폐경 전후 여성의 신체활동 및 생활습관과 골 밀도 수치와의 관련성

배성욱,남철현,홍성철,최연희,이정옥,양숙희 대한보건협회 2002 대한보건연구 Vol.28 No.3

To evaluate the degree of bone mineral density according to physical activity, lifestyle in pre- and postmenopausal women. The subjects were 951 premenopausal and 1,167 postmenopausal women who have examined in health promotion center of Yeungnam University Hospital in Daegu city from January, 1999 to Januaty, 2001. The test for bone mineral density. The physical activity and life style were evaluated by questionaire through interview. The results were summarized as follow. 1) The prevalence rates of reduced bone mineral density and osteoporosis in premenopausal women were 23.8% and 1.6%, respectively. However, these values were increased to 46.1% and 28.1% in postmenopausal women. 2) The regular exercise was revealed to have preventive effect for osteoporosis in pre- and postmenopausal women. Among the types of exercise, the most effective exercise was bowling and moderately effective exercise was swimming on prevention of osteoporosis, however, bare hand physical exercise was not significant effect on bone mineral density. 3) The risk for reducing bone mineral density was decreased in women who have higher educational background and income in pre- and postmenopausal. The bone mineral density was highest in white color worker and lowest in blue color worker. 4) The premenopausal women who favor meat were revealed higher bone mineral density than the women who favor vegetable. The women who have drunk none or small amount of alcohol were revealed increased bone mineral density and smoking was a risk factor for osteoporosis. These results suggested that to prevent osteoporosis, the systemized program for promoting anti-osteoporotic factor have to be developed and apply from the thirties whom have maximal bone mineral density.

Impact of Age, Tumor Size, Lymph Node Metastasis, Stage, Receptor Status and Menopausal Status on Overall Survival of Breast Cancer Patients in Pakistan

Mahmood, Humera,Faheem, Mohammad,Mahmood, Sana,Sadiq, Maryam,Irfan, Javaid Asian Pacific Journal of Cancer Prevention 2015 Asian Pacific journal of cancer prevention Vol.16 No.3

Background: Survival of breast cancer patients depends on a number of factors which are not only prognostic but are also predictive. A number of studies have been carried out worldwide to find out prognostic and predictive significance of different clinicopathological and molecular variables in breast cancer. This study was carried out at Nuclear Medicine, Oncology and Radiotherapy Institute (NORI), Islamabad, to find out the impact of different factors on overall survival of breast cancer patients coming from Northern Pakistan. Materials and Methods: This observational retrospective study was carried out in the Oncology Department of NORI Hospital. A total of 2,666 patients were included. Data were entered into SPSS 20. Multinomial logistic regression analysis was performed to determine associations of different variables with overall survival. P values <0.05 were considered significant. Results: The mean age of the patients was 47.6 years, 49.5% being postmenopausal. Some 1,708 were ER positive and 1,615 were PR positive, while Her 2 neu oncogene positivity was found in 683. A total of 1,237 presented with skin involvement and 426 had chest wall involvement. Some 1,663 had > 5cm tumors. Lymph node involvement was detected in 2,131. Overall survival was less than 5 years in 669 patients, only 324 surviving for more than 10 years, and in the remainder overall survival was in the range of 5-10 years. Conclusions: Tumor size, lymph node metastases, receptor status, her 2 neu positivity, skin involvement, and chest wall involvement have significant effects whereas age and menopausal status have no significant effect on overall survival of breast cancer patients in Pakistan.

연구논문 : 폐경 전,후 여성들의 체위, 영양소 섭취 상태 및 혈중 지질과의 관련성에 관한 연구

최윤희 ( Yun Hee Choi ),송태희 ( Tae Hee Song ) 한국식품영양학회 2013 韓國食品營養學會誌 Vol.26 No.3

Abstract This study was conducted to investigate the anthropometric data, nutrient intakes and serum profiles in premenopausal and postmenopausal women living in Gyeonggi-do Province, Republic of Korea. The subjects were 49 premenopausal women and 63 postmenopausal women who are not taking any hormone or cardiovascular drugs. Anthropometric measurements were taken by a trained practitioner and the data for dietary intakes were obtained by a 24-hour recall method. Serum samples were collected and analyzed for the total cholesterol, triglyceride (TG) and lipoprotein fractions. The mean age of the premenopausal women was 45.17±3.28 years and that of the postmenopausal women was 62.52±4.14 years. The height and weight were 157.86±4.35 ㎝, 58.75±6.01 ㎏ in premenopausal women and 156.42±3.62 ㎝, 57.63±5.38 ㎏ in postmenopausal women, respectively. WHR (waist hip ratio) in postmenopausal women was significantly higher than that of premenopausal women (p<0.05). There were no differences between the pre-and postmenopausal women in the intakes of energy, protein, fat, Ca, Fe, vitamin A, vitamin B1, vitamin B2, niacin, vitamin C and vitamin E. However carbohydrate and Na intakes in postmenopausal women were significantly higher than those of premenopausal women. In postmenopausal women, Ca intake was below and Na intake was extremely high considering KDRIs (Dietary Reference Intakes for Koreans). Serum triglyceride in postmenopausal women was positively correlated with age, BMI (body mass index) and WHR. Serum total cholesterol and triglyceride in postmenopausal women showed significantly negative correlations with fiber intake. These results suggest that it is necessary to help postmenopausal women maintain a healthy body weight. Postmenopausal women needs to increase Ca (calcium) intakes and diet quality by decreasing the intakes of Na (sodium). In addition, an adequate intakes of fiber is recommended for postmenopausal women to prevent cardiovascular disease.

폐경기 초로 여성의 결혼생활 만족도와 우울의 관계에서 노화와 죽음에 대한 태도의 매개 효과

손영수,김향미 대한노인병학회 2015 Annals of geriatric medicine and research Vol.19 No.3

Background: Depression is the most common medical and psychological affliction in presenile postmenopausal women. The aim of the present study was twofold: first, to investigate whether attitudes towards senility mediate the effect of marital satisfaction on depression in presenile postmenopausal women; second, to investigate whether attitudes towards death mediate the effect of marital satisfaction on depression in presenile postmenopausal women. Methods: One hundred thirty physically active, married female participants in their 50s, who were receiving postmenopausal hormone replacement therapy at Senile Women’s Clinic, Jeju National University Hospital, were recruited. To assess the women’s mental health and outlooks on life, the Korean version of Beck’s Depression Inventory, the Korean version of the attitudes towards ageing questionnaire, the Korean version of the attitudes towards death questionnaire, and the Korean marital satisfaction scale were used. Results: The effect of marital satisfaction on depression in presenile postmenopausal women was partially mediated by attitudes towards senility. Conversely, the effect of marital satisfaction on depression in presenile postmenopausal women was not mediated by attitudes towards death. Conclusion: In presenile postmenopausal women, apprehensions concerning senility are more influential than those concerning death in the onset of depression. Therefore, medical management and/or psychological counseling for presenile postmenopausal women with depression, should take into account their attitudes towards senility.

폐경기 이후 고령출산의 법적 제 문제

이은영 ( Eun Young Lee ) 홍익대학교 법학연구소 2013 홍익법학 Vol.14 No.1

The postmenopausal assisted childbearing of old women has become the object of controversy in Korea nowadays. The development of assisted reproductive technology made it possible for postmenopausal old women to bear children. The postmenopausal assisted childbearing was given a riotous welcome at the first stage, but is not welcomed now. The critics say that the postmenopausal assisted childbearing is motivated by parent`s selfish needs. According to their light, the postmenopausal assisted childbearing is likely to infringe on children`s wellbeing. In addition, it is highly probable to distort the rational and fair distribution of limited medical resources. From the viewpont of medical law, the issues in postmenopausal assisted childbearing can be summed up as following two questions. Can it be justified to discriminate of late assisted childbearing by age limit? What are the criteria for the limitation? The reproductive instinct of man is just an excuse of postmenopausal assisted childbearing of old women whose pregnancy success rate is considerably low. The limitless postmenopausal assisted childbearing of old women contradicts the ideal of fair distribution of limited medical resources. But the pregnancy and delivery of women is a part of private sphere. The childbearing depends on the right of reproductive autonomy. The right of reproductive autonomy is based on the human dignity and the right of pursuing happiness under Article 10 of the Constitution of the Republic of Korea. In a word, The state should not regulate postmenopausal assisted childbearing of old women simply because of age.

이소플라본 섭취수준이 폐경이 여성의 갱년기 증상 및 혈청내 호르몬 변화에 미치는 영향

원형재 ( Hyung Jae Won ),이병석 ( Byung Seok Lee ),이수경 ( Soo Kyung Lee ),최윤 ( Yoon Choi ),윤선 ( Sun Yoon ),박기현 ( Ki Hyun Park ),조동제 ( Dong Je Cho ),송찬호 ( Chan Ho Song ) 대한폐경학회 2001 대한폐경학회지 Vol.7 No.1

목적 : 본 연구는 이소플라본(Pulmuone. Co, Seoul, Korea) 보충제의 섭취수준에 따른 폐경기 여성의 갱년기증상과 호르몬의 변화 그리고 24시간 소변 내 이소플라본의 배설량에 미치는 효과를 알아보고자 하였다. 연구 방법: 페경여성 30명을 이소플라본 섭취 수준(100㎎/day n=11, 150㎎/day n=9. 200㎎/day n=10)에 따라 3 group으로 나누어 6개월간 이소플라본을 섭취하게 한 후 섭취 전 측정한 갱년기증상과 호르몬의 변화에 미치는 효과를 비교하였고, 24시간 소변 내 이소플라본의 배설량을 측정하였다. 결과: 이소플라본의 소변 내 배설량은 이소플라본의 섭취용량에 까라 증가하였으며 24시간 소변 내 이소플라본의 recovery는 genistein, daidzein 각각 15%, 7% 정도인 것으로 나타났다. 갱년기 증상중 안면 홍조는 이소플라본 섭취 6개월후 30.8%가 약간 좋아졌고 53.8%가 많이 좋아졌으며 피로감은 30.8%, 38.4%, 관절통은 36.4%, 18.1%가 약간 좋아졌다, 많이 좋아졌다고 응답하여 특히 안면홍조와 피로감에 효과가 있었던 것으로 보인다. 혈청내 호르몬의 변화중 LH, FSH, E1, E2, prolactin, DHEA-S의 유의적인 변화는 없었다. 그러나 Testosterone level은 100, 150㎎/day 이소플라본 섭취 6개월후 각각 0.2±0ng/㎖에서 0.51±0.21ng/㎖로, 0.2±0ng/㎖에서 0.38±0.15ng/㎖로 유의하게 증가된 소견을 보였다. 결론: 이소플라본 섭취가 폐경후 갱년기 증상의 호전에 영향을 주었으며 이는 호르몬 변화중 특히 testosterone level의 증가와 관련이 있을것으로 생각되며 앞으로 좀 더 장기적이고 많은 대상을 통한 연구가 필요할것으로 생각된다. Objectives: We investigated the effect of isoflavone on postmenopausal symptoms, urinary isoflavone excretion and hormonal changes to know the effect of isoflavone in postmenopausal women. Design and method: 30 postmenopausal women took part in this study. They are divided into 3 subgroups according to the dose of isoflavone supplementation of 100㎎/day, 150㎎/day, and 200㎎/day. Isoflavones were consumed for 6 months. To study the bioavailability of isoflavone, 24-hr urine was collected before and 7 day after each isoflavone supplementation. Initially LH, FSH, Prolactin, E1, E2, testosterone, DHEA-S were measured and 6 months after supplementation of isoflavone. Result: The urinary isoflavone excretion was dose dependent in postmenopausal women and average 24-hr urinary recoveries of daidzein and genistein were approximately 15% and 7% respectively. Isoflavone supplementations were effective in reducing the postmenopausal symptoms especially in hot flush(84.6%) and general weakness(69.2%). Serum LH, FSH, E1, E2, prolactin, DHEA-S level were not changed significantly but the level of testosterone increased significantly from 0.02±0ng/㎖ to 0.51±0.21ng/㎖ and from 0.26±0.1ng/㎖ to 0.49±0.3ng/㎖ in 100㎎ and 150㎎ isoflavone supplementation respectively. but not in 200㎎ isoflavone supplementation. Conclusion: Isoflavone may improve the postmenopausal symptoms by increasing serum testosterone level in postmenopausal women.

Urinary Tract Infection in Postmenopausal Women

Raul Raz 대한비뇨의학회 2011 Investigative and Clinical Urology Vol.52 No.12

Urinary tract infection (UTI) is the most common bacterial infection in women in general and in postmenopausal women in particular. Two groups of elderly women with recurrent UTI should be differentiated regarding age and general status: healthy, young postmenopausal women aged 50 to 70 years who are neither institutionalized or catheterized and elderly institutionalized women with or without a catheter. Bacteriuria occurs more often in elderly functionally impaired women, but in general it is asymptomatic. However, the risk factors associated with recurrent UTI in elderly women are not widely described. In a multivariate analysis it was found that urinary incontinence, a history of UTI before menopause, and nonsecretor status were strongly associated with recurrent UTI in young postmenopausal women. Another study described the incidence and risk factors of acute cystitis among nondiabetic and diabetic postmenopausal women. Independent predictors of infection included insulin-treated patients and a lifetime history of urinary infection. Borderline associations included a history of vaginal estrogen cream use in the past month, kidney stones, and asymptomatic bacteriuria at baseline. Another important factor in postmenopausal women is the potential role that estrogen deficiency plays in the development of bacteriuria. There are at least two studies showing a beneficial effect of estrogen in the management of recurrent bacteriuria in elderly women. One of these studies showed that vaginal estrogen cream reduced vaginal pH from 5.5±0.7 to 3.6±1.0, restored lactobacillus, and decreased new episodes of UTI. Another study reported similar results using an estriol vaginal ring. However, contradictory results are found in the literature. For example, additional studies found that the use of estriol-containing vaginal pessaries was less effective than oral nitrofurantoin macrocrystals in preventing UTI in postmenopausal women. Two other studies also did not find any benefit in the reduction of UTI by oral estrogen therapy. Unfortunately, the use of estrogen in preventing UTI in postmenopausal women remains questionable. New strategies have been researched for reducing the use of antibiotics in the prevention and treatment of UTI. Two of them are probiotics and cranberry juice or capsules. Although several studies regarding probiotics and cranberry juice or capsules have reported a reduction of episodes of UTI, there is no conclusive evidence that they are useful in the prevention of UTI in postmenopausal women. As for the optimal drug, dosage, and length of treatment for UTI in the elderly, there are no studies comparing these data with the treatment for young women.

Acute and Chronic Effects of Increased Physical Activity on Postprandial Triglyceride Metabolism in Postmenopausal Women

( Masashi Miyashita ) 한국체육학회 2015 국제스포츠과학 학술대회 Vol.2015 No.1

Purposes: The purposes of the present studies were to: examine the acute effect of increased weekend physical activity on postprandial triglyceride (TG) in postmenopausal women (Study 1), examine the chronic effect of increased physical activity of daily living on postprandial TG in postmenopausal women (Study 2), and compare the effects of prolonged sitting, with prolonged sitting interrupted by short bouts of walking and prolonged sitting after continuous walking on postprandial TG in postmenopausal women (Study 3). Methods: In Study 1, ten postmenopausal women, completed two trials in a random order: 1) control trial and 2) active trial. On the control trial, participants maintained their usual weekend lifestyle. On the active trial, participants increased their weekend activities above their usual lifestyle levels. On Monday of each trial, participants rested and consumed a standardised breakfast and lunch. Blood samples were collected in the fasted state (0 h) and at 2, 4, and 6 h after breakfast. In Study 2, twenty-eight postmenopausal women were randomly divided into two groups: active (n=14) and control (n=14) groups. The participants in the active group were asked to increase their activities above their usual lifestyle levels for 4 weeks. The participants in the control group maintained their usual lifestyle for 4 weeks. At baseline and after 4 weeks, all participants rested and consumed a standardised breakfast and lunch after a 24-h period of physical activity avoidance. Blood samples were collected in the fasted state (0 h) and at 2, 4, and 6 h after breakfast. In Study 3, fifteen postmenopausal women completed three trials in a random order: 1) prolonged sitting, 2) prolonged sitting interrupted with short bouts of walking, and 3) prolonged sitting with continuous walking at the start. On the sitting trial, participants rested for 8 hours. For the walking trials, participants walked briskly (gross energy expenditure = 0.33 MJ/30 min) in either twenty 90-sec bouts over 7 hours (starting at 0900) or one 30-min bout in the morning (0900-0930). Except for walking both exercise trials mimicked the sitting trial. In each trial, participants consumed a breakfast (0800) and lunch (1100). Blood samples were collected in the fasted state and at 2, 4, 6, and 8 h after breakfast. Results: In Study 1, the TG area under the curve was 13% lower in the active trial than control trial (8.8 ± 3.8 vs. 10.1 ± 3.9 mmol/L?6h, paired t-test: P = 0.024). In Study 2, there was no difference in the pattern of postprandial TG response between the active and control groups (trial × time interaction, P = 0.335). In Study 3, the TG area under the curve was 15% and 14% lower on the prolonged sitting interrupted with short bouts of walking trial than the prolonged sitting and the prolonged sitting after continuous walking trials (4.73 ± 2.50 vs. 5.52 ± 2.95 vs. 5.50 ± 2.59 mmol/L?8h respectively, main effect of trial: P = 0.023). Conclusion: These data help demonstrate how small increases in repeated acute bouts of light to moderate physical activity and breaking up sitting time with short periods of achievable activity can effect postprandial lipaemia, a cardiovascular risk factor, in postmenopausal women.

젊은 여성과 대퇴경부 저골밀도 폐경기 여성의 신체조성과 골밀도의 상관관계 연구

신승섭,Shin, Seung-Sub 대한고유수용성신경근촉진법학회 2011 PNF and Movement Vol.9 No.4

Purpose : The aim of this study was to investigate the correlations between body compositions and bone mineral density in young women and postmenopausal women with low bone mineral density. Methods : Eleven young women (age, $25.85{\pm}1.96yrs$; height, $160.28{\pm}2.16cm$; weight, $56.89{\pm}9.66kg$) and ten postmenopausal women (age, $25.85{\pm}1.96yrs$; height, $160.28{\pm}2.16cm$; weight, $56.89{\pm}9.66kg$) with low bone density on femur neck were participated in this study. All subjects performed the measure of body composition and BMD on lumbar body and femur neck. Results : The results were as follows. Percent body fat, waist-hip ratio and body mass index(BMI) were significantly increased in postmenopausal women. BMD in lumbar body and femur neck were significantly decreased in postmenopausal women. There were negative strong correlation between BMD of the femur and age in young women. There were negative strong correlation between BMD of the femur and age or the years of menopause in postmenopausal women. There were positive strong correlation between BMD of the femur and BMD of lumbar body. Conclusion : Percent body fat and BMI were more increased in young women than in postmenopausal women. And there were negative strong correlation between BMD and age or the years of menopause in postmenopausal women.

폐경 여성의 영양소 및 식품 섭취 상태 평가

허주미 ( Ju Mi Heo ),박용순 ( Yong Soon Park ),박형무 ( Hyoung Moo Park ) 대한폐경학회 2011 대한폐경학회지 Vol.17 No.1

연구목적: 한국 폐경 여성에서 영양소와 식품의 섭취 상태를 파악하고 연령증가에 따른 영양소 및 식품군별 섭취량의 차이를 파악하고자 하였다. 연구재료 및 방법: 서울 지역의 10개 병원에서 무작위로 추출된 50세 이상 폐경 여성 189명을 대상으로 반정량적 식품섭취빈도조사법으로 식품섭취량을 조사하고 Can-Pro version 3.0을 이용하여 영양소의 섭취상태를 분석하였다. 결 과: 한국 폐경 여성은 열량과 대부분의 영양소를 충분하게 섭취하였으나, 비타민 D와 칼슘의 섭취는 한국인 영양 섭취 기준의 60%와 78% 수준이었다. 칼륨과 엽산 또한 영양 섭취 기준에 비해 부족하였다. 반면 나트륨의 섭취는 영양 섭취 기준에 비해 3배 이상 높았다. 50∼64세 여성과 비교하여 65세 이상의 고령 폐경 여성에서는 지질, 식물성 지질, 다가불포화지방산, 오메가-3 지방산, 오메가-6 지방산, 식이섬유, 비타민 A, 카로틴, 비타민 D, 비타민 E, 티아민, 리보플라빈, 피리독신, 나이아신, 엽산, 비타민 C, 식물성 칼슘, 인, 나트륨, 칼륨, 철분, 식물성 철분 등의 영양소와, 과일, 생선, 버섯 등 식품군의 섭취량이 유의하게 감소하였다. 두 군의 폐경 여성 모두에서 비타민 D, 엽산, 칼슘, 칼륨의 섭취량이 한국인의 영양섭취기준과 비교하여 낮았다. 결론: 폐경 후 여성에서 비타민 D, 엽산, 칼슘, 칼륨의 섭취량이 낮았으며, 연령 증가에 따라 영양소 및 식품섭취가 감소함으로 영양상태의 개선을 위한 노력이 필요하다. Objectives: The purpose of this study was to determine the dietary intake of nutrients and food in postmenopausal Korean women. Methods: One hundred eighty-nine postmenopausal women were recruited from 10 different hospitals in Seoul. The dietary intake of nutrients and foods was obtained using a semi-quantitative food frequency questionnaire, including 102 foods based on the Korean food pattern. Results: Postmenopausal Korean women consumed energy and most of the nutrients adequately, except vitamin D, calcium, potassium, and folate. Intake of vitamin D and calcium was 60% and 78%, respectively, of the Korean Dietary Reference Intake (KDRI). Elderly postmenopausal women>65 years of age consumed significantly less nutrients, such as fat, n-3 and n-6 fatty acids, fiber, vitamin A, vitamin B complex, calcium, potassium, iron, fruit, fish, and mushrooms. The intake of vitamin D, calcium, potassium, and folate, was less than the KDRI in both groups of postmenopausal women. Conclusion: The results suggest that the intake of vitamin D, folate, calcium, and potassium was less than the KDRI in postmenopausal women and the nutritional status of elderly postmenopausal women was worse than younger postmenopausal women. (J Korean Soc Menopause 2011;17:12-20)