Cheng Sulin, Lyytikäinen Arja, Kröger Heikki, Lamberg-Allardt Christel, Alén Markku, Koistinen Arvo, Wang Qing Ju, Suuriniemi Miia, Suominen Harri, Mahonen Anitta, Nicholson Patrick H F, Ivaska Kaisa K, Korpela Riitta, Ohlsson Claes, Väänänen Kalervo H, Tylavsky Frances
Department of Health Sciences, University of Jyväskylä, Jyväskylä, Finland.
Am J Clin Nutr. 2005 Nov;82(5):1115-26; quiz 1147-8. doi: 10.1093/ajcn/82.5.1115.
Little is known about the relative effectiveness of calcium supplementation from food or pills with or without vitamin D supplementation for bone mass accrual during the rapid growth period.
The purpose was to examine the effects of both food-based and pill supplements of calcium and vitamin D on bone mass and body composition in girls aged 10-12 y.
This placebo-controlled intervention trial randomly assigned 195 healthy girls at Tanner stage I-II, aged 10-12 y, with dietary calcium intakes <900 mg/d to 1 of 4 groups: calcium (1000 mg) + vitamin D3 (200 IU), calcium (1000 mg), cheese (1000 mg calcium), and placebo. Primary outcomes were bone indexes of the hip, spine, and whole body by dual-energy X-ray absorptiometry and of the radius and tibia by peripheral quantitative computed tomography.
With the use of intention-to-treat or efficacy analysis, calcium supplementation with cheese resulted in a higher percentage change in cortical thickness of the tibia than did placebo, calcium, or calcium + vitamin D treatment (P = 0.01, 0.038, and 0.004, respectively) and in higher whole-body bone mineral density than did placebo treatment (P = 0.044) when compliance was >50%. With the use of a hierarchical linear model with random effects to control for growth velocity, these differences disappeared.
Increasing calcium intake by consuming cheese appears to be more beneficial for cortical bone mass accrual than the consumption of tablets containing a similar amount of calcium. Diverse patterns of growth velocity may mask the efficacy of supplementation in a short-term trial of children transiting through puberty.
在快速生长阶段，关于从食物或药丸中补充钙（无论是否补充维生素D）对骨量积累的相对有效性，人们了解甚少。
研究基于食物的钙和维生素D补充剂以及药丸补充剂对10 - 12岁女孩骨量和身体成分的影响。
这项安慰剂对照干预试验将195名处于坦纳I - II期、年龄10 - 12岁、膳食钙摄入量<900 mg/d的健康女孩随机分为4组：钙（1000 mg）+维生素D3（200 IU）、钙（1000 mg）、奶酪（含1000 mg钙）和安慰剂。主要结局指标包括通过双能X线吸收法测量的髋部、脊柱和全身的骨指标，以及通过外周定量计算机断层扫描测量的桡骨和胫骨的骨指标。
采用意向性分析或疗效分析，当依从性>50%时，补充奶酪钙导致胫骨皮质厚度的百分比变化高于安慰剂、钙或钙 + 维生素D治疗（分别为P = 0.01、0.038和0.004），且全身骨矿物质密度高于安慰剂治疗（P = 0.044）。使用具有随机效应的分层线性模型来控制生长速度时，这些差异消失。
通过食用奶酪增加钙摄入量似乎比食用含有等量钙的片剂对皮质骨量积累更有益。在经历青春期的儿童短期试验中，不同的生长速度模式可能掩盖补充剂的疗效。
