Kim Kyoung Min, Choi Sung Hee, Lim Soo, Moon Jae Hoon, Kim Jung Hee, Kim Sang Wan, Jang Hak Chul, Shin Chan Soo
Department of Internal Medicine (K.M.K., S.H.C., S.L., J.H.M., H.C.J.), Seoul National University Bundang Hospital and Seoul National University College of Medicine, Seongnam 137-761, Korea; Department of Internal Medicine (J.H.K., C.S.S.), Seoul National University Hospital and Seoul National University College of Medicine, Seoul 110-744, Korea; and Department of Internal Medicine (S.W.K.), Borame Hospital and Seoul National University College of Medicine, Seoul 156-707, Korea.
J Clin Endocrinol Metab. 2014 Jul;99(7):2409-17. doi: 10.1210/jc.2014-1006. Epub 2014 Mar 31.
Little is known about the interactions between dietary calcium intake and bone strength parameters in populations or areas with low calcium intake.
The objective of the study was to investigate the relationship between dietary calcium intake and bone mineral density (BMD) or bone geometry in an Asian population with low calcium intake.
This was a cross-sectional study of data from the Korea National Health and Nutrition Examination Survey, 2008-2010.
A total of 3448 men and 3812 women older than 50 years were stratified by daily dietary calcium intake: less than 400 mg/d, 400-799 mg/d, 800-1199 mg/d, and 1200 mg/d or greater.
BMD was measured by dual-energy X-ray absorptiometry and the geometric index was calculated.
Mean daily calcium intake was 470 mg/d in this population. BMD in the lumbar spine (both sexes) and femoral neck (women) was significantly lower only when calcium intake was less than 400 mg/d. In men, femoral neck and total hip BMD was positively related to calcium intake up to 1200 mg/d. Calcium intake less than 400 mg/d was negatively related to femoral cortical thickness and buckling ratio. These interactions disappeared when the 25-hydroxyvitamin D level was 30 ng/mL or greater in men and 20 ng/mL or greater in women.
Low calcium intake was significantly related with low BMD and increased risk of osteoporosis. However, the association between calcium and BMD was not consistently linear, and a sufficient vitamin D level appears to compensate for the negative influences of low calcium intake on bone.
在钙摄入量低的人群或地区，饮食钙摄入量与骨强度参数之间的相互作用鲜为人知。
本研究旨在调查钙摄入量低的亚洲人群中饮食钙摄入量与骨密度（BMD）或骨几何结构之间的关系。
这是一项对2008 - 2010年韩国国民健康与营养检查调查数据的横断面研究。
共有3448名50岁以上男性和3812名50岁以上女性按每日饮食钙摄入量分层：低于400毫克/天、400 - 799毫克/天、800 - 1199毫克/天以及1200毫克/天及以上。
采用双能X线吸收法测量骨密度，并计算几何指数。
该人群的平均每日钙摄入量为470毫克/天。仅当钙摄入量低于400毫克/天时，腰椎（男女）和股骨颈（女性）的骨密度显著降低。在男性中，股骨颈和全髋骨密度与钙摄入量在1200毫克/天以内呈正相关。钙摄入量低于400毫克/天与股骨皮质厚度和屈曲比呈负相关。当男性25 - 羟基维生素D水平达到30纳克/毫升或更高、女性达到20纳克/毫升或更高时，这些相互作用消失。
低钙摄入量与低骨密度和骨质疏松风险增加显著相关。然而，钙与骨密度之间的关联并非始终呈线性，充足的维生素D水平似乎可以弥补低钙摄入量对骨骼的负面影响。
