Pluskiewicz Wojciech, Adamczyk Piotr, Drozdzowska Bogna
Department and Clinic of Internal Diseases, Diabetology, and Nephrology, Metabolic Bone Diseases Unit, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Poland.
Department of Paediatrics, Faculty of Medical Sciences in Katowice, Medical University of Silesia in Katowice, Poland.
Endokrynol Pol. 2021;72(3):198-201. doi: 10.5603/EP.a2021.0021. Epub 2021 Mar 22.
The aim of the study was to verify the thesis that dietary calcium intake influences the risk of osteoporotic fractures established by online available calculators.
The study was performed in 521 postmenopausal women aged over 55 years, recruited in one osteoporotic outpatient clinic. Mean age was 67.7 ± 8.6 years. Fracture risk was established using FRAX (major and hip fractures, 10 years), Garvan calculator (any and hip fractures, 5 and 10 years), and the Polish algorithm available at www.fracture-risk.pl (any fractures, 5 years). Bone densitometry at the femoral neck was performed using a DPX device (Lunar, GE, USA) to calculate fracture risk by each of those calculators. Calcium intake was established based on a dietary questionnaire.
Mean values of fracture risk for all three calculators and T-score value for DXA measurement at the femoral neck did not correlate with calcium intake. A tendency to insignificantly lower calcium intake was observed in the subgroup with high hip fracture risk by FRAX (≥ 3%) vs. low hip FRAX (< 3%): 744 ± 328 mg/day vs. 765 ± 299 mg/day. The same analysis for FRAX major fracture risk revealed a similar tendency: 700 ± 299 mg/day and 760 ± 311 mg/day in high (≥ 20%) and low (< 20%) fracture-risk groups, respectively. Calcium intake did not influence the results obtained in the other two calculators at all. Calcium intake did not differ between subjects with prior falls and those without falls. However, if the number of falls was taken into account, the women who reported three and more falls had significantly lower calcium intake (621 ± 275 mg/day) than subjects with no falls (767 ± 304 mg/day; p < 0.05) or those with one fall (766 ± 317 mg/day; p < 0.05).
Calcium intake does not correlate with fracture risk established by calculators available on-line, but low calcium intake may increase the risk of falls.
本研究的目的是验证膳食钙摄入量会影响通过在线可用计算器确定的骨质疏松性骨折风险这一论点。
本研究在一家骨质疏松门诊招募的521名55岁以上绝经后女性中进行。平均年龄为67.7±8.6岁。使用FRAX(主要骨折和髋部骨折,10年)、加尔万计算器(任何骨折和髋部骨折,5年和10年)以及www.fracture-risk.pl上的波兰算法(任何骨折,5年)来确定骨折风险。使用DPX设备(美国通用电气公司的Lunar)对股骨颈进行骨密度测量,以通过上述每种计算器计算骨折风险。根据膳食问卷确定钙摄入量。
所有三种计算器的骨折风险平均值以及股骨颈DXA测量的T值与钙摄入量均无相关性。FRAX评估髋部骨折高风险组(≥3%)与低风险组(<3%)相比,钙摄入量有轻微降低的趋势:分别为744±328毫克/天和765±299毫克/天。对FRAX主要骨折风险进行同样的分析也显示出类似趋势:高骨折风险组(≥20%)和低骨折风险组(<20%)分别为700±299毫克/天和760±311毫克/天。钙摄入量对另外两种计算器得出的结果完全没有影响。有过跌倒史的受试者与没有跌倒史的受试者之间的钙摄入量没有差异。然而,如果考虑跌倒次数,报告跌倒三次及以上的女性的钙摄入量(621±275毫克/天)显著低于未跌倒的受试者(767±304毫克/天;p<0.05)或跌倒一次的受试者(766±317毫克/天;p<0.05)。
钙摄入量与在线计算器确定的骨折风险不相关,但低钙摄入量可能会增加跌倒风险。