Kim Hyun Joo, Kwon Hyuktae, Oh Seung-Won, Lee Cheol Min, Joh Hee-Kyung, Kim Youngju, Um Yoo-Jin, Ahn Sang Hyun
Department of Family Medicine, Seoul National University Hospital, Seoul, Korea.
Department of Family Medicine, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Korea.
Korean J Fam Med. 2015 Sep;36(5):216-20. doi: 10.4082/kjfm.2015.36.5.216. Epub 2015 Sep 18.
Postmenopausal osteoporosis is a common disease which can cause various morbidity and economic burden. Lactation is known to cause a decline in bone mineral density (BMD), but there are controversies on whether decreased BMD is fully recovered after lactation and whether lactation duration has an influence on postmenopausal BMD. This study was conducted to see whether breastfeeding is associated with postmenopausal bone loss using a highly representative sample of Korean population.
Retrospective cross sectional study was done using data collected from Korea National Health and Nutrition Examination Survey V. The study outcome was BMD measured with dual-energy X-ray absorptiometry and divided into 2 groups: normal or low BMD (T score<-1), and breastfeeding duration was categorized into 4 groups (never, 1st, 2nd, and 3rd tertile). Logistic regression analysis was done to examine the association between lactation duration and BMD.
Among 1,694 postmenopausal women (mean age, 63.5±9.1), 85.71% were in low BMD group. Compared to never breastfeeding group, postmenopausal women with longer than 79 months of breastfeeding duration are more likely to have low BMD (adjusted risk ratio [ARR]=1.24; 95% confidence interval, 1.17 to 1.32). As the duration of breastfeeding increases, ARR and risk difference for low BMD also increases (P for trend=0.008).
The study results showed that total breastfeeding duration was associated with postmenopausal low BMD. All women planning on breastfeeding should be aware of its risks and should take adequate dietary calcium and vitamin D before, during, and after breastfeeding.
绝经后骨质疏松症是一种常见疾病，可导致各种发病率和经济负担。已知哺乳期会导致骨密度（BMD）下降，但关于哺乳期后骨密度降低是否能完全恢复以及哺乳期长短是否对绝经后骨密度有影响存在争议。本研究旨在利用具有高度代表性的韩国人群样本，探讨母乳喂养与绝经后骨质流失是否相关。
采用韩国国家健康与营养检查调查V收集的数据进行回顾性横断面研究。研究结果是通过双能X线吸收法测量的骨密度，分为两组：骨密度正常或低（T值＜-1），母乳喂养持续时间分为四组（从未、第一、第二和第三三分位数）。进行逻辑回归分析以检验哺乳期与骨密度之间的关联。
在1694名绝经后女性（平均年龄63.5±9.1岁）中，85.71%属于低骨密度组。与从未母乳喂养组相比，母乳喂养持续时间超过79个月的绝经后女性更有可能骨密度低（调整风险比[ARR]=1.24；95%置信区间，1.17至1.32）。随着母乳喂养持续时间的增加，低骨密度的ARR和风险差异也增加（趋势P=0.008）。
研究结果表明，母乳喂养总时长与绝经后低骨密度有关。所有计划母乳喂养的女性都应意识到其风险，并在母乳喂养前、期间和之后摄入足够的膳食钙和维生素D。
