CALCIUM AND VITAMIN D EFFECT ON HIP BONE LOSS

这项拟议的研究旨在确定对骨骼的最大益处 髋部的矿物质密度可以通过增加摄入量来获得 老年人群中钙和维生素D的水平达到 预计既营养最佳，又安全。平均进食量 65岁以上的人维生素D和钙只有一半到三分之二 推荐量。这项研究将确定 与年龄相关的骨质流失可归因于这两种物质摄入不足。 并将提供参考数据，以供 更多侵入性或实验性干预的有效性可以是 评估过了。与激素和药物治疗相比，营养 干预措施几乎没有预期的副作用，成本低廉，而且可能 适合广泛横截面的老年人口。这个 拟议的研究将确定每日补充 500毫克元素钙(如柠檬酸)加上700国际单位的 胆钙素对424例男性髋部骨密度变化的影响 以及65岁或以上的女性。为期三年的随机双盲试验 建议进行审判。一半的参与者将被分配到 治疗组(钙+D)，另一半为安慰剂组。这个 两组人将按性别和年龄十年进行平衡。骨矿物质 股骨颈、侧棘和全身的密度将是 每半年测量一次，采用双能量吸光度测定法。其他待公布的数据 收集的数据包括血液和尿液测试结果以及 膳食钙，膳食维生素D，握力，体力活动， 阳光照射并传播到其他纬度。有关以下内容的信息 吸烟和饮酒、旅行、用药、种族背景和 跌倒的发生情况将通过面谈获得。量测 间隔时间是有计划的，以便骨丢失率的季节性变化 而其他变量不会扰乱分析或解释。 除了提供对骨骼的最大益处的估计之外 矿物密度可以通过提供足够的 钙和维生素D，这项研究将检查骨骼的季节性模式 骨丢失与钙的丢失、总体和季节关系 调节荷尔蒙，以及生化、生理和 行为因素对跌倒发生的影响。

The proposed study is designed to determine the maximum benefit to bone mineral density of the hip that can be derived from increasing intakes of calcium and vitamin D in an elderly population to levels which are expected to be both nutritionally optimal and safe. Average intakes of vitamin D and calcium in those over age 65 are only half to two-thirds of recommended amounts. This study will define what proportion of age-related bone loss is attributable to inadequate intakes of these two nutrients and will provide reference data against which the effectiveness of more invasive or experimental interventions can be assessed. Compared to hormonal and drug therapies, nutritional intervention has few expected side effects, is inexpensive, and can be appropriate for a wide cross-section of the elderly population. The proposed study will determine the effect of daily supplementation with 500 mg of elemental calcium (as citrate malate) plus 700 IU of cholecalciferol on changes in bone mineral density of the hip in 424 men and women who are 65 or older. A three-year randomized, double-blind trial is proposed. One half of the participants will be assigned to the treatment group (calcium+D) and the other half to a placebo group. The two groups will be balanced for sex and age decade. Bone mineral density of the femoral neck, lateral spine and whole body will be measured semi-annually by dual-energy absorptiometry. Other data to be collected include results of blood and urine tests and measures of dietary calcium, dietary vitamin D, grip strength, physical activity, sunlight exposure and travel to other latitudes. Information about smoking and alcohol use, travel, medication use, ethnic background and the occurrence of falls will be obtained by interview. Measurement intervals are planned so that seasonal variation in rates of bone loss and other variables will not confound the analyses or interpretation. In addition to providing an estimate of the maximum benefit to bone mineral density that can be derived from the provision of adequate calcium and vitamin D, this study will examine seasonal patterns of bone loss, overall and seasonal relationships between bone loss and calcium regulating hormones, and influences of biochemical, physiological and behavioral factors on the occurrence of falls.