - Anna Han
- Department of Cancer Biology, Thomas Jefferson University, Philadelphia, PA 19107, USA;
| | - Yongsoon Park
- Department of Food and Nutrition, Hanyang University, 222 Wangsimni-ro, Seongdong-gu, Seoul 04763, Korea;
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Hong SJ, Yang BE, Yoo DM, Kim SJ, Choi HG, Byun SH. Analysis of the relationship between periodontitis and osteoporosis/fractures: a cross-sectional study. BMC Oral Health 2021; 21:125. [PMID: 33731091 PMCID: PMC7968237 DOI: 10.1186/s12903-021-01496-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 03/02/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Chronic periodontitis is a multifactorial inflammatory disease resulting in patients exhibiting high levels of inflammatory factors causing systemic inflammatory bone destruction that may lead to osteoporosis development. The association between periodontitis and osteoporosis has been documented; however, the findings remain unclear. This study aimed to identify the association between periodontitis and osteoporosis using a cross-sectional study design and Korean Genome and Epidemiology Study (KoGES) health examinee data. METHODS This cross-sectional study used epidemiological data from the KoGES during 2004-2016. Of 125,324 participants (age, 40-79 years), 9969 with periodontitis and 115,332 controls (without periodontitis) were selected. We analyzed the history of osteoporosis and fractures of all participants. All participants were examined according to age, sex, income group, obesity, smoking habits, alcohol consumption, and food intake. To analyze the odds ratio (OR) of periodontitis for those with osteoporosis and fractures, a logistic regression model was used. RESULTS The adjusted odds ratio (aOR) of periodontitis for osteoporosis was 2.16 (95% confidence interval [CI], 2.01-2.31; P < 0.001). The aOR of periodontitis for any fracture was 1.54 (95% CI 1.46-1.62; P < 0.001). CONCLUSION Osteoporosis and fractures are associated with periodontitis. Performing regular oral hygiene and examinations of bone mineral density are recommended to prevent aggravation of osteoporosis and periodontitis.
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Affiliation(s)
- Seok-Jin Hong
- Research Center of Clinical Dentistry, Hallym University Clinical Dentistry Graduate School, Chuncheon, 24252, Korea.,Department of Otorhinolaryngology-Head and Neck Surgery, Hallym University College of Medicine, Dongtan, 18450, Korea
| | - Byoung-Eun Yang
- Research Center of Clinical Dentistry, Hallym University Clinical Dentistry Graduate School, Chuncheon, 24252, Korea.,Department of Oral and Maxillofacial Surgery, Dentistry, Hallym University College of Medicine, Anyang, 14068, Korea
| | - Dae-Myoung Yoo
- Hallym Data Science Laboratory, Hallym University College of Medicine, Anyang, Korea
| | - Sung-Jae Kim
- Department of Orthopaedic Surgery, Hallym University College of Medicine, Dongtan, 18450, Korea
| | - Hyo-Geun Choi
- Research Center of Clinical Dentistry, Hallym University Clinical Dentistry Graduate School, Chuncheon, 24252, Korea. .,Hallym Data Science Laboratory, Hallym University College of Medicine, Anyang, Korea. .,Department of Otorhinolaryngology-Head and Neck Surgery, Hallym University College of Medicine, Anyang, 14068, Korea.
| | - Soo-Hwan Byun
- Research Center of Clinical Dentistry, Hallym University Clinical Dentistry Graduate School, Chuncheon, 24252, Korea. .,Department of Oral and Maxillofacial Surgery, Dentistry, Hallym University College of Medicine, Anyang, 14068, Korea.
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Hatefi A, Alvandi A. Efficient estimators with categorical ranked set samples: estimation procedures for osteoporosis. J Appl Stat 2020; 49:803-818. [PMID: 35707814 PMCID: PMC9041723 DOI: 10.1080/02664763.2020.1841742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 10/19/2020] [Indexed: 10/23/2022]
Abstract
Ranked set sampling (RSS) design as a cost-effective sampling is a powerful tool in situations where measuring the variable of interest is costly and time-consuming; however, ranking information about sampling units can be obtained easily through inexpensive and easy to measure characteristics at little or no cost. In this paper, we study RSS data for analysis of an ordinal population. First, we compare the problem of non-representative extreme samples under RSS and commonly-used simple random sampling. Using RSS data with tie information, we propose non-parametric and maximum likelihood estimators for population parameters. Through extensive numerical studies, we investigate the effect of various factors including ranking ability, tie generating mechanisms, the number of categories and population setting on the performance of the estimators. Finally, we apply the proposed methods to the bone disorder data to estimate the proportions of patients with osteopenia and osteoporosis status.
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Affiliation(s)
- Armin Hatefi
- Department of Mathematics and Statistics, Memorial University of Newfoundland, St. John's, NL, Canada
| | - Amirhossein Alvandi
- Department of Mathematics and Statistics, Memorial University of Newfoundland, St. John's, NL, Canada
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Kim S, Jung HW, Won CW. What are the illnesses associated with frailty in community-dwelling older adults: the Korean Frailty and Aging Cohort Study. Korean J Intern Med 2020; 35:1004-1013. [PMID: 32264654 PMCID: PMC7373975 DOI: 10.3904/kjim.2019.097] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 04/12/2019] [Accepted: 04/29/2019] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND/AIMS Frailty is mainly due to an age-related decrease in the physiological reserves needed to maintain biological homeostasis, but it can also occur as a result of chronic diseases. The purpose of this study was to identify illnesses associated with frailty in Korean community-dwelling older adults. METHODS This was a cross-sectional study that included 2,936 older adults aged between 70 and 84 years who had completed both interviews and physical function assessments for the Korean Frailty and Aging Cohort Study. Current illnesses diagnosed by physicians were included in the analysis. The definition of frailty was derived from the Fried frailty phenotype. RESULTS The prevalence of hypertension, diabetes mellitus (DM), arthritis, osteoporosis, urinary incontinence, and lung disease (including asthma, chronic obstructive pulmonary disease, and chronic bronchitis) was higher in the frail group (p < 0.05). After adjusting for age, sex, physical activity, alcohol, smoking, education, and presence of a spouse, the odds ratios for DM and urinary incontinence in frailty were 1.51 (95% confidence interval [CI], 1.10 to 2.01; p = 0.01) and 1.88 (95% CI, 1.11 to 3.18; p = 0.02). CONCLUSION In Korean community-dwelling older adults, DM and urinary incontinence were associated with frailty after adjusting for various factors. In the future, the list of comorbid diseases that are appropriate for Korean population-specific frailty assessment should be inventoried.
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Affiliation(s)
- Sunyoung Kim
- Department of Family Medicine, Kyung Hee University College of Medicine, Seoul, Korea
| | - Hee-Won Jung
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Chang Won Won
- Elderly Frailty Research Center, Department of Family Medicine, Kyung Hee University College of Medicine, Seoul, Korea
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Lee SH, Ryu SY, Park J, Shin MH, Han MA, Choi SW. The Relationship of Neutrophil-Lymphocyte Ratio and Platelet-Lymphocyte Ratio with Bone Mineral Density in Korean Postmenopausal Women. Chonnam Med J 2019; 55:150-155. [PMID: 31598472 PMCID: PMC6769246 DOI: 10.4068/cmj.2019.55.3.150] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 06/14/2019] [Accepted: 06/25/2019] [Indexed: 11/13/2022] Open
Abstract
The neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) are known to be markers of the systemic inflammatory response. However, the few studies that have been done on the relationship between the NLR and PLR and osteoporosis have yielded inconsistent results. Therefore, we assessed the relationship between the NLR and PLR and bone mineral density (BMD). This study was conducted with postmenopausal patients admitted to an orthopaedic hospital. Data including BMD, NLR, PLR and covariates were obtained from the subjects' medical records. In total, 407 postmenopausal patients were enrolled in this study. Analysis of covariance was performed to identify significant differences in BMD according to NLR and PLR. After adjusting for other covariates, a quartile of NLR was negatively associated with the mean value of lumbar BMD (p=0.040, p for trend=0.005) but not with the mean value of femur neck BMD. However, there were no significant associations among the PLR, the BMD of the lumbar and the femur neck. In conclusion, the quartile of NLR was negatively associated with the mean value of lumbar BMD in Korean postmenopausal patients.
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Affiliation(s)
- San-Hui Lee
- Department of Health Science, Graduate School of Chosun University, Gwangju, Korea
| | - So-Yeon Ryu
- Department of Preventive Medicine, Chosun University Medical School, Gwangju, Korea
| | - Jong Park
- Department of Preventive Medicine, Chosun University Medical School, Gwangju, Korea
| | - Min-Ho Shin
- Department of Preventive Medicine, Chonnam National University Medical School, Hwasun, Korea
| | - Mi-Ah Han
- Department of Preventive Medicine, Chosun University Medical School, Gwangju, Korea
| | - Seong-Woo Choi
- Department of Preventive Medicine, Chosun University Medical School, Gwangju, Korea
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Kim HY, Kim Y. Associations of obesity with osteoporosis and metabolic syndrome in Korean postmenopausal women: a cross-sectional study using national survey data. Arch Osteoporos 2019; 14:64. [PMID: 31218525 DOI: 10.1007/s11657-019-0615-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Accepted: 06/04/2019] [Indexed: 02/03/2023]
Abstract
UNLABELLED In a representative sample of 3058 Korean postmenopausal women, we studied which types of obesity were more or less desirable for developing concomitant osteoporosis and metabolic syndrome (MS), with the goal of helping clinicians identify steps to reduce patients' risk. Different definitions of obesity showed different relationships with osteoporosis and MS in this population. PURPOSE To examine sample characteristics, prevalence, and the risk of osteoporosis and metabolic syndrome among four groups of postmenopausal women classified by obesity. METHODS Data from the Korea National Health and Nutrition Examination Survey were analyzed using the Rao-Scott chi-square test, analysis of variance, and multinomial logistic regression analysis. The four groups included body mass index (BMI)-based obese, waist circumference (WC)-based obese, BMI-, and WC-based obese, and non-obese women, using BMI and WC cutoffs for obesity of ≥ 25 kg/m2 and ≥ 80 cm, respectively. RESULTS The prevalence of osteoporosis and MS was 40.8% and 48.5%, respectively. Age, socioeconomic status, smoking status, and hormone therapy use differed among the obese groups. The odds ratios of simultaneously having both osteoporosis and MS in the BMI- and WC-based obese, BMI-based obese, WC-based obese, and non-obese groups were 7.39 (95% confidence interval [CI] = 4.83-11.31), 0.74 (95% CI = 0.27-1.98), 7.07 (95% CI = 4.72-10.58), and 1, respectively. CONCLUSIONS The findings demonstrate the most and the least desirable types of obesity in terms of risk for both osteoporosis and MS. Public health practitioners may consider the type of obesity to reduce or prevent both conditions in postmenopausal women.
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Affiliation(s)
- Hyun-Young Kim
- Department of Nursing, Jeonju University, 303 Cheonjam-ro, Wansan-gu, Jeonju-si, 55069, Republic of Korea
| | - Yunmi Kim
- College of Nursing, Eulji University, 553 Sanseong-daero, Sujeong-gu, Seongnam-si, 13135, Republic of Korea.
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Jung Y, Ko Y, Kim HY, Ha YC, Lee YK, Kim TY, Choo DS, Jang S. Gender differences in anti-osteoporosis drug treatment after osteoporotic fractures. J Bone Miner Metab 2019. [PMID: 29536198 DOI: 10.1007/s00774-018-0904-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
This study examined differences between men and women in factors affecting anti-osteoporosis drug treatment after osteoporotic fracture. Using a national claims database, we analyzed patients aged 50 years and older who experienced their first osteoporotic fracture between January 1, 2008, and December 31, 2012. We examined whether patients were prescribed anti-osteoporosis drugs within 6 months post-fracture. Factors associated with treatment status were identified using multivariate logistic regression. Among a total of 556,410 patients aged 50 and older, only 37% were prescribed anti-osteoporosis drugs within 6 months post-fracture. Female patients with fractures were more likely to receive pharmacotherapy than male patients (41.7 vs. 19.3%). Older age significantly increased the likelihood of receiving anti-osteoporosis drugs after osteoporotic fracture. For men, the adjusted odds ratio for receiving therapy was greatest in those aged 80 years and older (OR 6.4), and for women, it was largest in those aged 70-79 (OR 3.33). Both men and women were more likely to be prescribed drugs after a spine fracture, with men having significantly greater odds of receiving drug therapy (men, OR 7.1, 95% CI 6.5-7.9; women 4.79, CI 4.63-4.96). Patients with rheumatic disease or other osteoporosis-inducing comorbid disease were more likely to be prescribed anti-osteoporosis drugs. Our findings indicate that a lack of anti-osteoporosis pharmacotherapy after fracture remains a problem in Korea, especially among men, highlighting the need for effective quality improvement interventions to maximize post-fracture treatment rates.
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Affiliation(s)
- Youn Jung
- Korea Institute for Health and Social Affairs, Sejong, Republic of Korea
| | - Yeonhee Ko
- Gachon University Gil Medical Center, Incheon, South Korea
| | - Ha Young Kim
- Department of Internal Medicine, Wonkwang University Sanbon Hospital, Gunpo, South Korea
| | - Yong Chan Ha
- Department of Orthopaedic Surgery, Chung-Ang University College of Medicine, Seoul, South Korea
| | - Young-Kyun Lee
- Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Tae-Young Kim
- Department of Orthopaedic Surgery, Konkuk University Hospital, School of Medicine, Konkuk University, Seoul, South Korea
| | - Dong-Soo Choo
- Big Data Steering Department, National Health Insurance Service, Wonju, South Korea
| | - Sunmee Jang
- College of Pharmacy and Gachon Institute of Pharmaceutical Sciences, Gachon University, 191 Hambakmoei-ro, Yeonsu-gu, Incheon, 21936, South Korea.
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Jang M, Kim H, Lea S, Oh S, Kim JS, Oh B. Effect of duration of diabetes on bone mineral density: a population study on East Asian males. BMC Endocr Disord 2018; 18:61. [PMID: 30185190 PMCID: PMC6126021 DOI: 10.1186/s12902-018-0290-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Accepted: 08/24/2018] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND The aim of the present study is to evaluate the association between BMD and type 2 DM status in middle-aged and elderly men. To investigate a possible correlation, the present study used the BMD dataset of the Korea National Health and Nutrition Examination Survey (KNHANES) from 2008 to 2011. METHODS In total, 37,753 individuals participated in health examination surveys between 2008 and 2011. A total of 3383 males aged ≥50 years were eligible. They underwent BMD measurement through dual-energy X-ray absorptiometry (DXA). The fasting plasma glucose and insulin levels of participants were also measured. RESULTS Men with prediabetes and diabetes had significantly higher mean BMD at all measured sites than control men did, irrespective of DM status. This was confirmed by multivariable linear regression analyses. DM duration was an important factor affecting BMD. Patients with DM for > 5 years had lower mean BMD in the total hip and femoral neck than those with DM for ≤5 years. Per multivariable linear regression analyses, patients with DM for > 5 years had significantly lower mean BMD at the femoral neck than those with DM ≤5 years. CONCLUSIONS DM duration was significantly associated with reduced femoral neck BMD.
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Affiliation(s)
- Miso Jang
- Department of Family Medicine and Center for Cancer Prevention and Detection, Hospital, National Cancer Center, 323, Ilsan-ro, Ilsandong, Goyang-si, Gyeonggi-do 10408 Republic of Korea
| | - Hyunkyung Kim
- Department of Family Medicine, DDH Hospital, 60, Hi park 2-ro, Ilsanseo-gu, Goyang-si, Gyeonggi-do 10234 Republic of Korea
| | - Shorry Lea
- Center for Health Promotion, Cheil General Hospital, 17, Seoae-ro 1-gil, Jung-gu, Seoul, 04619 Republic of Korea
| | - Sohee Oh
- Department of Biostatistics, SMG-SNU Boramae Medical Center, 20, Boramae-ro 5-gil, Dongjak-gu, Seoul, 07061 Republic of Korea
| | - Jong Seung Kim
- Department of Family Medicine, SMG-SNU Boramae Medical Center, 20, Boramae-ro 5-gil, Dongjak-gu, Seoul, 07061 Republic of Korea
| | - Bumjo Oh
- Department of Family Medicine, SMG-SNU Boramae Medical Center, 20, Boramae-ro 5-gil, Dongjak-gu, Seoul, 07061 Republic of Korea
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Ahn CB, Je JY. Bone health-promoting bioactive peptides. J Food Biochem 2018; 43:e12529. [PMID: 31353486 DOI: 10.1111/jfbc.12529] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 01/22/2018] [Accepted: 02/02/2018] [Indexed: 02/02/2023]
Abstract
Bioactive peptides, derivatives of proteins, show versatile biological effects and represent potential health-promoting agents as functional food ingredients and/or nutraceuticals. Bone health depends on the balance between bone formation and resorption. When the balance is disrupted, bone diseases such as osteoporosis and fragility fractures may result. Accumulating evidence suggests that peptides derived from endogenous proteins and food proteins enhance bone health. This article reviews the literature on peptides exhibiting bone health-promoting effects. Possible biochemical mechanisms and production of these peptides are briefly discussed. PRACTICAL APPLICATIONS: Bioactive peptides are derived from food proteins via enzymatic hydrolysis, are already commercially available. In vitro and in vivo bone health-promoting effects of bioactive peptides have been shown in several animal models of osteoporosis and fractures. Thus, peptides can be used as functional food ingredients and/or nutraceuticals. However, their exact role and safety in human subjects should be evaluated prior to commercialization.
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Affiliation(s)
- Chang-Bum Ahn
- Division of Food and Nutrition, Chonnam National University, Gwangju, 61186, Republic of Korea
| | - Jae-Young Je
- Department of Marine-Bio Convergence Science, Pukyong National University, Busan, 48547, Republic of Korea
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Lee S, Seo DH, Kim KM, Lee EY, Kim HC, Kim CO, Youm Y, Rhee Y. Contingent association between the size of the social support network and osteoporosis among Korean elderly women. PLoS One 2017; 12:e0180017. [PMID: 28700637 PMCID: PMC5507492 DOI: 10.1371/journal.pone.0180017] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Accepted: 06/08/2017] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE To investigate the association between the number of personal ties (or the size of the social support network) and the incidence of osteoporosis among older women in Korea. METHODS Data from the Korean Urban Rural Elderly Study were used. Bone density was measured by dual-energy X-ray absorptiometry at the lumbar spine (L1-L4) and femur neck. T-score, the standardized bone density compared with what is normally expected in a healthy young adult, was measured and the presence of osteoporosis was determined, if the T-score was < -2.5. The social support network size was measured by self-responses (number of confidants and spouse). RESULTS Of the 1,846 participants, 44.9% were diagnosed with osteoporosis. The association between the social support network size and the incidence of osteoporosis was curvilinear in both bivariate and multivariate analyses. Having more people in one's social support network size was associated with lower risk of osteoporosis until it reached around four. Increasing the social support network size beyond four, in contrast, was associated with a higher risk of osteoporosis. This association was contingent on the average intimacy level of the social network. At the highest average intimacy level ("extremely close"), increasing the number of social support network members from one to six was associated with linear decrease in the predicted probability of osteoporosis from 45% to 30%. However, at the lowest average intimacy level ("not very close"), the predicted probability of osteoporosis dramatically increased from 48% to 80% as the size of the social network increased from one to six. CONCLUSION Our results show that maintaining a large and intimate social support network is associated with a lower risk of osteoporosis among elderly Korean women, while a large but less-intimate social relationship is associated with a higher risk.
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Affiliation(s)
- Seungwon Lee
- Department of Sociology, Yonsei University, Seoul, South Korea
| | - Da Hea Seo
- Department of Endocrinology and Metabolism, Inha University School of Medicine, Incheon, South Korea
| | - Kyoung Min Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Eun Young Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, South Korea
| | - Hyeon Chang Kim
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Chang Oh Kim
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Yoosik Youm
- Department of Sociology, Yonsei University, Seoul, South Korea
| | - Yumie Rhee
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
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Kim Y, Kim HY, Kim JH. Associations Between Reported Dietary Sodium Intake and Osteoporosis in Korean Postmenopausal Women: The 2008-2011 Korea National Health and Nutrition Examination Survey. Asia Pac J Public Health 2017; 29:430-439. [DOI: 10.1177/1010539517712759] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- Yunmi Kim
- Eulji University, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - Hyun-Young Kim
- Jeonju University, Wansan-gu, Jeonju-si, Republic of Korea
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Lim HS, Kim SK, Lee HH, Byun DW, Park YH, Kim TH. Comparison in Adherence to Osteoporosis Guidelines according to Bone Health Status in Korean Adult. J Bone Metab 2016; 23:143-8. [PMID: 27622178 PMCID: PMC5018607 DOI: 10.11005/jbm.2016.23.3.143] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Revised: 06/24/2016] [Accepted: 07/01/2016] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Osteoporosis one of the most serious disease to decrease the quality of life and cause economic loss. Thus, prevention of osteoporosis has become an important health concern. The study examined in adherence to osteoporosis guidelines and compared the levels of adherence to osteoporosis guidelines between bone health status in Korean adult. METHODS This study used data from a nationally represented sample of Koreans (n=3,419) from 2008 to 2011 Korea National Health and Nutrition Examination Survey. We were divided into three groups by T-score: normal, osteopenia and osteoporosis. Assessment of adherence level was based on 5 components of osteoporosis guidelines, considering intake of sodium, calcium and protein, smoking and regular exercise. RESULTS The sex, body mass index, income and educational level did not significantly differ between three groups. Deficient intake of calcium was significantly associated with a threefold greater odds in osteoporosis group (OR 3.6; 95% confidence interval [CI] 2.52-5.22). Excessive protein intake was significantly increased the risk only in osteoporosis group compared to the normal group (OR 1.71; 95% CI 1.15-2.62). Smoking increased the risk in osteoporosis group compared to the normal group (OR 2.88; 95% CI 1.75-4.76), osteoporosis group compared to the osteopenia group (OR 2.69; 95% CI 1.61-4.55). CONCLUSIONS Nutritional factor (intake of calcium and protein) and lifestyle-related factor (smoking and exercise) must be accompanied the management for bone health. An adherence of guidelines is considered very important for the prevention of osteoporosis.
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Affiliation(s)
- Hee-Sook Lim
- Department of Preventive Medicine, Soonchunhyang University College of Medicine, Cheonan, Korea.; Department of Clinical Nutrition, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Soon-Kyung Kim
- Department of Food Sciences & Nutrition, Soonchunhyang University, Asan, Korea
| | - Hae-Hyeog Lee
- Department of Obstetrics and Gynecology, Soonchunhyang University College of Medicine, Bucheon, Korea
| | - Dong Won Byun
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Seoul, Korea
| | - Yoon-Hyung Park
- Department of Preventive Medicine, Soonchunhyang University College of Medicine, Cheonan, Korea
| | - Tae-Hee Kim
- Department of Obstetrics and Gynecology, Soonchunhyang University College of Medicine, Bucheon, Korea
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Lee I, Ha C, Kang H. Association of sarcopenia and physical activity with femur bone mineral density in elderly women. J Exerc Nutrition Biochem 2016; 20:23-8. [PMID: 27298809 PMCID: PMC4899897 DOI: 10.20463/jenb.2016.03.20.1.8] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Revised: 03/17/2016] [Accepted: 03/17/2016] [Indexed: 12/01/2022] Open
Abstract
[Purpose] This study examined the association of femur bone mineral density (BMD) with body composition and physical activity in elderly women. [Methods] This was a cross sectional study involving 119 women with mean age of 73.1±5.5 years. Body composition parameters including body mass index (BMI), percent of body fat (%BF), appendicular skeletal muscle mass (ASM) index and femur BMD was measured by dual-energy X-ray absorptiometry (DXA). Physical activity was assessed by the uniaxial accelerometer for 7 consecutive days including weekends. Based on femur BMD T-scores, subjects were classified as optimal group, osteopenia group, and osteoporosis group. Based on ASM index, subjects were classified as normal group and sarcopenia group. According to WHO recommendations of physical activity for elderly, the subjects were classified as active group or inactive group. Logistic regression analyses were used to determine the odds ratio (OR) for osteopenia and osteoporosis. [Results] There were linear decreases for body composition parameters including weight (P=.023), BMI (P=.039), lean mass (P=.032), ASM index (P=.007) and physical activity parameters including daily of step (P<.001), low intensity physical activity (P<.001), moderate intensity physical activity (P=.001) across femur BMD levels. Compared to the normal group (OR=1), the sarcopenia group had a significantly higher OR (OR=4.823; P=.042), and the inactive group had a significantly higher OR (OR=5.478; P=.005) having osteopenia and osteoporosis when compared to the active group (OR=1). [Conclusion] The findings of this study suggested that physical activity along with a healthy nutrition should be promoted as a preventive strategy against osteopenia and osteoporosis in elderly women.
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Affiliation(s)
- Inhwan Lee
- College of Sport Science, Sungkyunkwan University, Suwon Korea
| | - Changduk Ha
- College of Sport Science, Sungkyunkwan University, Suwon Korea
| | - Hyunsik Kang
- College of Sport Science, Sungkyunkwan University, Suwon Korea
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