Association between Bone Metabolism and Vestibular Problems in the Modified Romberg Test: Data from the 2009–2010 Korean National Health and Nutrition Examination Survey
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Population and Data Collection
2.2. Evaluation of Falling, Modified Romberg Test, and Pure Tone Audiometry
2.3. Factors Associated with Dizziness and Bone Metabolism
2.4. Evaluation of Bone Metabolism and Osteoporosis
2.5. Statistical Analysis
3. Results
3.1. Factors Associated with Falling and Vestibular Problems in the Modified Romberg Test
3.2. Sex Differences in Factors Associated with Vestibular Problems in the Modified Romberg Test
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Conflicts of Interest
References
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Vestibular Problems in the Modified Romberg test (+) (n = 158) | Vestibular Problems in the Modified Romberg test (−) (n = 3896) | p-Value c | OR | 95% CI | Falling (+) (n = 626) | Falling (−) (n = 3428) | p-Value c | OR | 95% CI | |
---|---|---|---|---|---|---|---|---|---|---|
Age | 70.98 ± 8.19 | 62.55 ± 8.37 | <0.001 * | 1.097 | 1.067–1.127 | 65.32 ± 8.67 | 62.43 ± 8.42 | 0.012 * | 1.018 | 1.004–1.032 |
Male | 3.4 a | 96.6 a | 0.1182 b | 1.248 | 0.901–1.729 | 11.0 | 89.0 | <0.001 *,b | 1.645 | 1.307–2.071 |
Female | 4.3 a | 95.7 a | 19.0 | 81.0 | ||||||
BMI (kg/m2) | 22.75 ± 3.13 | 24.07 ± 3.04 | <0.001 * | 0.863 | 0.809–0.920 | 23.76 ± 3.31 | 24.07 ± 3.00 | 0.004 | 0.952 | 0.921–0.985 |
% a | Vestibular Problems in the Modified Romberg Test (+) | Vestibular Problems in the Modified Romberg Test (−) | The Univariable Analysis | The Multivariable Analysis † | ||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
p-Value | OR | 95% CI | p-Value | OR | 95% CI | |||||||
Otolaryngologic conditions (physical examination and questionnaire) | ||||||||||||
Tinnitus | ||||||||||||
No (%) | 75.5 | 3.7 | 96.3 | Referent | ||||||||
Yes (%) | 24.5 | 4.5 | 95.5 | 0.238 | 1.237 | 0.869–1.760 | ||||||
Hearing loss | ||||||||||||
No (%) | 76.3 | 2.6 | 97.4 | Referent | Referent | |||||||
Yes (%) | 23.7 | 8.1 | 91.9 | <0.001 * | 3.337 | 2.421–4.599 | 0.010 * | 1.63 | 1.123–2.365 | |||
Falling | ||||||||||||
No (%) | 84.6 | 2.9 | 97.1 | Referent | ||||||||
Yes (%) | 15.4 | 9.1 | 90.9 | <0.001 * | 3.3 | 2.357–4.621 | ||||||
General conditions for activity | ||||||||||||
Limitation of activity | ||||||||||||
No (%) | 78.6 | 2.7 | 97.3 | Referent | Referent | |||||||
Yes (%) | 21.4 | 8.4 | 91.6 | <0.001 * | 3.355 | 2.431–4.631 | 0.003 * | 1.891 | 1.244–2.874 | |||
Stress | ||||||||||||
No (%) | 75.6 | 3.5 | 96.5 | Referent | ||||||||
Yes (%) | 24.4 | 5.1 | 94.9 | 0.031 * | 1.46 | 1.036–2.057 | 0.451 | 1.169 | 0.779–1.753 | |||
EQ-5D index (Mean) b,† | 0.91 ± 0.14 | 0.81 ± 0.21 | 0.91 ± 0.14 | <0.001 * | 0.046 | 0.022–0.096 | 0.11 | 0.404 | 0.133–1.226 | |||
Visual disturbance | ||||||||||||
No (%) | 98.6 | 3.8 | 96.2 | Referent | Referent | |||||||
Yes (%) | 1.4 | 10.9 | 89.1 | 0.007 * | 3.099 | 1.307–7.346 | 0.503 | 0.699 | 0.245–1.994 | |||
Underlying diseases | ||||||||||||
Diagnosis of stroke | ||||||||||||
No (%) | 97.1 | 3.9 | 96.1 | Referent | ||||||||
Yes (%) | 2.9 | 5.1 | 94.9 | 0.5 | 1.334 | 0.577–3.080 | ||||||
Diagnosis of osteoarthritis | ||||||||||||
No (%) | 78.9 | 3.4 | 79.3 | Referent | Referent | |||||||
Yes (%) | 21.1 | 5.7 | 94.3 | 0.002 * | 1.718 | 1.216–2.428 | 0.343 | 1.223 | 0.807–1.851 | |||
Depressive mood | ||||||||||||
No (%) | 83.3 | 3.7 | 96.3 | Referent | ||||||||
Yes (%) | 16.7 | 4.7 | 95.3 | 0.23 | 1.275 | 0.857–1.897 | ||||||
Diagnosis of depression | ||||||||||||
No (%) | 95 | 3.9 | 96.1 | Referent | ||||||||
Yes (%) | 5 | 4 | 96 | 0.962 | 1.018 | 0.493–2.103 | ||||||
Diagnosis of Hypertension | ||||||||||||
No (%) | 61.2 | 3 | 97 | Referent | Referent | |||||||
Yes (%) | 38.8 | 5.3 | 94.7 | <0.001 * | 1.839 | 1.337–2.530 | 0.115 | 1.349 | 0.929–1.958 | |||
Diagnosis of Diabetes | ||||||||||||
No (%) | 86.1 | 3.6 | 96.4 | Referent | Referent | |||||||
Yes (%) | 13.9 | 5.7 | 94.3 | 0.019 * | 1.613 | 1.083–2.403 | 0.18 | 1.35 | 0.870–2.095 | |||
Diagnosis of Anemia | ||||||||||||
No (%) | 90.7 | 3.6 | 96.4 | Referent | Referent | |||||||
Yes (%) | 9.3 | 6.4 | 93.6 | 0.010 * | 1.803 | 1.152–2.822 | 0.361 | 0.785 | 0.467–1.319 | |||
Osteoporosis | ||||||||||||
Normal | 27.5 | 1.4 | 98.6 | Referent | ||||||||
Osteopenia | 50.5 | 4 | 96 | <0.001 * | 2.953 | 1.659–5.256 | 0.15 | 1.555 | 0.853–2.835 | |||
Osteoporosis | 22 | 6.8 | 93.2 | <0.001 * | 5.205 | 2.873–9.430 | 0.43 | 1.303 | 0.675–2.513 | |||
DEXA T score (total femur) | −0.35 ± 1.03 | −0.97 ± 1.14 | −0.32 ± 1.01 | <0.001 * | 0.531 | 0.452–0.624 | ||||||
DEXA T score (femur neck) | −1.24 ± 1.06 | −1.89 ± 1.15 | −1.21±1.05 | <0.001 * | 0.523 | 0.444–0.615 | ||||||
DEXA T score (lumbar) | −1.22 ± 1.36 | −1.64 ± 1.49 | −1.20 ± 1.35 | <0.001 * | 0.776 | 0.683–0.882 | ||||||
vitamin D (ng/mL) | 20.05 ± 7.22 | 18.57 ± 6.78 | 20.11 ± 7.23 | <0.001 * | 0.969 | 0.946–0.992 | <0.001 * | 0.951 | 0.926–0.976 | |||
alkaline phosphatase (IU/L) | 247.18 ± 75.81 | 270.26 ± 94.72 | 246.24 ± 74.81 | <0.001 * | 1.003 | 1.002–1.005 | 0.108 | 1.002 | 1.000–1.004 | |||
PTH (pg/mL) | 68.89 ± 29.99 | 73.59 ± 32.58 | 68.70 ± 29.86 | 0.047 * | 1.004 | 1.000–1.008 |
% a | Falling (+) | Falling (−) | The Univariable Analysis | The Multivariable Analysis † | ||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
p-Value | OR | 95% CI | p-Value | OR | 95% CI | |||||||
Otolaryngologic conditions (Physical examination and questionnaire) | ||||||||||||
Tinnitus | ||||||||||||
No (%) | 75.5 | 24.5 | 75.5 | Referent | Referent | |||||||
Yes (%) | 24.5 | 12.5 | 87.5 | <0.001 * | 2.281 | 1.905–2.730 | <0.001 * | 1.907 | 1.562–2.328 | |||
Hearing loss | ||||||||||||
No (%) | 76.3 | 13.7 | 86.3 | Referent | Referent | |||||||
Yes (%) | 23.7 | 21.0 | 79.0 | <0.001 * | 1.666 | 1.383–2.007 | 0.152 | 1.176 | 0.942–1.468 | |||
General conditions for activity | ||||||||||||
Limitation of activity | ||||||||||||
No (%) | 78.6 | 12.6 | 81.3 | Referent | Referent | |||||||
Yes (%) | 21.4 | 26.1 | 73.9 | <0.001 * | 2.457 | 2.043–2.954 | 0.002 * | 1.451 | 1.145–1.840 | |||
Stress | ||||||||||||
No (%) | 75.6 | 13.0 | 87.0 | Referent | Referent | |||||||
Yes (%) | 24.4 | 22.5 | 77.5 | <0.001 * | 1.937 | 1.614–2.326 | 0.004 * | 1.391 | 1.110–1.743 | |||
EQ-5D index (Mean) † | 0.90 ± 0.15 b | 0.84 ± 0.19 b | 0.92±0.13 b | <0.001 * | 0.051 | 0.030–0.086 | <0.001* | 0.286 | 0.141–0.578 | |||
Visual disturbance | ||||||||||||
No (%) | 98.6 | 15.2 | 84.8 | Referent | ||||||||
Yes (%) | 1.4 | 36.4 | 63.6 | <0.001 * | 3.199 | 1.835–5.580 | 0.373 | 1.342 | 0.702–2.566 | |||
Underlying diseases | ||||||||||||
Diagnosis of Stroke | ||||||||||||
No (%) | 97.1 | 15.3 | 84.7 | Referent | ||||||||
Yes (%) | 2.9 | 21.2 | 78.8 | 0.082 | 1.492 | 0.951–2.339 | ||||||
Diagnosis of Osteoarthritis | ||||||||||||
No (%) | 78.9 | 13.9 | 86.1 | Referent | Referent | |||||||
Yes (%) | 21.1 | 21.4 | 78.6 | <0.001 * | 1.688 | 1.393–2.045 | 0.707 | 1.046 | 0.827–1.324 | |||
Depressive mood | ||||||||||||
No (%) | 83.3 | 13.9 | 86.1 | Referent | Referent | |||||||
Yes (%) | 16.7 | 23.0 | 77.0 | <0.001 * | 1.844 | 1.504–2.260 | 0.337 | 1.132 | 0.879–1.459 | |||
Diagnosis of Hypertension | ||||||||||||
No (%) | 61.2 | 13.6 | 86.4 | Referent | ||||||||
Yes (%) | 38.8 | 18.3 | 81.7 | <0.001 * | 1.425 | 1.200–1.691 | 0.045 * | 1.230 | 1.005–1.504 | |||
Diagnosis of Diabetes | ||||||||||||
No (%) | 86.1 | 15.0 | 85.0 | Referent | Referent | |||||||
Yes (%) | 13.9 | 18.3 | 81.7 | 0.042 * | 1.274 | 1.009–1.608 | 0.423 | 1.112 | 0.857–1.443 | |||
Diagnosis of Anemia | ||||||||||||
No (%) | 90.7 | 14.8 | 85.2 | Referent | Referent | |||||||
Yes (%) | 9.3 | 21.5 | 78.5 | 0.001 * | 1.578 | 1.214–2.052 | 0.910 | 1.018 | 0.747–1.387 | |||
Osteoporosis | ||||||||||||
Normal | 27.5 | 10.4 | 89.6 | Referent | ||||||||
Osteopenia | 50.5 | 15.5 | 84.5 | <0.001 * | 1.582 | 1.247–2.007 | 0.552 | 1.083 | 0.833–1.407 | |||
Osteoporosis | 22.0 | 21.9 | 78.1 | <0.001 * | 2.422 | 1.864–3.147 | 0.574 | 1.099 | 0.790–1.529 | |||
DEXA T score (total femur) | −0.35 ± 1.03 b | −0.59 ± 1.06 b | −0.30 ± 1.01 b | <0.001 * | 0.760 | 0.699–0.828 | ||||||
DEXA T score (femur neck) | −1.24 ± 1.06 b | −1.56 ± 1.07 b | −1.18 ± 1.05 b | <0.001 * | 0.706 | 0.649–0.769 | ||||||
DEXA T score (lumbar) | −1.22 ± 1.36 b | −1.52 ± 1.38 b | −1.16 ± 1.35 b | <0.001 * | 0.818 | 0.766–0.875 | ||||||
vitamin D (ng/mL) | 20.05 ± 7.22 b | 19.79 ± 6.89 b | 20.10 ± 7.28 b | 0.329 | 0.994 | 0.982–1.006 | ||||||
alkaline phosphatase (IU/L) | 247.18 ± 75.81 b | 251.01 ± 79.11 b | 246.48 ± 75.19 b | 0.169 | 1.001 | 1.000–1.002 | ||||||
PTH (pg/mL) | 68.89 ± 29.99 b | 67.66 ± 29.27 b | 69.11 ± 30.11 b | 0.266 | 0.998 | 0.995–1.001 |
Model | R | R Square | F | p |
---|---|---|---|---|
Vitamin D | 0.052 | 0.003 | 9.929 | 0.002 * |
Vitamin D * Sex | 0.057 | 0.003 | 5.909 | 0.003 * |
Vitamin D * Sex * Osteoporosis | 0.108 | 0.012 | 14.374 | <0.001 * |
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Kim, S.Y.; Cho, Y.-S.; Kim, J.-S.; Koo, J.-W. Association between Bone Metabolism and Vestibular Problems in the Modified Romberg Test: Data from the 2009–2010 Korean National Health and Nutrition Examination Survey. J. Clin. Med. 2020, 9, 2415. https://doi.org/10.3390/jcm9082415
Kim SY, Cho Y-S, Kim J-S, Koo J-W. Association between Bone Metabolism and Vestibular Problems in the Modified Romberg Test: Data from the 2009–2010 Korean National Health and Nutrition Examination Survey. Journal of Clinical Medicine. 2020; 9(8):2415. https://doi.org/10.3390/jcm9082415
Chicago/Turabian StyleKim, So Young, Yang-Sun Cho, Ji-Soo Kim, and Ja-Won Koo. 2020. "Association between Bone Metabolism and Vestibular Problems in the Modified Romberg Test: Data from the 2009–2010 Korean National Health and Nutrition Examination Survey" Journal of Clinical Medicine 9, no. 8: 2415. https://doi.org/10.3390/jcm9082415
APA StyleKim, S. Y., Cho, Y.-S., Kim, J.-S., & Koo, J.-W. (2020). Association between Bone Metabolism and Vestibular Problems in the Modified Romberg Test: Data from the 2009–2010 Korean National Health and Nutrition Examination Survey. Journal of Clinical Medicine, 9(8), 2415. https://doi.org/10.3390/jcm9082415