title: Association between household size, residential area, and osteoporosis: analysis of 2008 to 2011 Korea National Health and Nutrition Examination Survey.
abstract: OBJECTIVE
  The prevalence of single-person households has rapidly increased in Korea. Individuals living alone and in rural areas may have a higher risk of various metabolic diseases due to differences in lifestyle. However, few studies have investigated the association of household size and residential area with health-related problems. This study aimed to evaluate the association of household size and residential area with risk of osteoporosis in postmenopausal women.
  
  
  METHODS
  This cross-sectional study enrolled 3,058 postmenopausal women from the 2008 to 2011 Korea National Health and Nutrition Examination Survey (KNHANES). We examined the association between bone mineral density (BMD) and household size and residential area.
  
  
  RESULTS
  Individuals living in rural areas had significantly lower BMD of the lumbar spine than those living in an urban area. Subsequently, we divided the participants into four groups according to household size and residential areas. Lumbar spine BMD was significantly lower in individuals living in rural single-person households than those in urban households with two or more individuals, even after adjustment for multiple confounding factors. In addition, individuals in rural single-person households had significantly greater odds of osteoporosis in the lumbar spine than those in urban households with two or more residents.
  
  
  CONCLUSIONS
  Individuals in rural single-person households had significantly lower BMD and greater odds of osteoporosis in lumbar spine than urban households with two or more individuals. The results of this study suggest that individuals living in rural single-person households may benefit from more careful screening for osteoporosis.
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea.
authors.forename: Sung-Woo
authors.initials: SW
authors.lastname: Kim
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea.
authors.forename: Kwi-Hyun
authors.initials: KH
authors.lastname: Bae
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea.
authors.forename: Jung-Beom
authors.initials: JB
authors.lastname: Seo
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea.
authors.forename: Jae-Han
authors.initials: JH
authors.lastname: Jeon
authors.affiliation: Department of Preventive Medicine, Kyungpook National University School of Medicine, Daegu, Korea.
authors.forename: Won-Kee
authors.initials: WK
authors.lastname: Lee
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea.
authors.forename: In-Kyu
authors.initials: IK
authors.lastname: Lee
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea.
authors.forename: Jung-Guk
authors.initials: JG
authors.lastname: Kim
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea.
authors.forename: Keun-Gyu
authors.initials: KG
authors.lastname: Park
mesh_terms: D015502:Absorptiometry, Photon; D000368:Aged; D015519:Bone Density; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D005191:Family Characteristics; D005260:Female; D006801:Humans; D016015:Logistic Models; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008875:Middle Aged; D009749:Nutrition Surveys; D016017:Odds Ratio; D015663:Osteoporosis, Postmenopausal / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000503:physiopathology; D056910:Republic of Korea / Q000453:epidemiology; D012111:Residence Characteristics; D012307:Risk Factors; D012423:Rural Health; D012847:Single Person; D013997:Time Factors; D014504:Urban Health
keywords: Bone density; Osteoporosis; Postmenopausal women; Rural resident; Single household