Establishment of a public health guideline for osteoporosis prevention : based on the results of a long-term follow-up study

确定自1990年以来接受干预的中年妇女15年间骨密度（BMD）的系列变化及相关生活方式因素。我们对1990年参加基线调查的日本福井县农业或渔业社区的209名中年妇女进行了后续调查。使用一致的筛选工具和访谈程序确定以下参数，以确保与基线数据进行可靠的比较。共有123名女性（58.9%）参与了随访调查，老年人的参与率较低。除拒绝外，不参加的主要原因是死亡、医疗机构入院和疾病。参与者的平均年龄为70.5±9.3岁，绝经后平均年龄为22.6±10.5岁。各年龄组骨质疏松症患病率50-59岁为22%，60-69岁为32%，70-79岁为43%，80-89岁为59%。在40-49岁年龄组中，更多的女性腰椎骨密度明显下降，导致骨密度比基线下降约1%。骨密度的下降在60-69岁年龄组中有所减弱，但在70-79岁年龄组中有所加速，较基线下降了近0.6%。骨密度为负的女性握力明显低于骨密度为正或维持的女性。运动组的骨密度下降程度低于非运动组，尽管运动对老年人的影响不那么明显。在基线为绝经前的妇女中，每天喝一杯牛奶可以改善%BMD为负的情况。我们评估了牛奶对绝经后持续时间的影响，发现每天喝一次牛奶对绝经后不到20年的人预防骨矿物质流失也有效。我们15年的随访研究表明，体重、牛奶摄入量和绝经前的定期运动与预防中年妇女骨矿物质流失有关

To determine the serial changes in bone mineral density(BMD) and related lifestyle factors during a 15-year period in middle-aged women undergoing intervention since 1990. We conducted a follow-up survey of 209 middle-aged women from either farming or fishing communities in Fukui prefecture, Japan, who participated in the baseline survey in 1990. The following parameters were determined using consistent screening instruments and interview procedures to ensure reliable comparison with the baseline data.A total of 123 women(58.9%) participated in the follow-up survey, with a lower participation rate for the elderly. The major reasons for non-participation besides refusal were death, health care facility admission, and diseases. The participants had a mean age of 70.5 ± 9.3 years and were 22.6 ± 10.5 years post-menopause, on average. The prevalence of osteoporosis in each age group was 22% in 50-59-years-olds, 32% in 60-69-years-olds, 43% in 70-79-years-olds, and 59% in 80-89-years-olds. … More Women in the 40-49-years-old age group showed a marked decrease in the lumbar spine BMD that resulted in an approximately 1% decline in BMD from the baseline. The BMD decline was attenuated in the 60-69-years-old age group, but accelerated in 70-79-years-olds, with a nearly 0.6% decline from the baseline.Grip strength was significantly reduced in women with a negative %BMD compared to those with a positive or maintained %BMD. The degree of BMD decline was lower in the exercise than non-exercise group, although the effect of exercise was less evident in the elderly. In women who were pre-menopausal at the baseline, a negative %BMD was improved by drinking a glass of milk once a day. We evaluated the effect of milk in relation to the duration of the post-menopausal period, and found that single daily milk consumption was also effective for those who were less than 20 years post-menopause in preventing bone mineral loss.Our 15-year follow-up study suggested that body weight, milk consumption, and regular exercise pre-menopause were associated with the prevention of bone mineral loss in middle-aged women Less