Osteoporosis: Park HM

Chan SP, Chen JF, Chu LW, Van DP, Hosking D, Ip TP, Koh L, Kung A, Lai NS, Lau E, Lee JK, Leewattana R, Min YK, Nghia ND, Boonsong O, Park HM, Ringe J, Setyohadi B, Shin CS, Soontrapa S, Taechakraichana N, Tanjung F, Tobing D, Tsai KS, Woo J, Yang RS. · c/o Department of Medicine, University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong Special Administrative Region, People's Republic of China. · Public Health Nutr. · Pubmed #18647434 No free full text.

Abstract: BACKGROUND: Vitamin D is essential for Ca absorption, prevention of falls and fracture, and maintenance of muscle strength and balance. Lack of awareness of the importance of vitamin D in bone health is common in Asia. OBJECTIVE: To define key statements, objectives and actions for improving osteoporosis management and vitamin D inadequacy in Asia. RESULTS AND CONCLUSION: This declaration was jointly produced by specialists at the Asia Metaforum on the Role of Vitamin D and the Management of Osteoporosis, held in September 2006 in Hong Kong, to define actions to prevent vitamin D insufficiency in Asia. Although developed specifically for Asia, some or all of these statements may be applicable to other regions of the world.

Lee ES, Ahn J, Park HM. · Department of Obstetrics and Gynecology, Chung-Ang University, School of Medicine, Yongsan Gu, Seoul, Korea. · Asia Pac J Clin Nutr. · Pubmed #19329392 No free full text.

Abstract: OBJECTIVE: To determine the vitamin D status of Korean postmenopausal women during the winter months according to the intake of vitamin D supplements. DESIGN: Cross sectional study of serum 25(OH)D levels according to the intake of vitamin D supplements in postmenopausal women. METHOD: Between November 2006 and February 2007, 254 postmenopausal women who visited our menopausal clinic for hormone therapy or osteoporosis medication were recruited. Serum 25(OH)D levels were measured with a radioimmunoassay kit and the results were compared among groups that were classified according to the intake amount of vitamin D supplements. RESULTS: The mean serum 25(OH)D level was 83.3 +/- 32.8 nmol/L and it increased as the intake amount of vitamin D supplements increased. The mean serum 25(OH)D level was not significantly different between groups 1 (no vitamin D supplements) and 2 (daily 100-300 IU supplements). However, the mean serum 25(OH)D level was significantly higher in group 3 (daily 400 IU supplements) than in group 1. While the mean value of group 4 (daily 600 IU) was not significantly different from that of group 3, it was significantly lower than that of group 5 (daily 800-900 IU). CONCLUSION: Vitamin D supplementation is highly effective in improving vitamin D status and the vitamin D status in this study population was improved considerably when compared to previous studies. Therefore, it is concluded that the prevalence of vitamin D insufficiency should be re-evaluated in postmenopausal women in most countries including Korea.

Kang BM, Kim MR, Park HM, Yoon BK, Lee BS, Chung HW, Cho SH, Choi H, Kim JG. · College of Medicine, University of Ulsan, Seoul, Korea. · Menopause. · Pubmed #16607108 No free full text.

Abstract: OBJECTIVE: To assess the attitudes of Korean physicians toward hormone therapy (HT) after publication of the Women's Health Initiative (WHI) study. DESIGN: Self-administered questionnaires, consisting of 22 items, were sent by mail to the members of the Korean Society of Menopause. RESULTS: More than 95% of Korean physicians were aware of the WHI study. The HT prescription rate decreased by 16% after publication of the WHI report; approximately half of the physicians who continued prescribing HT changed their prescriptions. The largest decreases occurred in regimens using conjugated equine estrogens and medroxyprogesterone acetate, for which prescriptions of sequential and continuous-combined regimens decreased by 20.7% and 22.7%, respectively. In contrast, the prescription rate for tibolone increased by 3.6%. Approximately 30% of physicians changed from standard to low doses, and 67.8% shortened the duration of HT. After publication of the WHI report, the main reasons for not prescribing or discontinuing HT were patient refusal and increased risk of cardiovascular disease, rather than breast cancer risk. After publication of the WHI report, the number of physicians who prescribed alternative or complementary medicines increased, the rate of HT prescription for the prevention of osteoporosis decreased, and the number of postmenopausal outpatients decreased. CONCLUSIONS: Despite the results of the WHI report, most Korean physicians who participated in this study continued prescribing HT; however, approximately half of those who continued prescribing HT changed their prescriptions. The greatest change occurred in regimens using conjugated equine estrogens and medroxyprogesterone acetate.

Park HM, Sedrine WB, Reginster JY, Ross PD, Anonymous00113. · Chung-Ang University, Seoul, Korea. · J Clin Densitom. · Pubmed #14514994 No free full text.

Abstract: The Osteoporosis Self-assessment Tool for Asians (OSTA) was developed to help physicians focus their efforts on patients at increased risk, and encourage appropriate use of bone mineral density (BMD) measurements. Previously, OSTA performed well in a sample of women from eight countries in Asia, and in a validation group of Japanese women. In this study, we evaluate the performance of OSTA using a sample of 1101 postmenopausal women from a clinic in Korea who had femoral neck BMD measurements by dual-energy X-ray absorptiometry (DXA). The OSTA had a high sensitivity (87%), and good specificity (67%) for identifying osteoporosis (BMD T-scores <or= -2.5); the corresponding values were 80% and 72% for identifying T-scores <or= -2.0. The prevalence of osteoporosis ranged from 2% among women classified as low risk (OSTA > -1) to 64% among those classified as high risk (OSTA < -4); these results were almost identical to those reported earlier for a sample of women from eight Asian countries. We conclude that the OSTA risk tool performed well in this sample of postmenopausal Korean women, similar to previous results in other Asian women. The OSTA tool is free and very easy to use; risk can be tabulated by age and weight, so that calculations are not necessary. Using OSTA could encourage patients and clinicians to actively assess osteoporosis, and measure BMD when appropriate, before fractures occur.

Koh LK, Sedrine WB, Torralba TP, Kung A, Fujiwara S, Chan SP, Huang QR, Rajatanavin R, Tsai KS, Park HM, Reginster JY, Anonymous00013. · Department of Endocrinology, Singapore General Hospital, Singapore. · Osteoporos Int. · Pubmed #11580084 No free full text.

Abstract: Patients with low bone mineral density (BMD) have a high risk of future fractures, and should be actively considered for treatment to reduce their risk. However, BMD measurements are not widely available in some communities, because of cost and lack of equipment. Simple questionnaires have been designed to help target high-risk women for BMD measurements, thereby avoiding the cost of measuring women at low risk. However, such tools have previously focused on evaluation of non-Asian women. We collected information about numerous risk factors from postmenopausal Asian women in eight countries in Asia using questionnaires, and evaluated the ability of these risk factors to identify women with osteoporosis as defined by femoral neck BMD T-scores < or =-2.5. Multiple variable regression analysis and item reduction yielded a final tool based on only age and body weight. This risk index had a sensitivity of 91% and specificity of 45%, with an area under the curve of 0.79. Previously published risk indices based on larger numbers of variables performed similarly well in this Asian population. Large differences in risk were identified using our index to create three categories: 61% of the high-risk women had osteoporosis, compared with only 15% and 3% of the intermediate- and low-risk women, respectively. The low-risk group represented 40% of all women, for whom BMD measurements are probably not needed unless important risk factors, such as prior nonviolent fracture or corticosteroid use, are present. An existing population-based sample of postmenopausal Japanese women was used to validate our index. In this sample of Japanese women the sensitivity was 98% and specificity was 29%; the low-risk category, for whom BMD is probably unnecessary, represented 25% of all women. We conclude that our index performed well for classifying the risk of osteoporosis among postmenopausal Asian women and applying it would result in more prudent use of BMD technology.