Calcium intake and hip fracture risk in men and women: a meta-analysis of prospective cohort studies and randomized controlled trials.
Calcium intake and hip fracture risk in men and women: a meta-analysis of prospective cohort studies and randomized controlled trials.
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DOI：
10.1093/ajcn/86.5.1780
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发表时间：
2007-12
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影响因子：
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通讯作者：
H. Bischoff-Ferrari;B. Dawson-Hughes;J. Baron;P. Burckhardt;Ruifeng Li;D. Spiegelman;B. Specker;J. Orav;J. Wong;H. Staehelin;Éilis J. O’Reilly;D. Kiel;W. Willett
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文献类型：
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作者：
H. Bischoff-Ferrari;B. Dawson-Hughes;J. Baron;P. Burckhardt;Ruifeng Li;D. Spiegelman;B. Specker;J. Orav;J. Wong;H. Staehelin;Éilis J. O’Reilly;D. Kiel;W. Willett
背景：总钙摄入量在预防髋部骨折风险中的作用尚未完全确定。目的在队列研究和临床试验的Meta分析的基础上，评价钙摄入量与髋部骨折风险的关系。结果在女性中(7项前瞻性队列研究，170,991名女性，2,954名髋部骨折)，总钙摄入量与髋部骨折风险无关[每300毫克总钙/天的汇集风险比(RR)=1.01；95%CI：0.97，1.05]。在男性中(5项前瞻性队列研究，68,606名男性，214名髋部骨折)，每300毫克总钙/日的汇集RR为0.92(95%CI：0.82，1.03)。根据对814例非椎体骨折进行的5项临床试验(女性5666例，主要是绝经后女性，以及男性1074例)，补钙(800-1600 mg/d)和安慰剂治疗非椎体骨折的合并RR为0.92(95%CI：0.81，1.05)。根据4项不同结果的髋部骨折临床试验(6504名受试者139个髋部骨折)，钙和安慰剂之间的合并RR为1.64(95%CI：1.02，2.64)。敏感性分析，包括另外两个有100人参加的小规模试验或按方案进行的结果，并没有显著改变结果。结论前瞻性队列研究的综合结果表明，女性或男性的钙摄入量与髋部骨折的风险并不显著相关。随机对照试验的综合结果显示，补钙并不能降低髋部骨折的风险，而增加风险是可能的。对于任何非脊椎骨折，在随机试验中都有中性影响。
BACKGROUND The role of total calcium intake in the prevention of hip fracture risk has not been well established. OBJECTIVE The objective of the study was to assess the relation of calcium intake to the risk of hip fracture on the basis of meta-analyses of cohort studies and clinical trials. RESULTS In women (7 prospective cohort studies, 170,991 women, 2,954 hip fractures), there was no association between total calcium intake and hip fracture risk [pooled risk ratio (RR) per 300 mg total Ca/d = 1.01; 95% CI: 0.97, 1.05]. In men (5 prospective cohort studies, 68,606 men, 214 hip fractures), the pooled RR per 300 mg total Ca/d was 0.92 (95% CI: 0.82, 1.03). On the basis of 5 clinical trials (n = 5666 women, primarily postmenopausal, plus 1074 men) with 814 nonvertebral fractures, the pooled RR for nonvertebral fractures between calcium supplementation (800-1600 mg/d) and placebo was 0.92 (95% CI: 0.81, 1.05). On the basis of 4 clinical trials with separate results for hip fracture (6,504 subjects with 139 hip fractures), the pooled RR between calcium and placebo was 1.64 (95% CI:1.02, 2.64). Sensitivity analyses including 2 additional small trials with <100 participants or per-protocol results did not substantially alter results. CONCLUSIONS Pooled results from prospective cohort studies suggest that calcium intake is not significantly associated with hip fracture risk in women or men. Pooled results from randomized controlled trials show no reduction in hip fracture risk with calcium supplementation, and an increased risk is possible. For any nonvertebral fractures, there was a neutral effect in the randomized trials.