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钙和维生素 D 补充 5 年对循环脂质变化的影响:来自妇女健康倡议的结果。

Effect of 5 y of calcium plus vitamin D supplementation on change in circulating lipids: results from the Women's Health Initiative.

机构信息

Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA.

出版信息

Am J Clin Nutr. 2010 Apr;91(4):894-9. doi: 10.3945/ajcn.2009.28579. Epub 2010 Feb 24.

Abstract

BACKGROUND

Dietary calcium and vitamin D intakes may be inversely associated with cardiovascular disease (CVD) risk, possibly because of their potential beneficial effects on circulating lipids. Clinical trials that have evaluated the effect of calcium supplementation on lipids are limited by a short follow-up, and data on vitamin D are scarce.

OBJECTIVE

The objective was to evaluate the effect of a longer-term effect (over 5 y) of calcium and vitamin D (CaD) supplementation on changes in the concentrations of several lipids: LDL, HDL, non-HDL, total cholesterol, triglycerides, and lipoprotein(a) [Lp(a)].

DESIGN

The study was conducted in 1259 postmenopausal women in the Calcium plus Vitamin D Trial (1 g elemental Ca as carbonate plus 400 IU vitamin D(3)/d compared with placebo) of the Women's Health Initiative. Analyses were conducted by intention-to-treat. Repeated measurements on lipids during follow-up were analyzed by linear mixed-effects models.

RESULTS

Overall, the change in lipids was relatively small [< or =5% except for Lp(a), which was 20-25%], and there was no significant difference in the mean change of any lipid variable between the active and placebo groups.

CONCLUSIONS

Our results indicate that CaD supplementation is not associated with lipid changes over 5 y. Existing and future CaD trials should consider evaluating this association for different doses of supplements. This study was registered at clinicaltrials.gov as NCT00000611.

摘要

背景

膳食钙和维生素 D 的摄入量与心血管疾病(CVD)风险呈负相关,这可能是因为它们对循环脂质有潜在的有益作用。评估钙补充剂对脂质影响的临床试验受到随访时间短的限制,而且关于维生素 D 的数据也很少。

目的

本研究旨在评估钙和维生素 D(CaD)补充剂的长期(5 年以上)作用对几种脂质浓度变化的影响:LDL、HDL、非-HDL、总胆固醇、甘油三酯和脂蛋白(a)[Lp(a)]。

设计

本研究在妇女健康倡议的钙加维生素 D 试验(1 g 元素钙作为碳酸盐加 400 IU 维生素 D(3)/d 与安慰剂相比)中进行,共有 1259 名绝经后妇女参与。通过意向治疗进行分析。通过线性混合效应模型分析随访期间脂质的重复测量值。

结果

总体而言,脂质的变化相对较小(<或=5%,除了 Lp(a)为 20-25%),且活性组和安慰剂组之间任何脂质变量的平均变化均无显著差异。

结论

我们的结果表明,CaD 补充剂与 5 年内的脂质变化无关。现有的和未来的 CaD 试验应考虑评估不同剂量补充剂的这种关联。本研究在 clinicaltrials.gov 上注册为 NCT00000611。

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