Charles P
Aarhus Bone and Mineral Research Group, University Department of Endocrinology and Metabolism, Aarhus Amts Universitetshospital, Denmark.
J Intern Med. 1992 Feb;231(2):161-8. doi: 10.1111/j.1365-2796.1992.tb00519.x.
Calcium is important for bone health. It has been customary to focus on dietary calcium intake, but of central importance for the body needs in the individual patient is the actual calcium absorption. This absorption consists of an active vitamin D-mediated component and a passive diffusional component. A number of different methods are available for the evaluation of calcium absorption. At present the calcium absorption tests using calcium isotopes (radioactive or stable) appear to be the most reproducible way of determining calcium absorption. The major nutrient sources for calcium are milk and milk products, whereas some of the green vegetables have a low bioavailability of calcium. When deciding whether an increased calcium intake is advisable, the following questions must be answered. What is the calcium absorptive status of the patient? How should the calcium supplement be dispensed? What calcium salt should be used? When should calcium supplements be taken? What is the compliance of the patient? When should the treatment be evaluated? The calcium supplement might be taken as milk (or milk products) or, in patients with lactose intolerance, as calcium supplements. Quite a number of calcium supplements are available on the market, and many of them are marketed without proper knowledge of the bioavailability of the actual preparation. For the benefit of our patients it is now reasonable to demand such investigations before marketing calcium supplements.
钙对骨骼健康很重要。过去一直习惯关注膳食钙的摄入量，但对个体患者身体需求而言，实际的钙吸收才是至关重要的。这种吸收包括一个由活性维生素D介导的部分和一个被动扩散部分。有多种不同方法可用于评估钙的吸收。目前，使用钙同位素（放射性或稳定性同位素）的钙吸收测试似乎是确定钙吸收最具可重复性的方法。钙的主要营养来源是牛奶及奶制品，而一些绿色蔬菜的钙生物利用度较低。在决定是否应增加钙摄入量时，必须回答以下问题。患者的钙吸收状况如何？钙补充剂应如何给药？应使用哪种钙盐？钙补充剂应何时服用？患者的依从性如何？应何时评估治疗效果？钙补充剂可以以牛奶（或奶制品）的形式服用，或者对于乳糖不耐受的患者，以钙补充剂的形式服用。市场上有相当多的钙补充剂，其中许多在销售时并未充分了解实际制剂的生物利用度。为了我们患者的利益，现在在销售钙补充剂之前要求进行此类研究是合理的。
