Hantikainen Essi, Grotta Alessandra, Ye Weimin, Adami Hans-Olov, Surkan Pamela J, Serafini Mauro, Michaëlsson Karl, Bellocco Rino, Trolle Lagerros Ylva
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Box 281, 171 77 Stockholm, Sweden.
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Box 281, 171 77 Stockholm, Sweden; Department of Epidemiology, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA.
Bone. 2016 Sep;90:31-6. doi: 10.1016/j.bone.2016.05.006. Epub 2016 May 27.
Dietary antioxidants may play an important role in the prevention of bone loss and associated fractures by reducing levels of oxidative stress. We prospectively investigated the association between dietary Non Enzymatic Antioxidant Capacity (NEAC) and the risk of hip fracture and whether this effect was modified by smoking.
In the Swedish National March Cohort 13,409 men and women over the age of 55 who had not experienced cancer, cardiovascular disease or hip fracture, were followed through record-linkages from 1997 through 2010. NEAC was assessed by a validated food frequency questionnaire collected at baseline. We categorized the distribution of NEAC into sex-specific quartiles and used multivariable adjusted Cox proportional hazards regression models to estimate hazard ratios (HRs) with 95% confidence intervals (95% CI).
During a mean follow-up time of 12.4years, we identified 491 incident cases of first hip fracture. Subjects in the highest quartile of dietary NEAC had a 39% lower risk of incident hip fracture compared to those in the lowest quartile (HR: 0.61; 95% CI: 0.44-0.85). The association was non-linear (p for non-linearity: 0.004) with a potential threshold between the first and the second quartile and no further risk reduction at higher levels of dietary NEAC. Due to a low smoking prevalence in our study population, we had limited power to detect effect modification between dietary NEAC and smoking on a multiplicative or additive scale.
Higher dietary NEAC intake is associated with lower risk of hip fracture in the elderly.
膳食抗氧化剂可能通过降低氧化应激水平在预防骨质流失及相关骨折方面发挥重要作用。我们前瞻性地研究了膳食非酶抗氧化能力（NEAC）与髋部骨折风险之间的关联，以及这种效应是否会因吸烟而改变。
在瑞典国家三月队列研究中，对13409名年龄在55岁以上、未患癌症、心血管疾病或髋部骨折的男性和女性进行了从1997年至2010年的记录链接随访。通过在基线时收集的经过验证的食物频率问卷评估NEAC。我们将NEAC的分布按性别分为四分位数，并使用多变量调整的Cox比例风险回归模型来估计风险比（HRs）及95%置信区间（95%CI）。
在平均12.4年的随访期内，我们确定了491例首次髋部骨折的发病病例。膳食NEAC最高四分位数的受试者与最低四分位数的受试者相比，发生髋部骨折的风险降低了39%（HR：0.61；95%CI：0.44 - 0.85）。这种关联是非线性的（非线性p值：0.004），在第一和第二四分位数之间存在潜在阈值，在更高的膳食NEAC水平下风险没有进一步降低。由于我们研究人群中的吸烟率较低，我们检测膳食NEAC与吸烟之间在乘法或加法尺度上的效应修饰的能力有限。
老年人摄入较高的膳食NEAC与较低的髋部骨折风险相关。
