Effects of dietary calcium compared with calcium supplements on estrogen metabolism and bone mineral density
Effects of dietary calcium compared with calcium supplements on estrogen metabolism and bone mineral density
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DOI：
10.1093/ajcn/85.5.1428
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发表时间：
2007-05-01
影响因子：
7.1
通讯作者：
Armamento-Villareal, Reina C.
中科院分区：
文献类型：
--
作者：
Napoli, Nicola;Thompson, Jennifer;Armamento-Villareal, Reina C.
背景：高钙摄入与高骨矿物质密度（BMD）和高尿雌激素代谢产物有关。然而，膳食钙和钙补充剂对雌激素代谢和BMD的作用仍然未知。目的：目的是调查钙摄入来源对雌激素代谢和BMD的重要性。设计：对168名健康绝经后白色妇女进行了研究，研究了补充剂和饮食中的平均每日总钙摄入量、尿雌激素代谢产物以及脊柱和股骨近端BMD。结果：主要从饮食中或从饮食和补充剂中获得钙的妇女，其非雌激素代谢物与雌激素代谢物（2-羟基雌酮1/16 α-羟基雌酮）的比例显著低于主要从补充剂中获得钙的妇女（P = 0.03）。主要从饮食中或同时从饮食和补充剂中获得钙的受试者校正后的BMD z评分显著高于主要从补充剂中获得钙的受试者，包括脊柱（P = 0.012）、股骨颈（P = 0.02）、全股骨（P = 0.003）和转子间（P = 0.005）。这种差异在那些主要从饮食中获得钙的人中尤其明显，他们的总钙摄入量低于那些主要从补充剂中获得钙的人。膳食来源的钙与雌激素代谢向活性16 α-雌二醇的转变有关。羟基代谢途径和更大的骨密度，因此可能会产生更有利的影响，在绝经后妇女的骨健康比钙补充剂。
Background: High calcium intake has been associated with both high bone mineral density (BMD) and high urinary estrogen metabolites. However, the role of dietary calcium and calcium supplements on estrogen metabolism and BMD remains unknown.Objective: The objective was to investigate the importance of the source of calcium intake on estrogen metabolism and BMD.Design: The average total daily calcium intake from supplements and diet, urinary estrogen metabolites, and spine and proximal femur BMD were studied in 168 healthy postmenopausal white women.Results: Women who obtained calcium primarily from the diet or from both the diet and supplements had significantly (P = 0.03) lower ratios of nonestrogenic to estrogenic metabolites (2-hydroxyestrone 1/16 alpha-hydroxyestrone) than did those who obtained calcium primarily from supplements. Adjusted BMD z scores were significantly greater in the subjects who obtained calcium primarily from the diet or from both the diet and supplements than in those who obtained calcium primarily from calcium supplements at the spine (P = 0.012), femoral neck (P = 0.02), total femur (P = 0.003), and intertrochanter (P = 0.005). This difference was evident especially in those who obtained calcium primarily from the diet, whose total calcium intake was lower than that in those who obtained calcium primarily from supplements.Conclusion: Calcium from dietary sources is associated with a shift in estrogen metabolism toward the active 16 alpha-hydroxyl metabolic pathway and with greater BMD and thus may produce more favorable effects in bone health in postmenopausal women than will calcium from supplements.