Low fractional calcium absorption increases the risk for hip fracture in women with low calcium intake
Low fractional calcium absorption increases the risk for hip fracture in women with low calcium intake
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DOI：
10.7326/0003-4819-132-5-200003070-00003
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发表时间：
2000-03-07
影响因子：
39.2
通讯作者：
Cummings, SR
中科院分区：
文献类型：
--
作者：
Ensrud, KE;Duong, T;Cummings, SR
背景：随着年龄的增长，钙吸收能力下降限制了对低钙摄入量的适应，并被认为会导致继发性甲状旁腺功能亢进症，增加髋部和其他骨折的风险。然而，钙吸收分数、膳食钙摄入量和骨折风险之间的关系从未被研究过。目的：确定低钙摄入量女性低钙吸收分数是否会增加随后发生髋部和其他非脊柱骨折的风险。设计：前瞻性队列研究。环境：马里兰州巴尔的摩县、俄勒冈州波特兰、明尼苏达州明尼阿波利斯和宾夕法尼亚州莫农加赫拉山谷的四个临床中心。DERV参与者：5452名年龄在69岁或以上的非黑人女性，参加研究的第四次检查。测量：使用3小时单同位素(Ca-45)技术测量钙吸收分数。结果：在平均4.8年的时间里，729名女性(13%)至少经历过一次非脊柱骨折；其中153名女性有髋部骨折。调整年龄后，钙吸收分数较低的女性患髋部骨折的风险增加(1-SD的相对风险为7.7%，钙吸收分数下降1.24[95%CI，1.05至1.48])。低钙吸收分数和低钙摄入量的女性发生髋部骨折的风险最大；在饮食钙摄入量低于400毫克/天的女性中，钙吸收分数处于或低于中位数32.3%的女性与吸收效率较高的女性相比，髋部骨折的风险增加2.5倍(CI为1.29倍至4.69倍)。钙吸收分数与其他非脊柱骨折的风险无关(每1-SD的相对风险[7.7%]钙吸收分数下降，1.05[CI，0.96至1.14])。结论：在老年女性中，低钙摄入环境下的低钙吸收分数增加了髋部骨折的风险。我们的发现支持II型骨质疏松症的假说，即钙吸收减少是老年人髋部骨折的重要危险因素。
Background: Decreased ability to absorb calcium with age limits adaptation to low calcium intake and is thought to lead to secondary hyperparathyroidism and increased risk for hip and other fractures. However, the associations between fractional calcium absorption, dietary calcium intake, and risk for fracture have never been studied.Objective: To determine whether low fractional calcium absorption in women with low calcium intake increases the risk for subsequent hip and other nonspine fractures.Design: Prospective cohort study. Setting: Four clinical centers in Baltimore County, Maryland; Portland, Oregon; Minneapolis, Minnesota; and the Monongahela Valley, Pennsylvania. Derv participants: 5452 nonblack women 69 years of age or and subsequent older participating in the fourth examination of the Study studied. of Osteoporotic Fractures.Measurements: Fractional calcium absorption was measured by using a 3-hour single isotope (Ca-45) technique. Incident fractures were identified prospectively and were confirmed by radiographic report,Results: During an average of 4.8 years, 729 women (13%) experienced at least one nonspine fracture; 153 of these women had hip fractures. After adjustment for age, women with lower fractional calcium absorption were at increased risk for hip fracture (relative risk per 1-SD [7.7%] decrease in fractional calcium absorption, 1.24 [95% CI, 1.05 to 1.48]). Women with low fractional calcium absorption and low calcium intake were at greatest risk for subsequent hip fracture; among women whose dietary calcium intake was less than 400 mg/d, those who had fractional calcium absorption at or below the median value of 32.3% had a 2.5-fold (CI, 1.29-fold to 4.69-fold) increase in risk for hip fracture compared with those who had greater absorption efficiency. Fractional calcium absorption was not related to risk for other nonspine fractures (relative risk per 1-SD [7.7%] decrease in fractional calcium absorption, 1.05 [CI, 0.96 to 1.14]).Conclusions: In elderly women, low fractional calcium absorption in the setting of low calcium intake increases the risk for hip fracture. Our findings support the hypothesis of type II osteoporosis, which postulates that decreased calcium absorption is an important risk factor for hip fracture in older persons.