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KMID : 1007020050030020098
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Korean Soceity of Osteroporosis
2005 Volume.3 No. 2 p.98 ~ p.109
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Geographic Difference in the Prevalence of Osteoporosis in Korea
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Cho Nam-Han
Shin Chol
Park Chan
Kimm Kyu-Chan
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Abstract
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Objectives: To investigate geographic differences in the prevalence of tibia and radius osteoporosis in a community-based cohort.
Methods: In this community cohort prospective study, a total of 10,038, 40～69 years old subjects (male=4,762, female=5,276) from both urban and rural regions were recruited; all of them underwent Quantitative Ultrasound (QUS) measurements at Radius and Tibia to diagnose osteoporosis. WHO criteria were used to interpret the QUS results for diagnose of osteoporosis. Standardized method including QUS measuring device and questionnaire was used by the trained researchers.
Results: The mean age of the rural subject was 55.5±8.8 that is significantly older in the urban region 49.1±7.9 (P＜0.001). Gender distribution in urban was very similar (male 50.3% vs female 49.7%) but higher proportion of female subject (55.4%) in rural. Many demographic characteristics were significantly different between the two groups; BMI was higher in urban (24.7±3 kg/m2 vs 24.4±3.3 k/m2) (P＜0.01), mean duration of residence was significantly longer in rural (41 years vs 13 years). Exception of blood pressures and triglyceride, all other metabolic variables were significantly higher in urban population. Mean SoS for radius was higher in rural but tibia value was higher in urban population. Mean age at menarche was significantly older in rural (16.1± .9 years vs 15.6±2 years) (P＜0.001). Amount of daily calcium intake, alcohol intake, coffee, carbonated drink, and green tea consumption was greater in urban, but more smokers and lesser exercise in rural subjects. We calculated standardized mortality rates by using the direct adjustment to make direct comparison between the two regions. At tibia, osteoporosis in rural was 11.4% (male=1.7%, female=20.8%) and urban 8.8% (male=2.2%, female=15.1%). At radius, osteoporosis in rural was 7.3% (male=3.3%, female= 11.1%) and urban 7.5% (male=3%, female=11.9%). Multiple logistic regression analysis revealed that rural dwelling was 3.3 times (95% CI 2.4～4.7, P＜0.0001) higher risk for osteoporosis at radius when compared to urban independent of female gender, age, BMI and blood pressures. These relationship also persisted at Tibia with 3.7 times (95% CI 2.5～5.5, P＜0.0001) higher risk in rural dwelling. Similar independent variables were persisted in addition to carbonated drink (＞ 5 times per week).
Conclusion: This is study results indicate that the most important predictors for tibia and radius osteoporosis were age, gender, blood pressure, BMI, and rural dwelling. We suggest that rural dwelling women should be closely monitored for osteoporosis, specifically tibia after 50 years of age.
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KEYWORD
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Urban-rural, Prevalence, Osteoporosis, Korea
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