Calcium and vitamin D supplementation decreases incidence of stress fractures in female Navy recruits
Calcium and vitamin D supplementation decreases incidence of stress fractures in female Navy recruits
复制标题
补充钙和维生素 D 可降低女海军新兵应力性骨折的发生率
DOI：
10.1359/jbmr.080102
复制
发表时间：
2008-05-01
影响因子：
6.2
通讯作者：
Thompson, Kerry
中科院分区：
文献类型：
--
作者：
Lappe, Joan;Cullen, Diane;Thompson, Kerry
简介：应力性骨折(SFX)是新兵中最常见和最令人衰弱的过度运动损伤之一，也是非军事运动人群的问题。这项随机、双盲、安慰剂对照研究的目的是确定钙和维生素D干预是否可以降低新兵基础训练期间SFX的发生率。材料和方法：我们招募了5201名海军女新兵志愿者，随机给予2000 mg钙和800IU维生素D或安慰剂。当新兵出现症状向五大湖诊所报到时，确定了SFX。结果：共有309例患者被诊断为SFX，发生率为5.9%/8wk。采用意向处理分析，包括所有登记的受试者，我们发现钙和维生素D组的SFX发生率比对照组低20%(分别为5.3%和6.6%，费舍尔精确检验p=0.0026)。按方案分析，仅包括完成研究的3700名新兵，发现补充组的骨折发生率比对照组低21%(分别为6.8%和8.6%，Fisher‘s精确测试，p=0.02)。结论：将这一发现推广到14416名在招募24个月期间在五大湖接受基础训练的女性，整个队列中补充钙和维生素D可以防止类似187人的骨折发生。SFX的这种下降将与发病率和财务成本的显著下降相关。
Introduction: Stress fractures (SFx) are one of the most common and debilitating overuse injuries seen in military recruits, and they are also problematic for nonmilitary athletic populations. The goal of this randomized double-blind, placebo-controlled study was to determine whether a calcium and vitamin D intervention could reduce the incidence of SFx in female recruits during basic training.Materials and Methods: We recruited 5201 female Navy recruit volunteers and randomized them to 2000 mg calcium and 800 IU vitamin D/d or placebo. SFx were ascertained when recruits reported to the Great Lakes clinic with symptoms. All SFx were confirmed with radiography or technetium scan according to the usual Navy protocol.Results: A total of 309 subjects were diagnosed with a SFx resulting in an incidence of 5.9% per 8 wk. Using intention-to-treat analysis by including all enrolled subjects, we found that the calcium and vitamin D group had a 20% lower incidence of SFx than the control group (5.3% versus 6.6%, respectively, p = 0.0026 for Fisher's exact test). The per protocol analysis, including only the 3700 recruits who completed the study, found a 21% lower incidence of fractures in the supplemented versus the control group (6.8% versus 8.6%, respectively, p = 0.02 for Fisher's exact test).Conclusions: Generalizing the findings to the population of 14,416 women who entered basic training at the Great Lakes during the 24 mo of recruitment, calcium and vitamin D supplementation for the entire cohort would have prevented similar to 187 persons from fracturing. Such a decrease in SFx would be associated with a significant decrease in morbidity and financial costs.