It is well defined that osteoporosis is an age related disorder and associated with decreased bone mass. It is one of the most important disease facing the aging population because of its association with fracture of the hip, vertebrae and
distal radius. The disease provoke a significant economic burden and major public health problem of an elderly. The life-time risk of hip fracture in white women is approximately 15% which is equal to the combined risk of breast, uterine, and ovarian cancer. Despite its deleterious effect on women’s health, knowledge of the epidemiology of osteoporosis in Korea is only beginning. 1970 in Korea has nown as the crossover period between the chronic and an infectious diseases. As the result, the infant mortality declined and an elderly population in Korea increased significantly in the past decade.
The average life expectancy of women in Korea is now about 75 years. Thus, the majority of Korean women will spend approximately one-third of their life in the postmenopause state. Therefore, better understanding of bone metabolism and fracture incidence in Korean population is a great interest for the medical community as well as for public health. Currently, no population based epidemiologic data are available to support the incidence of osteoporotic fractures in Korea. However, available data suggest that significant declining of bone mineral density (BMD [g/㎠] ) has been occurring in Korean women after menopause. In same population, peak BMD was observed around 33-39 years of age and continue to decline thereafter. An accelerated bone losses occur after the menopause and the average loss is approximately 13% within 15 years from the menopause. The incidence of fracture was highly correlated with an age and bone mineral density. The mean age of menopause in Korean women was 47 years and this age appears to getting younger when analyzed by the birth cohort. An earlier menopausal age and increase life expectancy place Korean women at increase risk for osteoporosis and bone fracture. Korean of Asian women are no longer protected from the risk of bone fracture. Therefore, an early prevention of intervention schemes are essential before the outbreak of osteoporosis and/or fracture occurs in Korean or Asian women.
Introduction
Many prospective studies indicate that the risk of fragility fractures increases progressively and continuously as bone mineral density declines (1-3). It is well documented that bone density in Asian women is lower than that of Caucasian
women. Despite a low bone density, the prevalence of bone fracture in Asian population is lower than the Caucasian rates (4-6). The low fracture incidence described in Asian populations are perhaps related to either under reporting of cases or cases of less bone loss during postmenopausal period. We postulated that less bone loss during postmenopausal period in Asian populations are responsible for the low fracture incidence. Therefore, in order to demonstrate our hypothesis of less bone loss in Korean women during postmenopausal period we will describe, l) general physical and metabolic characteristics in over 6700 female subjects from Cheil general hospital ; 2) the pattern of BMD change during the pre-and postmenopausal period from the same cohort.
Characteristics of Climacteric Korean Women
The mean age of the study subjects were 51.4±6.9 years and ranges from 20 to 94 years ; the mean menopause age was 47±5.5 years and ranges from 20 to 60 years. A handful of young women who experienced an early menopause was not the case of natural menopause but disease related phenomenon. Twenty-three percent of the subjects received a grade school edcuation, 24% with Junior high school, 38%with high school and 8% with a college level education, Furthermore, 3% of the women were nulliparity, 5.5% have one child, 36.7% have a two, 29% have a three, 16.2% have a four, and approximately 10% have more than 5 children. The mean height and weight was 1.57±0.05m and 57.3±7.3kg respectively. The mean body mass index (BMI, kg/㎡) was 23.2±2.8 The demographic and physical parameters of our hospital population shows heterogeneity and no sign of disparity from the general population (7).
The patients presented with a variety of climacteric symptoms. These symptoms include ; hot flushes, night sweats, insomnia, palpitations, headaches, panic attacks, mood changes, anxiety, irritability, poor memory, poor concentration, loss of confidence, indecisiveness, depression, tiredness/loss of energy, genital track atrophy, dyspareunia, loss of libido, increased urinary frequency, increased urgency, nocturia, dysuria, dry thin skin, dry hair, formication, aches and pains in joints. Lumbago was the most frequently complained
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