Physicians' Attitudes to Contemporary Issues on Osteoporosis Management in Korea

Ha, Yong-Chan,Lee, Young-Kyun,Lim, Yong-Taik,Jang, Sun-Mee,Shin, Chan Soo The Korean Society for Bone and Mineral Research 2014 대한골대사학회지 Vol.21 No.2

<P><B>Background</B></P><P>In management of osteoporosis, several concerns here have been raised. The current issue included the utilization of dual energy X-ray absorptiometry (DXA) and fracture-risk assessment (FRAX), screening of vitamin D deficiency and secondary osteoporosis, and long-term use of bisphosphonate and calcium supplements. There was no study on physicians' attitude on these current issues in Korea. Therefore, we investigated the physicians' attitude on these issues by survey.</P><P><B>Methods</B></P><P>We administered a 30-item questionnaire to all members of Korean Society for Bone and Mineral Research by email survey form. One hundred participants answered the questionnaire. The questionnaire included the questions about the physicians' attitude to current issues and the barriers to osteoporosis treatment in Korea.</P><P><B>Results</B></P><P>Most physicians used bone densitometry devices (99%) and, central DXA was the most accessible device (95%). Eighty-eight percent were aware of FRAX®, but among them, only 19.3% used it. The main reason for not using FRAX® was the lack of time in their proactive (76%). Screening for vitamin D status and secondary osteoporosis was performed by 59% and 52% of the respondents, respectively. The lack of awareness among patients and high costs of medication were perceived as the most important barriers to osteoporosis management in Korea.</P><P><B>Conclusions</B></P><P>This study provides physicians' perspective to the current issue for diagnostic and treatment of osteoporosis in Korea. To further improve osteoporosis management, educational programs for patients and doctors, and the improvement of reimbursement system should be considered in Korea.</P>

Characteristics of Patients Diagnosed with Osteoporosis in South Korea: Results from the National Claim Registry

Yoon, Hyun Koo,Lee, Young-Kyun,Ha, Yong-Chan The Korean Society for Bone and Mineral Research 2017 대한골대사학회지 Vol.24 No.1

<P><B>Background</B></P><P>Although osteoporosis is increasing medical issue in the elderly population, attempts to analyze the characteristics of patients diagnosed with osteoporosis are rare in South Korea. We investigated the characteristics of patients diagnosed with osteoporosis using Korea's National Health Insurance claims data, which includes almost Korean population.</P><P><B>Methods</B></P><P>We evaluated the patients who were diagnosed and treated with osteoporosis in medical institute in South Korea, using the national database by the Health Insurance Review & Assessment Service (HIRA). We evaluated the characteristic of patients and state of medical service utilization in 2010.</P><P><B>Results</B></P><P>The number of patients who were diagnosed with osteoporosis were 1,733,685, and almost of them (91.1%) were females. Fourteen point three percent of the patients had experienced osteoporosis-related fracture. The most commonly used type of institute and department was hospital and orthopedic surgery.</P><P><B>Conclusions</B></P><P>Considering increasing age population, basic information including characteristic of patients and current state of medical service utilization could be useful to perform appropriate management and treatment for osteoporosis patients in South Korea, using the National Health Insurance claims data.</P>

The Efficacy of Bisphosphonates for Prevention of Osteoporotic Fracture: An Update Meta-analysis

Byun, Ji-Hye,Jang, Sunmee,Lee, Sumin,Park, Suyeon,Yoon, Hyun Koo,Yoon, Byung-Ho,Ha, Yong-Chan The Korean Society for Bone and Mineral Research 2017 대한골대사학회지 Vol.24 No.1

<P><B>Background</B></P><P>The efficacy of bisphosphonates for osteoporotic fracture has been consistently reported in recent randomized controlled trials (RCTs) enrolling hundreds of patients. The objective of this study was to update knowledge on the efficacy of available bisphosphonates in the prevention of vertebral and non-vertebral fractures.</P><P><B>Methods</B></P><P>An approach “using systematic reviews” on PubMed and Cochrane Library was taken. Twenty-four RCTs investigating the effects of bisphosphonates for the prevention of osteoporotic fracture were included in final analysis. A pairwise meta-analysis was conducted with a random effects model. Subgroup analysis was performed according to the type of bisphosphonate.</P><P><B>Results</B></P><P>The use of bisphosphonate decrease the risk of overall osteoporotic fracture (odds ratio [OR] 0.62; <I>P</I><0.001), vertebral fracture (OR 0.55; <I>P</I><0.001) and non-vertebral fracture (OR 0.73; <I>P</I><0.001). Subgroup analysis indicated that zoledronic acid showed the lowest risk reduction (OR 0.61; <I>P</I><0.001) for overall osteoporotic fractures but no significance was observed for etidronate (OR 0.34; <I>P</I>=0.127).</P><P><B>Conclusions</B></P><P>This update meta-analysis re-confirmed that bisphosphonate use can effectively reduce the risk of osteoporotic fracture. However, there is a lack of evidence regarding etidronate for the prevention of osteoporotic fracture.</P>

Serum Vitamin D Level Related to Coffee Consumption in Korean Young Adults Using the 5th Korea National Health and Nutrition Examination Survey

Lim, Hee-Sook,Lee, Hae-Hyeog,Byun, Dong-Won,Lee, Bora,Enkhbold, Temuulee,Kim, Tae-Hee The Korean Society for Bone and Mineral Research 2017 대한골대사학회지 Vol.24 No.4

<P><B>Background</B></P><P>Even young adults are highly interested in their osteological health, yet their calcium intake does not match the level of such interest. Increase in bone loss is known to be associated with higher intake of caffeine and coffee consumption among the young Korean is rising steadily. This study was conducted to reveal the relationship between coffee consumption and serum vitamin D level in Korean young adults.</P><P><B>Methods</B></P><P>This study analyzed potential difference in lifestyle and concentration of vitamin D in blood in relation to coffee intake frequency of 2,523 subjects on the basis of data from the 5th Korea National Health and Nutrition Examination Survey.</P><P><B>Results</B></P><P>According to the analysis, groups of males, with high income, frequent social activity followed by alcohol consumption and smoking, and high rate of dining out showed a high frequency of coffee consumption. Vitamin D concentration among the groups was 16.2±5.3 mL and 80.3% of them were considered to be vitamin D-deficient. All the groups appeared to have deficiencies compared to males who did not consume caffeine at all.</P><P><B>Conclusions</B></P><P>The practice of having an adequate amount of coffee is needed, and more efforts should be done to improve vitamin D intake among young adults.</P>

Risk of Osteoporotic Fractures after Thyroid-stimulating Hormone Suppression Therapy in Patients with Thyroid Cancer

Lee, Youjin,Yoon, Byung-Ho,Lee, Seeyoun,Chung, Youn Kyung,Lee, Young-Kyun The Korean Society for Bone and Mineral Research 2019 대한골대사학회지 Vol.26 No.1

<P><B>Background</B></P><P>The effects of subclinical hyperthyroidism on fracture risk induced by thyroid-stimulating hormone (TSH) suppression therapy in patients with thyroid cancer still remains controversial. We performed a meta-analysis and systematic review to evaluate the effects of TSH suppression therapy on osteoporotic fracture in patients with thyroid cancer.</P><P><B>Methods</B></P><P>We performed a systematic search to identify studies which included osteoporotic fractures (hip fracture and vertebral fracture) in patients on TSH suppression therapy for thyroid cancer. Main outcome measures were occurrence and risk of osteoporotic fractures including hip and vertebral fractures between patients and controls.</P><P><B>Results</B></P><P>A systematic search yielded a total of 8 studies appropriate for review which included osteoporotic fracture outcome in patients on TSH suppression therapy for thyroid cancer. Studies with larger number of subjects showed the higher risk of osteoporotic fracture in group with TSH suppression therapy, although studies with smaller sample size presented a similar risk of fracture with control group.</P><P><B>Conclusions</B></P><P>Although studies were limited by small numbers, results suggested possible association between chronic TSH suppression therapy and the increased risk of osteoporotic fractures in patients with thyroid cancer.</P>

Incidence and Mortality after Proximal Humerus Fractures Over 50 Years of Age in South Korea: National Claim Data from 2008 to 2012

Park, Chanmi,Jang, Sunmee,Lee, Areum,Kim, Ha Young,Lee, Yong Beom,Kim, Tae Young,Ha, Yong Chan The Korean Society for Bone and Mineral Research 2015 대한골대사학회지 Vol.22 No.1

<P><B>Background</B></P><P>There has been lack of epidemiology of proximal humerus fracture using nationwide database in Asia. The purpose of this study was to investigate the incidence of proximal humerus fracture and its mortality following proximal humerus fracture in Korean over 50 years of age.</P><P><B>Methods</B></P><P>The Korean National Health Insurance data were evaluated to determine the incidence and mortality of proximal humerus fracture aged 50 years or older from 2008 through 2012.</P><P><B>Results</B></P><P>Proximal humerus fracture increased by 40.5% over 5 year of study. The incidence of fracture increased from 104.7/100,000 in 2008 to 124.7/100,000 in 2012 in women and from 45.3/100,000 in 2008 to 52.0/100,000 in 2012 in men, respectively. One year mortality rate after proximal humerus fracture was 8.0% in 2008 and 7.0% in 2012. One year mortality rate were 10.8% for men and 7.0% for women in 2008 and 8.5% for men and 6.4% for women in 2012.</P><P><B>Conclusions</B></P><P>Our study showed that the proximal humerus fracture in elderly was recently increasing and associated with high mortality in Korea. Considering proximal humerus fracture was associated with an increased risk of associated fractures and an increased mortality risk, public health strategy to prevent the proximal humerus fracture in elderly will be mandatory.</P>

Relationship between Serum 25-hydroxy-vitamin D Concentration and Risk of Metabolic Syndrome in Patients with Fatty Liver

Lim, Hee-Sook,Kim, Tae-Hee,Lee, Hae-Hyeog,Kim, Soon-Kyung,Lee, Bora,Park, Yoon-Hyung The Korean Society for Bone and Mineral Research 2017 대한골대사학회지 Vol.24 No.4

<P><B>Background</B></P><P>The vitamin D deficiency rate in Koreans is still high and dietary intake is insufficient. The purpose of this study was to provide basic data for the management of metabolic syndrome (MetS) by analyzing the effect of vitamin D levels on the MetS in patients with fatty liver.</P><P><B>Methods</B></P><P>We analyzed the MetS ratio and serum 25-hydroxy-vitamin D (25[OH]D) concentration in 151 adults diagnosed with fatty liver by using obesity index and blood profiles. We collected data on demographic factors, nutrient intake, and lifestyle habits.</P><P><B>Results</B></P><P>The mean 25(OH)D concentration of all subjects was 14 ng/mL and the insufficiency and deficiency rates were 40.4% and 29.8%. The proportion of MetS was 38.4% and the mean 25(OH)D level of MetS group was 12.1 ng/mL. Low-density lipoprotein cholesterol, triglyceride, and blood glucose were higher in the MetS group than in the normal group, and the waist circumference of the male was significantly higher than that of the normal group. The results showed that the lower the vitamin D concentration, the higher the risk of MetS (odds ratio, 1.47, 95% confidence interval, 0.98–2.81; <I>P</I>=0.043).</P><P><B>Conclusions</B></P><P>These results suggest that serum 25(OH)D levels may be a risk factor for MetS in patients with fatty liver.</P>