Division of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, WHO Collaborating Center for Osteoporosis Prevention, Geneva, Switzerland.
J Nutr. 2012 Apr;142(4):698-703. doi: 10.3945/jn.111.153692. Epub 2012 Feb 22.
The prevention of increased bone remodeling in postmenopausal women at low 10-y risk of osteoporotic fractures essentially relies on reinforcement of environmental factors known to positively influence bone health, among which nutrition plays an important role. In institutionalized women in their mid-eighties, we previously found that consumption of fortified soft plain cheese increased vitamin D, calcium, and protein intakes, reduced bone resorption biochemical markers, particularly the serum bone specific acid phosphatase tartrate resistant acid phosphatase, isoform 5b (TRAP 5b) that reflects osteoclast activity, and stimulated the serum bone anabolic factor insulin-like growth factor-I (IGF-I). Whether these effects occur in much younger women was tested in a prospective control study. Seventy-one healthy postmenopausal women aged 56.6 ± 3.9 y (mean ± SD) with low spontaneous supply of both Ca and vitamin D were randomized to consume daily (treated, n = 36) or not (controls, n = 35) two servings (2 × 100 g) of skimmed-milk, soft plain cheese for 6 wk. The vitamin D and Ca-fortified dairy product provided daily: 661 kJ, 2.5 μg vitamin D, 400 mg calcium, and 13.8 g protein. At the end of the intervention, the decrease in TRAP 5b and the increase in IGF-I were greater in the treated than in the control group (P < 0.02). The changes in serum carboxy terminal crosslinked telopeptide of type I collagen did not differ significantly between the two groups. In conclusion, like in elderly women, consumption by healthy postmenopausal women of a vitamin D and calcium-fortified dairy product that also increases the protein intake, reduces the serum concentration of the bone resorption biomarker TRAP 5b. This response, combined with the increase in serum IGF-I, is compatible with a nutrition-induced reduction in postmenopausal bone loss rate.
绝经后女性骨质疏松骨折 10 年风险低的情况下，增加骨重塑的预防主要依赖于强化已知对骨骼健康有积极影响的环境因素，其中营养起着重要作用。在 80 多岁的机构化女性中，我们之前发现，食用强化软质原味奶酪可增加维生素 D、钙和蛋白质的摄入量，减少骨吸收生化标志物，特别是血清骨特异性酸性磷酸酶抗酒石酸酸性磷酸酶 5b（TRAP 5b），它反映了破骨细胞的活性，并刺激了血清骨合成代谢因子胰岛素样生长因子-I（IGF-I）。这些作用是否发生在更年轻的女性中，我们在一项前瞻性对照研究中进行了测试。71 名健康的绝经后女性，年龄 56.6 ± 3.9 岁（均值 ± 标准差），钙和维生素 D 自发供应低，随机分为每日食用（治疗组，n = 36）或不食用（对照组，n = 35）两份脱脂牛奶、软质原味奶酪，持续 6 周。强化维生素 D 和钙的乳制品每天提供：661 kJ、2.5 μg 维生素 D、400 mg 钙和 13.8 g 蛋白质。干预结束时，与对照组相比，治疗组的 TRAP 5b 降低和 IGF-I 升高更为明显（P < 0.02）。两组间血清Ⅰ型胶原羧基末端交联肽的变化无显著差异。结论：与老年女性一样，健康绝经后女性食用强化维生素 D 和钙的乳制品也可增加蛋白质的摄入量，降低血清骨吸收生物标志物 TRAP 5b 的浓度。这种反应，结合 IGF-I 的增加，与营养诱导的绝经后骨丢失率降低是一致的。
