Rasch L A, de van der Schueren M A E, van Tuyl L H D, Bultink I E M, de Vries J H M, Lems W F
Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, Location VU University Medical Center, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands.
Department of Nutrition and Dietetics, VU University Medical Center, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands.
Calcif Tissue Int. 2017 Mar;100(3):271-277. doi: 10.1007/s00223-016-0221-8. Epub 2017 Jan 12.
Calcium supplements are prescribed for prevention of osteoporotic fractures, but there is controversy whether excess of calcium intake is associated with cardiovascular events. While an accurate estimation of dietary calcium intake is a prerequisite to prescribe the adequate amount of supplementation, the most adequate tools for estimating intake are time-consuming. The aim of this study is to validate a short calcium intake list (SCaIL) that is feasible in daily clinical practice.
Based on the food groups contributing most to daily dietary calcium intake and portion sizes determined in an earlier study, a three-item, 1-min SCaIL was designed. As a reference method, an extensive dietary history (DH) with specific focus on calcium-rich foods and extra attention for portion sizes was performed. Beforehand, a difference of ≥250 mg calcium between both methods was considered clinically relevant.
Sixty-six patients with either primary (n = 40) or secondary (n = 26) osteoporosis were included. On average, the SCaIL showed a small and clinically non-relevant difference in calcium intake with the DH: 24 ± 350 mg/day (1146 ± 440 vs. 1170 ± 485 mg, respectively; p = 0.568). Sensitivity and specificity of the SCaIL, compared to the DH, were 73 and 80%, respectively. However, in 50% of the individuals, a clinically relevant difference of ≥250 mg calcium was observed between both methods, while in 17% this was even ≥500 mg.
The SCaIL is a quick and easy questionnaire to estimate dietary calcium intake at a group level, but is not sufficiently reliable for use in individual patients. Remarkably, the mean dietary calcium intake estimated by the DH of 1170 mg/day indicates that a large proportion of osteoporosis patients might not even need calcium supplementation, although more data are needed to confirm this finding.
钙补充剂被用于预防骨质疏松性骨折，但钙摄入量过多是否与心血管事件相关仍存在争议。虽然准确估计膳食钙摄入量是开具适量补充剂的前提，但估计摄入量的最适当工具耗时较长。本研究的目的是验证一种在日常临床实践中可行的简短钙摄入量清单（SCaIL）。
基于先前研究中确定的对每日膳食钙摄入量贡献最大的食物组和份量，设计了一个包含三项、耗时1分钟的SCaIL。作为参考方法，进行了广泛的饮食史（DH）调查，特别关注富含钙的食物，并对份量给予额外关注。事先，两种方法之间钙含量差异≥250毫克被认为具有临床相关性。
纳入了66例原发性（n = 40）或继发性（n = 26）骨质疏松症患者。平均而言，SCaIL显示与DH相比，钙摄入量存在微小且无临床相关性的差异：分别为24±350毫克/天（分别为1146±440毫克和1170±485毫克；p = 0.568）。与DH相比，SCaIL的敏感性和特异性分别为73%和80%。然而，在50%的个体中，两种方法之间观察到钙含量具有临床相关性的差异≥250毫克，而在17%的个体中差异甚至≥500毫克。
SCaIL是一种快速简便的问卷，可在群体水平上估计膳食钙摄入量，但在个体患者中使用不够可靠。值得注意的是，DH估计的平均膳食钙摄入量为1170毫克/天，这表明很大一部分骨质疏松症患者可能甚至不需要补钙，尽管需要更多数据来证实这一发现。
