丹麦纯素食者的骨转换、钙稳态和维生素 D 状况。

Bone turnover, calcium homeostasis, and vitamin D status in Danish vegans.

机构信息

The Novo Nordisk Foundation Center for Basic Metabolic Research, Section of Metabolic Genetics, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.

Department of Clinical Biochemistry, Research Center for Ageing and Osteoporosis, Rigshospitalet, Glostrup, Denmark.

出版信息

Eur J Clin Nutr. 2018 Jul;72(7):1046-1054. doi: 10.1038/s41430-017-0081-y. Epub 2018 Jan 23.

DOI:10.1038/s41430-017-0081-y

PMID:29362456

Abstract

BACKGROUND/OBJECTIVES: A vegan diet has been associated with increased bone fracture risk, but the physiology linking nutritional exposure to bone metabolism has only been partially elucidated. This study investigated whether a vegan diet is associated with increased bone turnover and altered calcium homeostasis due to insufficient intake of calcium and vitamin D.

SUBJECTS/METHODS: Fractionated and total 25-hydroxyvitamin D (25(OH)-D), parathyroid hormone (PTH), calcium, and four bone turnover markers (osteocalcin, N-terminal propeptide of type I procollagen (PINP), bone-specific alkaline phosphatase (BAP), and C-terminal telopeptide of type I collagen (CTX)) were measured in serum from 78 vegans and 77 omnivores.

RESULTS

When adjusting for seasonality and constitutional covariates (age, sex, and body fat percentage) vegans had higher concentrations of PINP (32 [95% CI: 7, 64]%, P = 0.01) and BAP (58 [95% CI: 27, 97]%, P < 0.001) compared to omnivores, whereas CTX (30 [95% CI: -1, 72]%, P = 0.06) and osteocalcin (21.8 [95% CI: -9.3, 63.7]%, P = 0.2) concentrations did not differ between the two groups. Vegans had higher serum PTH concentration (38 [95% CI: 19, 60]%; P < 0.001) and lower 25(OH)-D serum concentration (-33 [95% CI: -45, -19]%; P < 0.001), but similar serum calcium concentration (-1 [95% CI: -3, 1]%, P = 0.18 compared to omnivores.

CONCLUSIONS

Vegans have higher levels of circulating bone turnover markers compared to omnivores, which may in the long-term lead to poorer bone health. Differences in dietary habits including intake of vitamin D and calcium may, at least partly, explain the observed differences.

摘要

背景/目的：素食与骨折风险增加有关，但营养暴露与骨代谢之间的生理学联系仅部分阐明。本研究旨在调查素食是否由于钙和维生素 D 摄入不足而导致骨转换增加和钙稳态改变。

受试者/方法：在血清中测量了 78 名素食者和 77 名杂食者的分馏和总 25-羟维生素 D（25(OH)-D）、甲状旁腺激素（PTH）、钙和四种骨转换标志物（骨钙素、I 型前胶原 N 端肽（PINP）、骨碱性磷酸酶（BAP）和 I 型胶原 C 端肽（CTX））。

结果

调整季节性和体质协变量（年龄、性别和体脂百分比）后，素食者的 PINP（32 [95% CI：7，64]%，P = 0.01）和 BAP（58 [95% CI：27，97]%，P < 0.001）浓度高于杂食者，而 CTX（30 [95% CI：-1，72]%，P = 0.06）和骨钙素（21.8 [95% CI：-9.3，63.7]%，P = 0.2）浓度在两组之间没有差异。素食者的血清 PTH 浓度更高（38 [95% CI：19，60]%；P < 0.001），25(OH)-D 血清浓度更低（-33 [95% CI：-45，-19]%；P < 0.001），但血清钙浓度相似（-1 [95% CI：-3，1]%，与杂食者相比，P = 0.18）。