Avendaño-Badillo Diana, Hernández-Avila Mauricio, Hernández-Cadena Leticia, Rueda-Hernández Gabriela, Solano-González Maritsa, Ibarra Luis G, Hu Howard, Téllez-Rojo Martha M
National Institute of Rehabilitation, Mexico.
Salud Publica Mex. 2009;51 Suppl 1:S100-7. doi: 10.1590/s0036-36342009000700013.
Calcium metabolism of the mother is modified during pregnancy because of the mineralization of the fetus skeleton.
To evaluate the association of calcium intake and bone demineralization during pregnancy.
At each trimester of pregnancy a validated food frequency intake questionnaire was administered to assess individual daily calcium intake in a cohort of 206 pregnant women, residents of Mexico City. Samples of urine were collected to measure levels of the cross-linked N-telopeptide of type I collagen (NTx), which is a biomarker of bone resorption. The association between calcium ingestion and bone resorption was analyzed using random effects models; non-linear associations were explored using generalized additive models.
Progressive increases in NTx levels were observed during pregnancy; with mean and standard deviation (SD) values during the first, second and third trimester of 76.50 (SD=38), 101.02 (SD=48.86) and 144.83 (SD=61.33) nmol BCE/mmol creatinine, respectively. Higher dietary calcium intake was associated with lower bone resorption (beta=-0.015; p<0.05). The association between age and NTx showed a non-linear trend with an inflexion point around 33 years: increase in maternal age below that point was associated with a decrease in bone resorption, while in older women the increase in age was associated with an increased resorption.
Our results suggest that calcium ingestion, specifically from dairy products, reduces bone resorption during pregnancy. For each 300 mg (a glass of milk) of calcium intake there is an estimated reduction in NTx level of 4.8 nmol BCE/mmol of creatinine (p<0.05).
由于胎儿骨骼的矿化,孕期母亲的钙代谢会发生改变。
评估孕期钙摄入量与骨质脱矿之间的关联。
在孕期的每个阶段,对墨西哥城的206名孕妇进行有效食物频率摄入问卷调查,以评估个体每日钙摄入量。收集尿液样本以测量I型胶原交联N-端肽(NTx)水平,NTx是骨吸收的生物标志物。使用随机效应模型分析钙摄入与骨吸收之间的关联;使用广义相加模型探索非线性关联。
孕期观察到NTx水平逐渐升高;妊娠第一、第二和第三阶段的平均值及标准差(SD)分别为76.50(SD = 38)、101.02(SD = 48.86)和144.83(SD = 61.33)nmol BCE/mmol肌酐。较高的膳食钙摄入量与较低的骨吸收相关(β = -0.015;p < 0.05)。年龄与NTx之间的关联呈非线性趋势,拐点约为33岁:低于该年龄的孕妇年龄增加与骨吸收减少相关,而年龄较大的女性年龄增加与骨吸收增加相关。
我们的结果表明,钙摄入,特别是来自乳制品的钙摄入,可减少孕期的骨吸收。每摄入300毫克(一杯牛奶)钙,估计NTx水平可降低4.8 nmol BCE/mmol肌酐(p < 0.05)。