Department of Obstetrics and Gynecology, The Catholic University of Korea, Yeouido St. Mary's Hospital, Seoul, Korea.
Department of Medical Statistics, The Catholic University of Korea College of Medicine, Seoul, Korea.
J Korean Med Sci. 2018 Nov 9;33(48):e311. doi: 10.3346/jkms.2018.33.e311. eCollection 2018 Nov 26.
In postmenopausal women, there is rapid bone loss due to estrogen depletion. In women, reproductive factors such as age at menarche, breastfeeding, and parity are considered risk factors of osteoporosis. Many reports suggest that obesity is associated with a reduced risk of osteoporosis. This nationwide, population-based study aims to identify the association between maternal age and osteoporosis risk in postmenopausal women of different obesity classifications.
We assessed data from the Korean National Health and Nutrition Examination Survey 2010-2012. The study included 1,328 postmenopausal women, after excluding women with missing data for reproductive history among 4,546 postmenopausal women in the survey. Multivariate regression was used to identify the association between childbirth age and postmenopausal bone mineral density after adjustments for confounding factors.
The prevalence of postmenopausal osteoporosis was 35.24% (n = 468). After dividing the subjects into obese and non-obese groups based on body mass index (BMI) and waist circumference, there were significant differences between non-osteoporosis and osteoporosis groups with regard to age at first childbirth, age at last childbirth, and parity in the BMI-based general obesity group. The prevalence of osteoporosis was highest in women older than 35 years old at last childbirth. The prevalence of osteoporosis was also greater in women with parity ≥ 4 compared to those with lower parity levels.
Postmenopausal women of older age at last childbirth and higher parity were at increased risk of osteoporosis in the BMI-based non-general obesity group.
绝经后妇女由于雌激素缺乏会出现快速的骨质流失。在女性中，初潮年龄、哺乳和生育史等生育因素被认为是骨质疏松症的危险因素。许多报告表明肥胖与骨质疏松症风险降低有关。这项全国性的基于人群的研究旨在确定不同肥胖分类的绝经后妇女中，母亲年龄与骨质疏松症风险之间的关系。
我们评估了 2010-2012 年韩国国家健康和营养检查调查的数据。研究纳入了 1328 名绝经后妇女，在剔除了调查中 4546 名绝经后妇女中因生育史数据缺失的妇女后，对这些妇女进行了分析。采用多元回归分析，在调整了混杂因素后，确定了生育年龄与绝经后骨密度之间的关系。
绝经后骨质疏松症的患病率为 35.24%（n=468）。根据体重指数（BMI）和腰围将受试者分为肥胖和非肥胖组后，在 BMI 为基础的一般肥胖组中，初产年龄、末产年龄和生育次数在非骨质疏松组和骨质疏松组之间存在显著差异。末次分娩年龄大于 35 岁的妇女骨质疏松症患病率最高。与生育次数较低的妇女相比，生育次数≥4 次的妇女骨质疏松症的患病率也更高。
在 BMI 为基础的非一般肥胖组中，末次分娩年龄较大和生育次数较高的绝经后妇女发生骨质疏松症的风险增加。
