Prevalence of osteoporosis among North Korean women refugees living in South Korea: A comparative cross-sectional study

Kyeong Jin Kim, Jee Hyun An, Kyoung Jin Kim, Ji Hee Yu, Nam Hoon Kim, Hye Jin Yoo, Hee Young Kim, Ji A. Seo, Nan Hee Kim, Kyung Mook Choi, Sei Hyun Baik, Sin Gon Kim

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4 Citations (Scopus)


Objective To investigate the prevalence of osteoporosis among North Korean women refugees when compared with South Korean women, who have identical genetic backgrounds but experience different environments. Design Comparative cross-sectional study. Setting North Korean Refugee Health in South Korea (NORNS) study in South Korea. Participants We evaluated 122 North Korean women who participated in NORNS study and 366 age-matched/menopausal status-matched South Korean women from the Korea University Medical Center (KUMC) health examination cohort. The median age of the NORNS participants was 46 years (IQR, 40-60 years) with 52 women (42.6%) being postmenopausal. Results Among the postmenopausal women, NORNS participants had a higher body mass index and number of pregnancies and lower physical activity than the KUMC participants. The overall prevalence of osteoporosis was 48% (25/52) and 17% (27/156) in NORNS and KUMC participants, respectively. The bone mineral density (BMD) values at the lumbar spine, femur neck and total hip were significantly lower in postmenopausal NORNS women than in the postmenopausal KUMC women. Old age, low body weight and late age of menarche were associated with low BMD among the postmenopausal North Korean refugees. In premenopausal participants, the NORNS women had lower body weight and physical activity than the KUMC women at baseline. All the NORNS women had normal Z-scores, although the BMD at the lumbar spine was significantly lower in NORNS women than in the KUMC women (0.952 vs 1.002 g/cm 2, p<0.001). Conclusions Osteoporosis is a prevalent health problem in postmenopausal North Korean women refugees living in South Korea. It is conceivable to prepare vigilant countermeasures for bone health deterioration in this growing population, especially for postmenopausal women. Further research is warranted to determine the cause of the differences between participants of the same ethnic group.

Original languageEnglish
Article number036230
JournalBMJ open
Issue number6
Publication statusPublished - 2020 Jun 11

Bibliographical note

Funding Information:
This study was partly supported by a grant of the Korean Health Technology R&D Project (HI14C2750), Ministry of Health & Welfare, Republic of Korea.

Publisher Copyright:
© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.


  • bone density
  • cross-sectional study
  • democratic people's republic of korea
  • osteoporosis

ASJC Scopus subject areas

  • General Medicine


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