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健康非骨质疏松老年男性补钙的随机对照试验

Randomized controlled trial of calcium supplementation in healthy, nonosteoporotic, older men.

作者信息

Reid Ian R, Ames Ruth, Mason Barbara, Reid Helen E, Bacon Catherine J, Bolland Mark J, Gamble Gregory D, Grey Andrew, Horne Anne

机构信息

Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland, New Zealand.

出版信息

Arch Intern Med. 2008 Nov 10;168(20):2276-82. doi: 10.1001/archinte.168.20.2276.

Abstract

BACKGROUND

There is no consistent evidence, to our knowledge, that calcium supplementation affects bone mineral density (BMD) in men, despite male osteoporosis being a common clinical problem.

METHODS

To determine the effects of calcium supplementation (600 mg/d, 1200 mg/d, or placebo) on BMD in men, we conducted a double-blind, randomized controlled trial for a 2-year period at an academic clinical research center. A total of 323 healthy men at least 40 years old (mean age, 57 years) were recruited by newspaper advertisement. Complete follow-up was achieved in 96% of subjects.

RESULTS

The BMD increased at all sites in the group receiving calcium, 1200 mg/d, by 1% to 1.5% more than those receiving placebo. The results for the group receiving calcium, 600 mg/d, were not different from the placebo group at any BMD site. There was no interaction between the BMD treatment effect and either age or dietary calcium intake. There were dosage-related, sustained decreases in serum parathyroid hormone (P < .001), total alkaline phosphatase activity (P = .01), and procollagen type 1 N-terminal propeptide (P < .001) amounting to 25%, 8%, and 20%, respectively, in the group receiving calcium, 1200 mg/d, at 2 years. Tooth loss, constipation, and cramps were unaffected by calcium supplementation, falls tended to be less frequent in the group receiving calcium, 1200 mg/d, but vascular events tended to be more common in the groups receiving calcium vs the group receiving placebo.

CONCLUSION

Calcium, 1200 mg/d, has effects on BMD in men comparable with those found in postmenopausal women but a dosage of 600 mg/d is ineffective for treating BMD.

TRIAL REGISTRATION

actr.org.au Identifier: 012605000274673.

摘要

背景

据我们所知,尽管男性骨质疏松是一个常见的临床问题,但尚无一致证据表明补钙会影响男性的骨矿物质密度(BMD)。

方法

为了确定补钙(600毫克/天、1200毫克/天或安慰剂)对男性骨密度的影响,我们在一个学术临床研究中心进行了一项为期2年的双盲随机对照试验。通过报纸广告招募了总共323名至少40岁(平均年龄57岁)的健康男性。96%的受试者完成了随访。

结果

接受1200毫克/天钙的组中,所有部位的骨密度均有所增加,比接受安慰剂的组高出1%至1.5%。接受600毫克/天钙的组在任何骨密度部位的结果与安慰剂组均无差异。骨密度治疗效果与年龄或饮食钙摄入量之间均无相互作用。在接受1200毫克/天钙的组中,2年后血清甲状旁腺激素(P < 0.001)、总碱性磷酸酶活性(P = 0.01)和1型前胶原N端前肽(P < 0.001)出现与剂量相关的持续下降,分别下降了25%、8%和20%。牙齿脱落、便秘和抽筋不受补钙影响,接受1200毫克/天钙的组跌倒倾向较少,但接受钙的组与接受安慰剂的组相比,血管事件往往更常见。

结论

每天1200毫克钙对男性骨密度的影响与绝经后女性相似,但每天600毫克的剂量对治疗骨密度无效。

试验注册

actr.org.au标识符:012605000274673。

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