Yeo Ui Hyang, Choi Chang Jin, Choi Whan Seok, Kim Kyung Soo
Department of Family Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 137-701, Korea.
J Bone Miner Metab. 2016 Jan;34(1):109-17. doi: 10.1007/s00774-015-0649-3. Epub 2015 Mar 20.
Breast-feeding has the deleterious effect of hypoestrogenemia coupled with loss of calcium in the maternal bone mass. It is not clear whether changes in bone metabolism in lactating women lead to changes in maternal bone mineral density (BMD) over a longer period. The aim of the present study was to investigate the relationship between the duration of breast-feeding and BMD in healthy South Korean women. We analyzed data from the 2010 Korea National Health and Nutrition Examination Survey, a cross-sectional survey of Korean citizens. A total of 1342 women older than 19 years were selected for analysis. In postmenopausal women, the duration of breast-feeding per child was associated with low lumbar spine BMD after adjustment for age, body mass index, smoking, alcohol intake, physical activity, serum 25-hydroxyvitamin D level, and daily intake of calcium and calories (P < 0.05, P trend < 0.005). Prolonged breast-feeding for more than 1 year per child was associated with a deleterious effect on lumbar spine BMD compared with never breast-feeding or a shorter duration of breast-feeding (P < 0.05). These effects were not shown in premenopausal women or in femur BMD. In conclusion, the duration of breast-feeding per child is negatively correlated with lumbar spine BMD in postmenopausal women, but not in premenopausal women. Although the cause of the different results between postmenopausal and premenopausal women is not clear, our findings suggest that proper protective strategies should be recommended during prolonged breast-feeding to maintain bone health later in life.
母乳喂养具有低雌激素血症的有害影响，同时会导致母体骨量中的钙流失。尚不清楚哺乳期妇女骨代谢的变化是否会在更长时期内导致母体骨矿物质密度（BMD）的改变。本研究的目的是调查健康韩国女性母乳喂养持续时间与骨矿物质密度之间的关系。我们分析了2010年韩国国民健康与营养检查调查的数据，这是一项针对韩国公民的横断面调查。总共选取了1342名19岁以上的女性进行分析。在绝经后女性中，在对年龄、体重指数、吸烟、饮酒、身体活动、血清25-羟基维生素D水平以及钙和热量的每日摄入量进行调整后，每个孩子的母乳喂养持续时间与腰椎骨矿物质密度较低相关（P < 0.05，P趋势 < 0.005）。与从未母乳喂养或母乳喂养时间较短相比，每个孩子母乳喂养超过1年对腰椎骨矿物质密度有有害影响（P < 0.05）。这些影响在绝经前女性或股骨骨矿物质密度中未表现出来。总之，绝经后女性中每个孩子的母乳喂养持续时间与腰椎骨矿物质密度呈负相关，但绝经前女性并非如此。尽管绝经后和绝经前女性结果不同的原因尚不清楚，但我们的研究结果表明，在长时间母乳喂养期间应推荐适当的保护策略，以维持晚年的骨骼健康。
