Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.
Crit Rev Food Sci Nutr. 2022;62(21):5733-5743. doi: 10.1080/10408398.2021.1890690. Epub 2021 Mar 22.
Considerable controversy exists regarding the association between calcium intake and mortality risk. Therefore, this study aimed to summarize available findings on the associations of total, dietary and supplemental calcium intake with all-cause, CVD, and cancer mortality. We searched PubMed, Scopus, Embase, and ISI Web of Knowledge until February 2020 to identify eligible publications. Random-effects models were used to calculate pooled effect sizes (ESs) and 95% confidence intervals (CIs) for highest versus lowest categories of calcium intake and to incorporate variation between studies. Linear and non-linear dose-response analyses were done to evaluate the dose-response relations between calcium intake and mortality. 36 publications were included in this systematic review and 35 in the meta-analysis. During the follow-up periods ranging from 4.2 to 28 years, the total number of deaths from all causes was 163,657 (83703 from CVD and 83929 from cancer). Total calcium intake was associated with a lower risk of CVD mortality (Pooled ES for highest v lowest category: 0.91; 95% CI: 0.83-0.99, =68.1%, < 0.001). Dietary calcium intake was associated with a lower risk of all-cause mortality (Pooled ES for highest v lowest category: 0.95; 95% CI: 0.92-0.99, =62.1%, < 0.001). Supplemental calcium intake was not significantly associated with risk of all-cause, CVD and cancer mortality. In the dose-response analysis, there was evidence of nonlinear association between calcium intake and risk of all-cause, CVD, and cancer mortality. In conclusion, a non-linear association between calcium intake with all-cause, CVD, and cancer mortality risk was observed in this meta-analysis. Moderate intake of total (1000-1800), dietary (600-1200), and supplemental calcium (600-1200) was inversely significantly associated with mortality risk but higher calcium intake was not associated with a lower risk of mortality.
关于钙摄入量与死亡率之间的关联存在相当大的争议。因此，本研究旨在总结关于总钙、饮食钙和补充钙摄入量与全因、心血管疾病和癌症死亡率之间关联的现有研究结果。我们在 PubMed、Scopus、Embase 和 ISI Web of Knowledge 上检索了截至 2020 年 2 月的合格出版物。使用随机效应模型计算钙摄入量最高与最低类别之间的汇总效应大小（ES）和 95%置信区间（CI），并纳入研究之间的差异。进行线性和非线性剂量反应分析，以评估钙摄入量与死亡率之间的剂量反应关系。本系统评价包括 36 篇出版物，荟萃分析包括 35 篇出版物。在随访时间从 4.2 年到 28 年的期间内，总死亡人数为 163657 人（83703 人死于心血管疾病，83929 人死于癌症）。总钙摄入量与心血管疾病死亡率降低相关（最高与最低类别之间的汇总 ES：0.91；95%CI：0.83-0.99，=68.1%， < 0.001）。饮食钙摄入量与全因死亡率降低相关（最高与最低类别之间的汇总 ES：0.95；95%CI：0.92-0.99，=62.1%， < 0.001）。补充钙摄入量与全因、心血管疾病和癌症死亡率无显著相关性。在剂量反应分析中，钙摄入量与全因、心血管疾病和癌症死亡率风险之间存在非线性关联的证据。总之，荟萃分析显示钙摄入量与全因、心血管疾病和癌症死亡率风险之间存在非线性关联。中等摄入量的总钙（1000-1800）、饮食钙（600-1200）和补充钙（600-1200）与死亡率风险呈显著负相关，但更高的钙摄入量与死亡率降低无关。
