Vernia Piero, Loizos Panagiotis, Di Giuseppantonio Irene, Amore Barbara, Chiappini Ambra, Cannizzaro Santi
Dipartimento di Medicina Interna e Specialità Mediche, Sapienza Università di Roma, Rome, Italy.
Dipartimento di Medicina Interna e Specialità Mediche, Sapienza Università di Roma, Rome, Italy.
J Crohns Colitis. 2014 Apr;8(4):312-7. doi: 10.1016/j.crohns.2013.09.008. Epub 2013 Oct 3.
BACKGROUND & AIMS: Osteopenia and increased risk for fractures in IBD result from several factors.
To investigate the dietary intake of calcium in IBD patients.
A 22-item quantitative validated frequency food questionnaire was used for quantifying dietary calcium in relation to gender and age, in 187 IBD patients, 420 normal- and 276 diseased controls.
Mann-Whitney, chi-square- and T-tests.
The mean calcium intake was 991.0 ± 536.0 (105.8% Recommended Daily Allowances) and 867.6 ± 562.7 SD mg/day (93.8% RDA) in healthy and diseased controls, and 837.8 ± 482.0 SD mg/day (92.7% RDA) in IBD, P<0.001. Calcium intake was high in celiac disease (1165.7 ± 798.8 SD mg/day, 120% RDA), and non-significantly lower in ulcerative colitis than in Crohn's disease (798.7 ± 544.1 SD mg/day vs 881.9 ± 433.0). CD and UC females, but not males, had a mean calcium intake well under RDA. In all study groups the intake was lower in patients believing that consumption of lactose-containing food induced symptoms, versus those who did not (105.8% vs 114.3% RDA in normal controls; 100.4% vs 87.6% RDA in IBD).
Diet in IBD patients contained significantly less calcium than in healthy controls. Gender and age, more than diagnosis, are central in determining inadequate calcium intake, more so in IBD. Self-reported lactose intolerance, leading to dietary restrictions, is the single major determinant of low calcium intake. Inadequate calcium intake is present in one third of IBD patients and represents a reversible risk factor for osteoporosis, suggesting the need for tailored nutritional advice in IBD.
炎症性肠病（IBD）患者出现骨质减少和骨折风险增加是由多种因素导致的。
调查IBD患者的钙膳食摄入量。
采用一份经过验证的包含22个项目的定量食物频率问卷，对187例IBD患者、420例正常对照者和276例疾病对照者的膳食钙摄入量按性别和年龄进行量化。
采用曼-惠特尼检验、卡方检验和t检验。
健康对照者和疾病对照者的平均钙摄入量分别为991.0±536.0（占推荐每日摄入量的105.8%）和867.6±562.7标准差毫克/天（占推荐每日摄入量的93.8%），IBD患者为837.8±482.0标准差毫克/天（占推荐每日摄入量的92.7%），P<0.001。乳糜泻患者的钙摄入量较高（1165.7±798.8标准差毫克/天，占推荐每日摄入量的120%），溃疡性结肠炎患者的钙摄入量略低于克罗恩病患者，但差异无统计学意义（798.7±544.1标准差毫克/天对881.9±433.0）。IBD女性患者（而非男性患者）的平均钙摄入量远低于推荐每日摄入量。在所有研究组中，认为食用含乳糖食物会引发症状的患者的钙摄入量低于不这么认为的患者（正常对照者中分别为占推荐每日摄入量的105.8%对114.3%；IBD患者中分别为占推荐每日摄入量的100.4%对87.6%）。
IBD患者饮食中的钙含量显著低于健康对照者。在决定钙摄入量不足方面，性别和年龄比疾病诊断更为关键，在IBD患者中更是如此。自我报告的乳糖不耐受导致饮食限制，是钙摄入量低的唯一主要决定因素。三分之一的IBD患者存在钙摄入不足的情况，这是骨质疏松症的一个可逆转风险因素，提示IBD患者需要针对性的营养建议。
