School of Nursing, Tianjin Medical University, Tianjin, 300070, China.
Department of bone medicine of Tianjin Hospital, Tianjin, China.
BMC Womens Health. 2019 Aug 13;19(1):110. doi: 10.1186/s12905-019-0808-0.
Postmenopausal osteoporosis (PMOP) has long been a pervasive public health concern. With the aging Chinese population, the prevention, assessment and management of postmenopausal osteoporosis were particularly important. During the breastfeeding, a large amount of Calcium loss from maternal bone for infants' growth. However, whether this loss is completely reversible remains controversial. As the relationship between breastfeeding and postmenopausal osteoporosis is different from society to society and is not clear from the literature, the purpose of this study was to determine whether breastfeeding was an independent factor for the development of PMOP based on Chinese postmenopausal population.
A retrospective cross-sectional investigation was conducted at Tianjin Xiaobailou health Community Healthcare Center between December 2017 and June 2018. Postmenopausal women over the age of 50 who underwent the annual health examination or visited the center to perform bone densitometry as a part of routine screening for disease were recruited. A trained community nurse administered a questionnaire to all participants by face-to-face interview. Participants were questioned about age, BMI, Vitamin D and calcium intake, the history of smoking, drinking and fracture, age of menarche, age of menopause, the number of pregnancy, parity, feeding pattern (breastfeeding, artificial feeding and mixed feeding) and overall breastfeeding duration. BMD measurements were carried out using quantitative ultrasound (QUS) at the bilateral radius.
A total of 202 women who met the inclusive and exclusive criteria were enrolled. Univariate analysis revealed that overall breastfeeding more than 24 months increased the risk of osteoporosis (OR 39.00, 95%CI 2.40-634.65, p = 0.010). However, multivariate estimate of the risk of osteoporosis by overall breastfeeding duration suggested that when controlling for age, BMI, the number of pregnancy and parity, the overall breastfeeding duration was not an independent risk factor for postmenopausal osteoporosis (OR 5.22, 95%CI 0.18-147.76, p = 0.333). Additionally, age (OR 1.16, 95%CI 1.05-1.29, p = 0.003), BMI (OR 1.26, 95%CI 1.04-1.54, p = 0.021) and the number of pregnancy (OR 1.80, 95%CI 1.08-2.98, p = 0.024) were significant associated with postmenopausal osteoporosis.
Breastfeeding was not associated with postmenopausal osteoporosis, while age, BMI and the number of pregnancy may contribute to increasing risk of postmenopausal osteoporosis in Chinese women.
绝经后骨质疏松症（PMOP）一直是一个普遍存在的公共卫生问题。随着中国人口老龄化，绝经后骨质疏松症的预防、评估和管理尤为重要。在哺乳期，大量的钙会从母体骨骼中流失，以满足婴儿的生长需求。然而，这种流失是否完全可以逆转仍存在争议。由于母乳喂养与绝经后骨质疏松症的关系因社会而异，且文献中并未明确阐明，因此本研究旨在确定母乳喂养是否是基于中国绝经后人群发生 PMOP 的独立因素。
2017 年 12 月至 2018 年 6 月，在天津市小白楼街社区卫生服务中心进行了一项回顾性横断面调查。招募了年龄在 50 岁以上、接受年度体检或因疾病常规筛查而到中心进行骨密度测量的绝经后女性。由经过培训的社区护士通过面对面访谈的方式向所有参与者发放问卷。询问参与者的年龄、BMI、维生素 D 和钙摄入量、吸烟、饮酒和骨折史、初潮年龄、绝经年龄、妊娠次数、产次、喂养方式（母乳喂养、人工喂养和混合喂养）和总母乳喂养时间。使用双侧桡骨定量超声（QUS）进行 BMD 测量。
共纳入符合纳入和排除标准的 202 名女性。单因素分析显示，总母乳喂养时间超过 24 个月会增加骨质疏松症的风险（OR 39.00，95%CI 2.40-634.65，p=0.010）。然而，通过总母乳喂养持续时间对骨质疏松症风险的多变量估计表明，在控制年龄、BMI、妊娠次数和产次后，总母乳喂养持续时间并不是绝经后骨质疏松症的独立危险因素（OR 5.22，95%CI 0.18-147.76，p=0.333）。此外，年龄（OR 1.16，95%CI 1.05-1.29，p=0.003）、BMI（OR 1.26，95%CI 1.04-1.54，p=0.021）和妊娠次数（OR 1.80，95%CI 1.08-2.98，p=0.024）与绝经后骨质疏松症显著相关。
母乳喂养与绝经后骨质疏松症无关，而年龄、BMI 和妊娠次数可能会增加中国女性绝经后骨质疏松症的风险。
