Abstract/References

Introduction: Secular changes in hip fracture incidence have been reported in the last few decades in Japan, but whether long-term bone mineral density (BMD) is also changing is unclear. This study aimed to determine whether BMD of Japanese women has changed over time.

Methods: Subjects were 10,649 adult women who underwent BMD measurement in a health check-up population in Niigata, Japan, between 1995 and 2013. BMD of the distal, non-dominant forearm was measured by dual-energy X-ray absorptiometry. Demographic information and BMI were also obtained. Secular trends were determined by linear regression analysis.

Results: BMD of subjects in their 40’s decreased significantly in the age-adjusted model (P for trend=0.0162), but not in the age- and BMI-adjusted model (P for trend=0.2171). BMD of subjects in their 50’s decreased marginally in the age-adjusted model (P for trend=0.0535), but not in the age- and BMI-adjusted model (P for trend=0.6601). BMDs of subjects in their 30’s and 60’s did not significantly change, while BMIs of subjects in their 40’s-60’s decreased significantly.

Conclusions: A secular decrease in BMD, partly attributed to decreases in BMI, was observed in middle-aged Japanese women from 1995 to 2013. Measures to help maintain suitable BMI will be necessary to prevent a decrease in BMD among women.

1. NIH Consensus Development Panel on Osteoporosis Prevention, Diagnosis, and Therapy. Osteoporosis prevention, diagnosis, and therapy. JAMA, 28:785-795, 2001.

2. Odén A, McCloskey EV, Johansson H, Kanis JA. Assessing the impact of osteoporosis on the burden of hip fractures. Calcif Tissue Int, 92:42-49, 2013.

3. Orimo H, Yaegashi Y, Hosoi T, et al. Hip fracture incidence in Japan:Estimates of new patients in 2012 and 25-year trends. Osteoporos Int, 27:1777-1784, 2016.

4. Miyasaka D, Endo N, Endo E, et al. Incidence of hip fracture in Niigata, Japan in 2004 and 2010 and the long-term trends from 1985 to 2010. J Bone Miner Metab, 34:92-98, 2016.

5. Cooper C, Cole ZA, Holroyd CR, et al. Secular trends in the incidence of hip and other osteoporotic fractures. Osteoporos Int, 22:1277-1288, 2011.

6. Lewiecki EM, Wright NC, Curtis JR, et al. Hip fracture trends in the United States, 2002 to 2015. Osteoporos Int, 29:717-722, 2018.

7. Xu Y, Wu Q. Decreasing trend of bone mineral density in US multiethnic population:analysis of continuous NHANES 2005-2014. Osteoporos Int, 29:2437-2446, 2018.

8. Cheung E, Bow C, Loong C, et al. A secular increase in BMD in Chinese women. J Bone Miner Metab, 32:48-55, 2014.

9. Nakamura K, Hoshino Y, Watanabe A, et al. Eating problems and related weight control behaviour in adult Japanese women. Psychother Psychosom, 68:51-55, 1999.

10. Santos I, Sniehotta FF, Marques MM, Carraça EV, Teixeira PJ. Prevalence of personal weight control attempts in adults:a systematic review and meta-analysis. Obes Rev, 18:32-50, 2017.

11. Ministry of Health, Labour, and Welfare, Japan: The National Health and Nutrition Survey in Japan, 2017. Ministry of Health, Labour, and Welfare, Tokyo, 2018. (in Japanese)

12. Nakamura K, Tanaka Y, Saitou K, Nashimoto M, Yamamoto M. Age and sex differences in the bone mineral density of the distal forearm based on health check-up data of 6343 Japanese. Osteoporos Int, 11:772-777, 2000.

13. Nakamura K, Kazama JJ, Tanaka Y, et al. Microscopic hematuria is associated with low bone mineral density in aged women and men. J Bone Miner Metab, 27:251-254, 2009.

14. Kung AWC, Yates S, Wong V. Changing epidemiology in hip fracture rate in Hong Kong. Arch Osteoporos, 2:43-47, 2007.

15. Nakamura K, Saito T, Nishiwaki T, et al. Correlations between bone mineral density and demographic, lifestyle, and biochemical variables in community-dwelling Japanese women 69 years of age and over. Osteoporos Int, 17:1202-1207, 2006.

16. Nakamura K, Oyama M, Saito T, et al. Nutritional and biochemical parameters associated with 6-year change in bone mineral density in community-dwelling Japanese women aged 69 years and older:The Muramatsu Study. Nutrition, 28:357-361, 2012.

17. Ministry of Health, Labour and Welfare, Japan: The National Health and Nutrition Survey in Japan, 2013. Ministry of Health, Labour, and Welfare, Tokyo, 2015. (in Japanese)

18. Hayashi F, Takimoto H, Yoshita K, Yoshiike N. Perceived body size and desire for thinness of young Japanese women:a population-based survey. Br J Nutr, 96:1154-1162, 2006.

19. Tatsuno I, Terano T, Nakamura M, et al. Lifestyle and osteoporosis in middle-aged and elderly women:Chiba bone survey. Endocr J, 60:643-650, 2013.

20. Ministry of Health, Labour and Welfare, Japan: The National Health and Nutrition Survey in Japan, 2004. Ministry of Health, Labour, and Welfare, Tokyo, 2006. (in Japanese)

21. Iwasaki M, Yamamoto S, Otani T, et al. Generalizability of relative risk estimates from a well-defined population to a general population. Eur J Epidemiol, 21:253-262, 2006.

22. Nakamura K, Tsugawa N, Saito T, et al. Vitamin D status, bone mass, and bone metabolism in home-dwelling postmenopausal Japanese women: Yo­kogoshi Study. Bone, 42:271-277, 2008.

23. Nakamura K, Ueno K, Nishiwaki T, et al. Nutrition, mild hyperparathyroidism, and bone mineral density in young Japanese women. Am J Clin Nutr, 82:1127-1133, 2005.

24. Kitamura K, Nakamura K, Saito T, et al. High serum 25-hydroxyvitamin D levels do not retard postmenopausal bone loss in Japanese women:the Yokogoshi Study. Arch Osteoporos, 8:153, 2013.