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临床实践中的钙补充:剂型、剂量及适应证综述

Calcium supplementation in clinical practice: a review of forms, doses, and indications.

作者信息

Straub Deborah A

机构信息

Canyon Ranch, 10237 East Desert Flower Place, Tucson, AZ 85749, USA.

出版信息

Nutr Clin Pract. 2007 Jun;22(3):286-96. doi: 10.1177/0115426507022003286.


DOI:10.1177/0115426507022003286
PMID:17507729
Abstract

Most Americans do not meet the adequate intake (AI) for calcium; calcium supplements can help meet requirements. Calcium supplementation has been found to be beneficial for bone health in children, young adults, and menopausal women. In addition to calcium, vitamin D is necessary for bone health and is generally deficient in the industrialized world. Calcium from carbonate and citrate are the most common forms of calcium supplements. Calcium carbonate, the most cost-effective form, should be taken with a meal to ensure optimal absorption. Calcium citrate can be taken without food and is the supplement of choice for individuals with achlorhydria or who are taking histamine-2 blockers or protein-pump inhibitors. Calcium lactate and calcium gluconate are less concentrated forms of calcium and are not practical oral supplements. Research on hydroxyapatite as a source of calcium is limited, so this form of calcium is not recommended. The maximum dose of elemental calcium that should be taken at a time is 500 mg. U.S. Pharmacopeia-verified calcium supplements meet vigorous manufacturing and quality requirements. Absorption from calcium-fortified beverages varies and in general is not equal to that of milk. Potential adverse effects of calcium supplementation include gastrointestinal complaints. Renal calculi in most studies have not been associated with calcium supplementation. The risk of advanced and fatal prostate cancer has been associated with calcium intakes from food or supplements in amounts >1500 mg/d.

摘要

大多数美国人钙的摄入量未达到适宜摄入量(AI);补钙剂有助于满足需求。已发现补钙对儿童、年轻人和绝经后女性的骨骼健康有益。除钙外,维生素D对骨骼健康也是必需的,而在工业化国家普遍缺乏。碳酸盐钙和枸橼酸钙是最常见的补钙剂形式。碳酸钙是最具成本效益的形式,应与食物一起服用以确保最佳吸收。枸橼酸钙可以空腹服用,是胃酸缺乏者或正在服用组胺-2受体阻滞剂或质子泵抑制剂者的首选补充剂。乳酸钙和葡萄糖酸钙的钙含量较低,不是实用的口服补充剂。关于羟基磷灰石作为钙源的研究有限,因此不推荐这种钙形式。一次服用元素钙的最大剂量为500毫克。美国药典认证的补钙剂符合严格的生产和质量要求。强化钙饮料的钙吸收情况各不相同,总体上不如牛奶。补钙的潜在不良反应包括胃肠道不适。在大多数研究中,肾结石与补钙无关。每日从食物或补充剂中摄入钙量>1500毫克会增加晚期和致命前列腺癌的风险。

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