Magnesium intake, bone mineral density, and fractures: results from the Women's Health Initiative Observational Study
Magnesium intake, bone mineral density, and fractures: results from the Women's Health Initiative Observational Study
复制标题
DOI：
10.3945/ajcn.113.067488
复制
发表时间：
2014-04-01
影响因子：
7.1
通讯作者：
Jackson, Rebecca D.
中科院分区：
文献类型：
--
作者：
Orchard, Tonya S.;Larson, Joseph C.;Jackson, Rebecca D.
背景：镁是骨骼的必要组成部分，但其与骨质疏松性骨折的关系尚不清楚。目的：我们检查了镁摄入量作为骨质疏松性骨折和骨矿物质密度 (BMD) 改变的危险因素。设计：这项前瞻性队列研究包括参加妇女健康倡议观察性研究的 73,684 名绝经后妇女。每日总镁摄入量是根据基线食物频率调查问卷和补充剂估算的。通过医疗记录审查确认髋部骨折；其他骨折是通过自我报告发现的。对 4778 名参与者进行了基线 BMD 分析。结果：与每日摄入量 < 206.5 mg Mg 的女性相比，摄入 > 422.5 mg Mg/d 的女性的基线髋部 BMD 高出 3% (P < 0.001)，全身 BMD 高出 2% (P < 0.001)。然而，髋部骨折和全身骨折的发生率和 RR 在镁的五分位数之间没有差异。相比之下，下臂或腕部骨折的风险随着镁摄入量的增加而增加[与五分位数 1 相比，五分位数 4 和 5 的多变量调整 HR 分别为 1.15 (95% CI: 1.01, 1.32) 和 1.23 (95% CI: 1.07, 1.42)； P-趋势 = 0.002]。此外，镁摄入量最高的女性身体活动量更大，跌倒的风险也更高[五分位数 4 的 HR：1.11（95% CI：1.06，1.16）；五分位数 5 的 HR：1.15（95% CI：1.10，1.20）； P-趋势 < 0.001]。结论：镁摄入量较低与髋部和全身 BMD 较低相关，但这一结果并不意味着骨折风险增加。镁摄入量略高于推荐膳食摄入量与下臂和手腕骨折增加有关，这可能与更多的体力活动和跌倒有关。该试验已在临床试验中注册。政府编号为 NCT00000611。
Background: Magnesium is a necessary component of bone, but its relation to osteoporotic fractures is unclear.Objective: We examined magnesium intake as a risk factor for osteoporotic fractures and altered bone mineral density (BMD).Design: This prospective cohort study included 73,684 postmenopausal women enrolled in the Women's Health Initiative Observational Study. Total daily magnesium intake was estimated from baseline food-frequency questionnaires plus supplements. Hip fractures were confirmed by a medical record review; other fractures were identified by self-report. A baseline BMD analysis was performed in 4778 participants.Results: Baseline hip BMD was 3% higher (P < 0.001), and whole body BMD was 2% higher (P < 0.001), in women who consumed > 422.5 compared with < 206.5 mg Mg/d. However, the incidence and RR of hip and total fractures did not differ across quintiles of magnesium. In contrast, risk of lower-arm or wrist fractures increased with higher magnesium intake [multivariate-adjusted HRs of 1.15 (95% CI: 1.01, 1.32) and 1.23 (95% CI: 1.07, 1.42) for quintiles 4 and 5, respectively, compared with quintile 1; P-trend = 0.002]. In addition, women with the highest magnesium intakes were more physically active and at increased risk of falls [HR for quintile 4: 1.11 (95% CI: 1.06, 1.16); HR for quintile 5: 1.15 (95% CI: 1.10, 1.20); P-trend < 0.001].Conclusions: Lower magnesium intake is associated with lower BMD of the hip and whole body, but this result does not translate into increased risk of fractures. A magnesium consumption slightly greater than the Recommended Dietary Allowance is associated with increased lower-arm and wrist fractures that are possibly related to more physical activity and falls. This trial was registered at clinicaltrials. gov as NCT00000611.