Impact of dairy products and dietary calcium on bone-mineral content in children: Results of a meta-analysis
Impact of dairy products and dietary calcium on bone-mineral content in children: Results of a meta-analysis
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DOI：
10.1016/j.bone.2008.02.022
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发表时间：
2008-08-01
期刊：
影响因子：
4.1
通讯作者：
Kupelnick, Bruce
中科院分区：
文献类型：
--
作者：
Huncharek, Michael;Muscat, Joshua;Kupelnick, Bruce
目的：虽然钙对于维持儿童骨骼健康至关重要，但该年龄段钙的最佳膳食摄入量，特别是乳制品的钙摄入量，尚无明确定义。进行荟萃分析以检查膳食钙/乳制品补充剂对该年龄组骨矿物质含量的影响。方法：使用先前描述的方法汇总随机对照干预试验和观察性研究的数据。感兴趣的结果是骨矿物质含量的平均差异汇总。采用敏感性分析来评估任何观察到的统计异质性，并检查特定研究特征对效果总结估计的影响。 结果：最初结合 21 项随机对照试验 (RCT) 的数据，使用全身骨矿物质含量 (TB-BMC) 作为感兴趣的结果，得出 TB-BMC 增加了 2 g（与对照相比，有补充），但没有统计学意义。这些数据显示出显着的统计异质性，敏感性分析显示，在基线膳食钙/乳制品摄入量正常或接近正常的研究对象中，补充乳制品/钙对骨矿物质含量几乎没有影响。敏感性分析表明基线钙摄入量可能解释统计异质性。将使用低摄入量受试者的三份报告汇总，得出统计显着的平均 BMC 为 49 克 (24.0-76-6)。使用钙/乳制品补充剂加维生素 D 合并两项随机对照试验也与腰椎 BMC 平均增加 35 克 (-6.8-41.8) 相关。由于缺乏其他解剖部位的 BMC 测量数据以及非随机研究的稀疏数据，排除了进一步的统计汇总。结论：增加膳食钙/乳制品（含或不含维生素 D）可显着增加基线摄入量低的儿童的全身和腰椎 BMC。 (C) 2008 Elsevier Inc. 保留所有权利。
Objective: Although calcium is essential for maintaining bone health in children, the optimum dietary intake of calcium in this age group, particularly in the form of dairy foods, is not well defined. A meta-analysis was conducted to examine the impact of dietary calcium/dairy supplementation on bone mineral content in this age group.Methods: Data were pooled from randomized controlled intervention trials and observational studies using previously described methods. The outcome of interest was a summary mean difference bone mineral content. Sensitivity analyses were employed to evaluate any observed statistical heterogeneity and to examine the influence of specific study characteristics on the summary estimate of effect.Results: Initially combining data from twenty-one randomized controlled trials (RCTs) using total body bone mineral content (TB-BMC) as the outcome of interest, yielded a non-statistically significant increase in TB-BMC of 2 g (supplemented versus controls). These data demonstrated substantial statistical heterogeneity with sensitivity analyses revealing that among study subjects with normal or near normal baseline dietary calcium/dairy intakes, supplemental dairy/calcium showed little impact on bone mineral content. Sensitivity analyses suggested that baseline calcium intake could potentially account for the statistical heterogeneity. Pooling the three reports utilizing low intake subjects yielded a statistically significant summary mean BMC of 49 g (24.0-76-6). Pooling two RCTs using calcium/dairy supplement plus vitamin D was also associated with an increase in lumbar spine BMC of, on average, 35 g (-6.8-41.8). The lack of data using BMC measurements at other anatomic sites as well as sparse data from non-randomized studies, precluded further statistical pooling.Conclusion: Increased dietary calcium/dairy products, with and without vitamin D, significantly increases total body and lumbar spine BMC in children with low base-line intakes. (C) 2008 Elsevier Inc. All rights reserved.