Sowers M F, Clark M K, Jannausch M L, Wallace R B
Department of Epidemiology, University of Michigan, Ann Arbor.
Am J Epidemiol. 1991 Apr 1;133(7):649-60. doi: 10.1093/oxfordjournals.aje.a115940.
In 1983/1984, a study of bone mass and fractures was begun in 827 women aged 20-80 years in three rural Iowa communities selected for the fluoride and calcium content of their community water supplies. The control community's water had a calcium content of 67 mg/liter and a fluoride content of 1 mg/liter. The higher-calcium community had water with a calcium content of 375 mg/liter and a fluoride content of 1 mg/liter. The higher-fluoride community's water had 15 mg/liter of calcium and 4 mg/liter of fluoride naturally occurring. In 1988/1989, a follow-up study characterized the 684 women still living and available for study. Residence in the higher-fluoride community was associated with a significantly lower radial bone mass in premenopausal and postmenopausal women, an increased rate of radial bone mass loss in premenopausal women, and significantly more fractures among postmenopausal women. There was no difference in the 5-year relative risk of any fracture in the higher-calcium community versus the control community; however, the relative risk was 2.1 (95% confidence interval (CI) 1.0-4.4) in women in the higher-fluoride community compared with women in the control community. There was no difference in the 5-year risk of wrist, spine, or hip fracture in the higher-calcium community versus the control community; however, the 5-year relative risk for women in the higher-fluoride community, compared with women in the control community, was 2.2 (95% CI 1.1-4.7). Estimates of risk were adjusted for age and body size.
1983年至1984年期间，在爱荷华州三个农村社区开展了一项针对827名年龄在20至80岁女性的骨量与骨折情况的研究，这些社区是根据其社区供水的氟化物和钙含量挑选出来的。对照社区的水钙含量为67毫克/升，氟化物含量为1毫克/升。高钙社区的水钙含量为375毫克/升，氟化物含量为1毫克/升。高氟社区的水中天然含有15毫克/升的钙和4毫克/升的氟化物。1988年至1989年，一项随访研究对仍在世且可供研究的684名女性进行了特征描述。居住在高氟社区与绝经前和绝经后女性桡骨骨量显著降低、绝经前女性桡骨骨量流失率增加以及绝经后女性骨折显著增多有关。高钙社区与对照社区在任何骨折的5年相对风险方面没有差异；然而，与对照社区的女性相比，高氟社区女性的相对风险为2.1（95%置信区间（CI）1.0 - 4.4）。高钙社区与对照社区在手腕、脊柱或髋部骨折的5年风险方面没有差异；然而，与对照社区的女性相比，高氟社区女性的5年相对风险为2.2（95% CI 1.1 - 4.7）。风险估计已根据年龄和体型进行了调整。
