CALCIUM SUPPLEMENTATION AND INCREASES IN BONE-MINERAL DENSITY IN CHILDREN
CALCIUM SUPPLEMENTATION AND INCREASES IN BONE-MINERAL DENSITY IN CHILDREN
复制标题
DOI：
10.1056/nejm199207093270204
复制
发表时间：
1992-07-09
影响因子：
158.5
通讯作者：
PEACOCK, M
中科院分区：
文献类型：
--
作者：
JOHNSTON, CC;MILLER, JZ;PEACOCK, M
背景 儿童时期钙的饮食摄入量增加，通常是牛奶中的钙，与成年后骨量增加有关;骨量的增加在改变以后骨折的风险方面很重要。然而，这种增加是否是由于牛奶中的钙含量引起的尚不确定。 我们对70对同卵双胞胎（平均[+/-SD]年龄，10+/-2岁;范围，6 - 14岁）进行了一项为期3年的双盲安慰剂对照试验，研究补钙（每天1000 mg柠檬酸苹果酸钙）对骨密度的影响。在每对双胞胎中，一个作为另一个的对照; 45对完成了研究。采用光子吸收法测量桡骨两个部位（基线、6个月、1年、2年和3年）和髋部和脊柱三个部位（基线和3年）的骨密度。 服用安慰剂的双胞胎的平均每日钙摄入量为908 mg，服用钙补充剂的双胞胎为1612 mg（894 mg来自饮食，718 mg来自补充剂）。在整个研究过程中处于青春期前的22对双胞胎中，给予补充剂的双胞胎在两个桡骨部位的骨矿物质密度显著增加（骨密度增加的平均差异：中段半径，5.1%[95%置信区间，1.5%至8.7%];桡骨远端，3.8%[95%置信区间，1.4 - 6.2%]）和腰椎（增加2.8%[95%置信区间，1.1%至4.5%]）;三个股骨部位中有两个部位的增加差异接近显著性（股骨颈的沃德三角，2.9%;大转子，3.5%）。在23对经历青春期或青春期后的双胞胎中，给予补充剂的双胞胎没有得到任何好处。 在青春期前儿童的平均膳食钙摄入量接近推荐的膳食允许量，钙补充剂提高骨密度的增加率。如果持续增加，峰值骨密度应该增加，骨折的风险降低。
Background. Increased dietary intake of calcium during childhood, usually as calcium in milk, is associated with increased bone mass in adulthood; the increase in mass is important in modifying the later risk of fracture. Whether the increase is due to the calcium content of milk, however, is not certain.Methods. We conducted a three-year, double-blind, placebo-controlled trial of the effect of calcium supplementation (1000 mg of calcium citrate malate per day) on bone mineral density in 70 pairs of identical twins (mean [+/-SD] age, 10+/-2 years; range, 6 to 14). In each pair, one twin served as a control for the other; 45 pairs completed the study. Bone mineral density was measured by photon absorptiometry at two sites in the radius (at base line, six months, and one, two, and three years) and at three sites in the hip and in the spine (at base line and three years).Results. The mean daily calcium intake of the twins given placebo was 908 mg, and that of the twins given calcium supplements was 1612 mg (894 mg from the diet and 718 mg from the supplement). Among the 22 twin pairs who were prepubertal throughout the study, the twins given supplements had significantly greater increases in bone mineral density at both radial sites (mean difference in the increase in bone mineral density: midshaft radius, 5.1 percent [95 percent confidence interval, 1.5 to 8.7 percent]; distal radius, 3.8 percent [95 percent confidence interval, 1.4 to 6.2 percent]) and in the lumbar spine (increase, 2.8 percent [95 percent confidence interval, 1.1 to 4.5 percent]) after three years; the differences in the increases at two of three femoral sites approached significance (Ward's triangle in the femoral neck, 2.9 percent; greater trochanter, 3.5 percent). Among the 23 pairs who went through puberty or were postpubertal, the twins given supplements received no benefit.Conclusions. In prepubertal children whose average dietary intake of calcium approximated the recommended dietary allowance, calcium supplementation enhanced the rate of increase in bone mineral density. If the gain persists, peak bone density should be increased and the risk of fracture reduced.