Mayo Clinic, Scottsdale, AZ 85259, USA.
J Am Board Fam Med. 2009 Nov-Dec;22(6):610-6. doi: 10.3122/jabfm.2009.06.080217.
The use of oral calcium supplementation among the elderly for prevention and treatment of osteoporosis and osteopenia is increasing. The incidence of aortic valve disease and coronary artery disease also is increasing. No study thus far has been done to demonstrate whether this affects the progression of calcification in both the valves and vasculature. We sought to determine whether ingestion of oral calcium supplementation has an effect on aortic valve calcification (AVC) and coronary artery calcification (CAC).
We performed an independent assessment of AVC, CAC, and calcium supplementation among patients enrolled in the Epidemiology of Coronary Artery Calcification study who were >60 years of age and had baseline and 4-year follow-up AVC data. In this population-based study of Olmsted County (Minnesota) residents, AVC and CAC scores were determined prospectively by electron beam computed tomography. We evaluated baseline demographic data and analyzed whether those patients using calcium supplementation had a higher rate of progression of both AVC and CAC.
We identified 257 patients (mean age, 67.8+/-5.2 years), 144 of whom were women. Twenty-five patients (all women) reported using calcium supplements. Analysis of the 144 women (25 taking calcium supplementation) showed there was no difference in the progression of AVC (mean difference in baseline and follow-up AVC score; no supplement versus supplement, 30+/-9 vs 39+/-28; P=.73) or CAC (mean difference in baseline and follow-up CAC score; no supplement vs supplement, 47+/-15 vs 112+/-22; P=.154). There were no significant differences between the 2 groups with regard to baseline AVC, serum calcium, renal function, diabetes, hypertension, cholesterol, or body mass index.
In this community-based observational study with a 4-year follow-up, no significant increased progression of AVC or CAC was found in women taking oral calcium supplementation. Larger prospective, randomized studies are needed to confirm these findings.
老年人使用口服钙剂来预防和治疗骨质疏松症和低骨量症的情况越来越多。主动脉瓣疾病和冠状动脉疾病的发病率也在增加。迄今为止,尚无研究表明这是否会影响瓣膜和血管的钙化进展。我们试图确定口服钙剂的摄入是否会影响主动脉瓣钙化(AVC)和冠状动脉钙化(CAC)。
我们对参与冠状动脉钙化流行病学研究的患者进行了独立的 AVC、CAC 和钙补充剂评估,这些患者年龄>60 岁,并且具有基线和 4 年随访的 AVC 数据。在这项基于人群的明尼苏达州奥姆斯特德县(Olmsted County)居民研究中,通过电子束计算机断层扫描前瞻性地确定了 AVC 和 CAC 评分。我们评估了基线人口统计学数据,并分析了使用钙补充剂的患者是否具有更高的 AVC 和 CAC 进展率。
我们确定了 257 名患者(平均年龄 67.8±5.2 岁),其中 144 名为女性。25 名患者(均为女性)报告使用了钙补充剂。对 144 名女性(25 名服用钙补充剂)的分析表明,AVC 的进展没有差异(基线和随访时 AVC 评分的平均差异;无补充剂与补充剂,30±9 与 39±28;P=.73)或 CAC(基线和随访时 CAC 评分的平均差异;无补充剂与补充剂,47±15 与 112±22;P=.154)。两组之间在基线 AVC、血清钙、肾功能、糖尿病、高血压、胆固醇或体重指数方面没有显著差异。
在这项具有 4 年随访的基于社区的观察性研究中,服用口服钙剂的女性中未发现 AVC 或 CAC 的明显进展增加。需要进行更大的前瞻性、随机研究来证实这些发现。