Department of Internal Medicine, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam.
Eur J Clin Nutr. 2012 Jan;66(1):75-82. doi: 10.1038/ejcn.2011.131. Epub 2011 Aug 3.
BACKGROUND/OBJECTIVES: The effect of vegan diet on bone loss has not been studied. The aim of this study was to examine the association between veganism and bone loss in postmenopausal women.
SUBJECTS/METHODS: The study was designed as a prospective longitudinal investigation with 210 women, including 105 vegans and 105 omnivores. Femoral neck (FN) bone mineral density (BMD) was measured in 2008 and 2010 by dual-energy X-ray absorptiometry (Hologic QDR4500). The incidence of vertebral fracture was ascertained by X-ray report. Serum levels of C-terminal telopeptide of type I collagen (βCTX) and N-terminal propeptide of type I procollagen (PINP) were measured by Roche Elecsys assays. Serum concentration of 25-hydroxyvitamin D and parathyroid hormone were measured by electrochemiluminescence.
Among the 210 women who initially participated in the study in 2008, 181 women had completed the study and 29 women were lost to follow-up. The rate of loss in FN BMD was -1.91±3.45%/year in omnivores and -0.86±3.81%/year (P=0.08) in vegans. Lower body weight, higher intakes of animal protein and lipid, and corticosteroid use were associated with greater rate of bone loss. The 2-year incidence of fracture was 5.7% (n=5/88) in vegans, which was not significantly different from omnivores (5.4%, n=6/93). There were no significant differences in βCTX and PINP between vegans and omnivores. The prevalence of vitamin D insufficiency in vegans was higher than in omnivores (73% versus 46%; P=0.0003).
Vegan diet did not have adverse effect on bone loss and fracture. Corticosteroid use and high intakes of animal protein and animal lipid were negatively associated with bone loss.
背景/目的：素食对骨质流失的影响尚未得到研究。本研究旨在探讨素食与绝经后妇女骨质流失的关系。
本研究设计为前瞻性纵向研究，纳入 210 名女性，包括 105 名素食者和 105 名杂食者。采用双能 X 线吸收法（Hologic QDR4500）于 2008 年和 2010 年测量股骨颈（FN）骨密度（BMD）。通过 X 射线报告确定椎骨骨折的发生率。采用罗氏 Elecsys 测定血清 I 型胶原 C 端肽（βCTX）和 I 型前胶原 N 端肽（PINP）水平。采用电化学发光法测量血清 25-羟维生素 D 和甲状旁腺激素浓度。
在 2008 年最初参加研究的 210 名女性中，有 181 名完成了研究，29 名失访。杂食者 FN BMD 的丢失率为-1.91±3.45%/年，素食者为-0.86±3.81%/年（P=0.08）。较低的体重、较高的动物蛋白和脂质摄入量以及皮质类固醇的使用与更大的骨丢失率相关。素食者 2 年骨折发生率为 5.7%（n=5/88），与杂食者（5.4%，n=6/93）无显著差异。素食者和杂食者之间的βCTX 和 PINP 无显著差异。素食者维生素 D 不足的患病率高于杂食者（73%比 46%；P=0.0003）。
素食饮食对骨质流失和骨折没有不良影响。皮质类固醇的使用以及动物蛋白和动物脂质的高摄入量与骨质流失呈负相关。
