Kong Sung Hye, Kim Jung Hee, Hong A Ram, Cho Nam H, Shin Chan Soo
Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; and.
Department of Preventive Medicine, Ajou University School of Medicine, Suwon, Republic of Korea
Am J Clin Nutr. 2017 Jul;106(1):27-34. doi: 10.3945/ajcn.116.148171. Epub 2017 Jun 14.
The role of dietary calcium intake in cardiovascular disease (CVD), stroke, and fracture is controversial. Most previous reports have evaluated populations with high calcium intake. We aimed to evaluate whether high dietary calcium intake was associated with the risk of CVD, stroke, and fracture in a population with low calcium intake. In a prospective cohort study beginning in 2001 in Ansung-Ansan, Korea, 2158 men and 2153 women aged >50 y were evaluated for all-cause mortality, CVD, stroke, and fractures over a median 9-y follow-up. During follow-up, 242 and 100 deaths, 149 and 150 CVD events, 58 and 82 stroke events, and 211 and 292 incident fractures occurred in men and women, respectively. The first quartiles of energy-adjusted dietary calcium intake were 249 mg/d (IQR: 169 mg/d) in men and 209 mg/d (IQR: 161 mg/d) in women. Both men and women with higher dietary calcium intake tended to have higher fat, protein, sodium, phosphorus, fruit, and vegetable intakes. In men, outcomes were not significantly associated with dietary calcium intake with or without adjustments, and CVD risk tended to increase with increasing energy-adjusted dietary calcium intake, but this was not statistically significant ( = 0.078 and = 0.093 with and without adjustment, respectively). In women, CVD risk and dietary calcium intake showed a U-shaped association; the HRs (95% CIs) without adjustment relative to the first quartile were 0.71 (0.47, 1.07), 0.57 (0.36, 0.88), and 0.52 (0.33, 0.83) for quartiles 2, 3, and 4, respectively, and the values after adjustment were 0.70 (0.45, 1.07), 0.51 (0.31, 0.81), and 0.49 (0.29, 0.83) for quartiles 2, 3, and 4, respectively. In Korean women, increased dietary calcium intake was associated with a decreased CVD risk, but it did not influence the risk of stroke or fracture.
膳食钙摄入量在心血管疾病（CVD）、中风和骨折中的作用存在争议。以往大多数报告评估的是钙摄入量高的人群。我们旨在评估高膳食钙摄入量与低钙摄入量人群中CVD、中风和骨折风险之间的关联。在一项始于2001年韩国安城 - 安山的前瞻性队列研究中，对2158名年龄大于50岁的男性和2153名年龄大于50岁的女性进行了为期9年的全因死亡率、CVD、中风和骨折评估。随访期间，男性和女性分别发生242例和100例死亡、149例和150例CVD事件、58例和82例中风事件以及211例和292例新发骨折。能量调整后的膳食钙摄入量的第一个四分位数在男性中为249毫克/天（四分位距：169毫克/天），在女性中为209毫克/天（四分位距：161毫克/天）。膳食钙摄入量较高的男性和女性往往脂肪、蛋白质、钠、磷、水果和蔬菜的摄入量也较高。在男性中，无论是否进行调整，结果与膳食钙摄入量均无显著关联，并且CVD风险倾向于随着能量调整后的膳食钙摄入量增加而增加，但这在统计学上并不显著（调整前和调整后的P值分别为0.078和0.093）。在女性中，CVD风险与膳食钙摄入量呈U形关联；相对于第一个四分位数，未调整时第二、第三和第四个四分位数的风险比（95%置信区间）分别为0.71（0.47，1.07）、0.57（0.36，0.88）和0.52（0.33，0.83），调整后分别为0.70（0.45，1.07）、0.51（0.31，0.81）和0.49（0.29，0.83）。在韩国女性中，膳食钙摄入量增加与CVD风险降低相关，但对中风或骨折风险没有影响。
