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Z-score discordance and contributing factors in healthy premenopausal women with low bone mineral density: the Korean National Health and Nutrition Examination Survey 2008-9

 Kyeong Hye Park  ;  Jung Soo Lim  ;  Kyoung Min Kim  ;  Yumie Rhee  ;  Sung-Kil Lim 
 Journal of Bone and Mineral Metabolism, Vol.34(6) : 668-677, 2016 
Journal Title
 Journal of Bone and Mineral Metabolism 
Issue Date
Adolescent ; Adult ; Body Mass Index* ; Bone Density* ; Female ; Fractures, Bone/epidemiology ; Fractures, Bone/etiology ; Fractures, Bone/metabolism* ; Humans ; Male ; Middle Aged ; Nutrition Surveys ; Osteoporosis/complications ; Osteoporosis/epidemiology ; Osteoporosis/metabolism* ; Postmenopause/metabolism ; Republic of Korea/epidemiology ; Risk Factors
Discordance ; Low bone mineral density ; Premenopausal women ; Z-score
The premenopausal period is important for bone health and prevention of future fractures, but measuring bone mineral density (BMD) at only one site may not be sufficient to determine therapeutic strategies for low BMD in premenopausal women due to the presence of Z-score discordance. In this study, we investigated Z-score discordance in addition to contributing factors of idiopathic low BMD in healthy premenopausal Korean women. We studied 3003 premenopausal women aged 18-50 years, without secondary causes for low BMD and history of fragility fracture, who had participated in the Fourth Korean National Health and Nutrition Examination Surveys (2008-2009). Low body mass index (BMI), low vitamin D level, and low body muscle mass were associated with low BMD even in premenopausal women. Risk factors differed depending on the anatomic site. Low BMI and low vitamin D level were risk factors for low femoral neck BMD (FN-BMD), but not for low lumbar spine BMD (LS-BMD). Only total muscle mass had a slight effect on low LS-BMD. Z-score discordance was much higher than expected, in 75 and 73.8 % of the low LS-BMD and low FN-BMD groups, respectively. Our findings suggest the need to consider BMD discordance in premenopausal women and also to provide information on correctable factors affecting low BMD in younger populations. Long-term follow-up is needed to evaluate the possible effect of Z-score discordance on the prognosis of osteoporosis and subsequent fracture risk.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
이유미(Rhee, Yumie) ORCID logo https://orcid.org/0000-0003-4227-5638
임승길(Lim, Sung Kil)
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