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牛奶和钙补充对中国孕妇骨密度和骨转换的影响:一项随机对照试验。

Effect of milk and calcium supplementation on bone density and bone turnover in pregnant Chinese women: a randomized controlled trail.

机构信息

Department of Nutrition, School of Public Health, Sun Yat-sen University, Guangzhou, China.

出版信息

Arch Gynecol Obstet. 2011 Feb;283(2):205-11. doi: 10.1007/s00404-009-1345-0. Epub 2010 Jan 1.

Abstract

OBJECTIVE

Calcium demand is increased during pregnancy. However, few randomized controlled trials examined the effects of calcium supplementation on bone mass during pregnancy. This study determined effects of calcium and milk supplementation on maternal bone mineral density (BMD) and bone turnover in pregnant Chinese women with habitual low calcium intake.

METHODS

In this randomized controlled trial, 36 Chinese pregnant women (24-31 years, 18 gestational weeks) were randomly assigned to the following three arms (12 each): I, usual diet; II, "I" + 45 g milk powder (containing 350 mg calcium); or III, "II" + 600 mg calcium/day from gestational age of 20 weeks to 6 weeks post-partum (PP). BMD was measured post-treatment using dual-energy X-ray absorptiometry. Dietary intakes, 24-h urinary calcium, bone resorption (urinary hydroxyproline) and formation (serum osteocalcin) biomarkers were examined at the gestational age of 20 and 34 weeks, and 6 weeks PP.

RESULTS

A dose-dependent relationship was observed between calcium intake and BMDs. The BMD values were significantly higher in subjects with calcium and milk supplementation than those in the controls at the whole body and spine (p < 0.05) but not at the hip sites. We found significant decreases in changes of urinary hydroxyproline, and significant increases in serum osteocalcin during the intervention period in the calcium/milk intervention groups than those in the control group (all p < 0.05).

CONCLUSION

Calcium/milk supplementation during pregnancy is associated with greater BMD at the spine and whole body and suppresses bone resorption in Chinese women with habitual low calcium intake.

摘要

目的

孕期钙需求增加。然而,很少有随机对照试验研究钙补充对孕期骨量的影响。本研究旨在探讨钙和牛奶补充对习惯性低钙摄入的中国孕妇的母体骨密度(BMD)和骨转换的影响。

方法

在这项随机对照试验中,36 名中国孕妇(24-31 岁,18 孕周)被随机分为以下三组(每组 12 人):I 组,常规饮食;II 组,“I”+45 克奶粉(含 350 毫克钙);或 III 组,从妊娠 20 周到产后 6 周(PP)每天补充 600 毫克钙。治疗后采用双能 X 线吸收法测量 BMD。在妊娠 20 周、34 周和产后 6 周时检测膳食摄入量、24 小时尿钙、骨吸收(尿羟脯氨酸)和形成(血清骨钙素)生物标志物。

结果

钙摄入量与 BMD 值呈剂量依赖性关系。钙和牛奶补充组的全身和脊柱 BMD 值明显高于对照组(p<0.05),但髋部 BMD 值无显著差异。我们发现,在干预期间,钙/牛奶干预组的尿羟脯氨酸变化明显减少,血清骨钙素明显增加,而对照组则没有(均 p<0.05)。

结论

孕期钙和牛奶补充与习惯性低钙摄入的中国孕妇脊柱和全身 BMD 增加有关,并抑制骨吸收。

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