Calcium intake and fracture risk: Results from the study of osteoporotic fractures
Calcium intake and fracture risk: Results from the study of osteoporotic fractures
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DOI：
10.1093/oxfordjournals.aje.a009052
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发表时间：
1997-05-15
影响因子：
5
通讯作者：
Fox, K
中科院分区：
文献类型：
--
作者：
Cumming, RG;Cummings, SR;Fox, K
一项队列研究调查了膳食钙、钙和维生素 D 补充剂与髋部 (n=332)、踝关节 (n=210)、肱骨近端 (n=241)、腕部 (n=467) 和椎骨 (n=389) 骨折风险之间的关系，该研究涉及 9,704 名 65 岁或以上的美国白人女性，基线评估于 1986 年至 1988 年在美国四个国家进行大都市区。通过经过验证的食物频率问卷在基线评估膳食钙摄入量，在平均 6.6 年的随访期间，每 4 个月收集一次新发非椎骨骨折的数据；新椎体骨折的识别基于平均间隔 3.7 年的基线和随访脊柱 X 光片的比较，结果针对许多潜在的混杂因素进行了调整，包括体重、体力活动、雌激素使用、蛋白质摄入量以及跌倒、骨质疏松和骨折史。膳食钙摄入量与所研究的任何骨折风险之间没有重要关联。当前使用钙补充剂与髋部骨折（相对风险=1.5，95%置信区间1.1-2.0）和椎骨骨折（相对风险=1.4，95%置信区间1.1-1.9）风险增加相关；目前使用 Turns 抗酸药片与肱骨近端骨折风险增加相关（相对风险 = 1.7，95% 置信区间 1.3-2.4）。没有证据表明维生素 D 补充剂具有保护作用，尽管不能排除钙补充剂对骨折风险的真正不利影响，但我们的发现更有可能是由于补充剂使用适应症控制不充分造成的混杂因素。总之，这项研究没有发现钙对骨折风险有实质性的有益作用。
The relation between dietary calcium, calcium, and vitamin D supplements and the risk of fractures of the hip (n=332), ankle (n=210), proximal humerus (n=241), wrist (n=467), and vertebrae (n=389) was investigated in a cohort study involving 9,704 US white women aged 65 years or older, Baseline assessments took place in 1986-1988 in four US metropolitan areas. Dietary calcium intake was assessed at baseline with a validated food frequency questionnaire, Data on new nonvertebral fractures were collected every 4 months during a mean of 6.6 years of follow-up; identification of new vertebral fractures was based on comparison of baseline and follow-up radiographs of the spine done a mean of 3.7 years apart, Results were adjusted for numerous potential confounders, including weight, physical activity, estrogen use, protein intake, and history of falls, osteoporosis, and fractures, There were no important associations between dietary calcium intake and the risk of any of the fractures studied. Current use of calcium supplements was associated with increased risk of hip (relative risk=1.5, 95% confidence interval 1.1-2.0) and vertebral (relative risk=1.4, 95% confidence interval 1.1-1.9) fractures; current use of Turns antacid tablets was associated with increased risk of fractures of the proximal humerus (relative risk=1.7, 95% confidence interval 1.3-2.4). There was no evidence of a protective effect of vitamin D supplements, Although a true adverse effect of calcium supplements on fracture risk cannot be ruled out, it is more likely that our findings are due to inadequately controlled confounding by indications for use of supplements. In conclusion, this study did not find a substantial beneficial effect of calcium on fracture risk.