女性钙补充剂的摄入量与心血管疾病风险
Calcium supplement intake and risk of cardiovascular disease in women.
作者信息
Paik J M, Curhan G C, Sun Q, Rexrode K M, Manson J E, Rimm E B, Taylor E N
机构信息
Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA,
出版信息
Osteoporos Int. 2014 Aug;25(8):2047-56. doi: 10.1007/s00198-014-2732-3. Epub 2014 May 7.
UNLABELLED
Some recent reports suggest that calcium supplement use may increase risk of cardiovascular disease. In a prospective cohort study of 74,245 women in the Nurses' Health Study with 24 years of follow-up, we found no independent associations between supplemental calcium intake and risk of incident coronary heart disease (CHD) and stroke.
INTRODUCTION
Some recent reports suggest that calcium supplements may increase cardiovascular disease (CVD) risk. The objective was to examine the independent associations between calcium supplement use and risk of CVD.
METHODS
We conducted a prospective cohort study of supplemental calcium use and incident CVD in 74,245 women in the Nurses' Health Study (1984-2008) free of CVD and cancer at baseline. Calcium supplement intake was assessed every 4 years. Outcomes were incident CHD (nonfatal or fatal MI) and stroke (ischemic or hemorrhagic), confirmed by medical record review.
RESULTS
During 24 years of follow-up, 4,565 cardiovascular events occurred (2,709 CHD and 1,856 strokes). At baseline, women who took calcium supplements had higher levels of physical activity, smoked less, and had lower trans fat intake compared with those who did not take calcium supplements. After multivariable adjustment for age, body mass index, dietary calcium, vitamin D intake, and other CVD risk factors, the relative risk of CVD for women taking >1,000 mg/day of calcium supplements compared with none was 0.82 (95% confidence interval [CI] 0.74 to 0.92; p for trend <0.001). For women taking >1,000 mg/day of calcium supplements compared with none, the multivariable-adjusted relative risk for CHD was 0.71 (0.61 to 0.83; p for trend < 0.001) and for stroke was 1.03 (0.87 to 1.21; p for trend = 0.61). The relative risks were similar in analyses limited to non-smokers, women without hypertension, and women who had regular physical exams.
CONCLUSIONS
Our findings do not support the hypothesis that calcium supplement intake increases CVD risk in women.
未标注
最近的一些报告表明，使用钙补充剂可能会增加心血管疾病的风险。在一项对护士健康研究中74245名女性进行的前瞻性队列研究中，经过24年的随访，我们发现补充钙的摄入量与冠心病（CHD）和中风的发病风险之间没有独立的关联。
引言
最近的一些报告表明，钙补充剂可能会增加心血管疾病（CVD）的风险。目的是研究使用钙补充剂与CVD风险之间的独立关联。
方法
我们对护士健康研究（1984 - 2008年）中74245名基线时无CVD和癌症的女性进行了一项关于补充钙使用情况和CVD发病情况的前瞻性队列研究。每4年评估一次钙补充剂的摄入量。通过病历审查确认的结局为冠心病（非致命性或致命性心肌梗死）和中风（缺血性或出血性）。
结果
在24年的随访期间，发生了4565例心血管事件（2709例冠心病和1856例中风）。在基线时，服用钙补充剂的女性比未服用钙补充剂的女性身体活动水平更高、吸烟更少且反式脂肪摄入量更低。在对年龄、体重指数、膳食钙、维生素D摄入量和其他CVD风险因素进行多变量调整后，每天服用超过1000毫克钙补充剂的女性与未服用者相比，CVD的相对风险为0.82（95%置信区间[CI]为0.74至0.92；趋势p值<0.001）。每天服用超过1000毫克钙补充剂的女性与未服用者相比，冠心病的多变量调整后相对风险为0.71（0.61至0.83；趋势p值<0.001），中风的相对风险为1.03（0.87至1.21；趋势p值 = 0.61）。在仅限于不吸烟者、无高血压女性和定期进行体检的女性的分析中，相对风险相似。
结论
我们的研究结果不支持钙补充剂摄入量会增加女性CVD风险这一假设。
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