Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Department of Nutrition, School of Public Health, Sun Yat-sen University, Guangzhou, China.
Department of Medical Statistics & Epidemiology, School of Public Health, Sun Yat-sen University, Zhongshan Road 2, Guangzhou, 510080, China.
Osteoporos Int. 2021 Nov;32(11):2205-2216. doi: 10.1007/s00198-021-05960-0. Epub 2021 Apr 22.
The role of protein intake in bone has been controversial. Our case-control study among Chinese elderly concluded that a higher consumption of protein, even substituted for fat, is associated with lowered hip fracture risk. Differences in protein sources, amino acids composition, gender, and calcium sufficiency may explain the inconsistency.
The aim of the study was to investigate the association of dietary protein intakes with hip fracture risk among Chinese elderly.
This was a 1:1 age and sex matched cross-sectional study of case-control design among 1070 pairs of elderly Chinese people aged 55 to 80 years. Patients who were newly diagnosed (within 2-week) hip fracture by X-ray were recruited from four hospitals in Guangdong Province of China. Dietary intakes were evaluated by a validated food frequency questionnaire for total protein, protein from different sources, amino acids profiles, and estimated renal acid load in diet.
Daily average intakes of total protein were 58.1±27.0 (women) and 65.7±31.8 (men) g/d for cases, and 66.8±21.5 (women) and 72.1±24.4 (men) for controls (p<0.001). Multivariable regression indicated that, compared with the lowest quartile, the highest quartile of consumption of energy adjusted total protein [OR: 0.360 (0.2060.630) for women and 0.381 (0.1530.949) for men] and animal protein [0.326 (0.183, 0.560) for women and 0.335 (0.1360.828) for men] was significantly associated with the lowered risk of hip fracture in a dose-response manner (all p for trend <0.05). A significant hip fracture risk reduction was observed in women with higher intakes of sulfur amino acids [OR: 0.464 (0.2860.753)] and aromatic amino acids [0.537 (0.326~0.884)] but not in men. Subgroup analysis suggested that these associations were more evident in elderly with lower body mass index and dietary calcium intake less than 400 mg/d.
A higher level of protein intake, even substituted for fat, is associated with lowered hip fracture risk.
蛋白质在骨骼中的作用一直存在争议。我们在中国老年人中的病例对照研究得出结论，较高的蛋白质摄入，甚至用脂肪替代，与降低髋部骨折风险有关。蛋白质来源、氨基酸组成、性别和钙充足性的差异可能解释了这种不一致性。
本研究旨在探讨中国老年人膳食蛋白质摄入量与髋部骨折风险的关系。
这是一项在中国广东省四家医院进行的新诊断（2 周内）髋部骨折的病例对照设计的 1:1 年龄和性别匹配的横断面研究。患者从中国广东省四家医院招募。通过验证的食物频率问卷评估总蛋白质、不同来源蛋白质、氨基酸谱和饮食中估计的肾脏酸负荷的膳食摄入量。
病例组的每日平均总蛋白摄入量为女性 58.1±27.0 g/d 和男性 65.7±31.8 g/d，对照组为女性 66.8±21.5 g/d 和男性 72.1±24.4 g/d（p<0.001）。多变量回归表明，与最低四分位相比，最高四分位的能量调整后总蛋白[女性：0.360（0.2060.630）和男性：0.381（0.1530.949）]和动物蛋白[女性：0.326（0.1830.560）和男性：0.335（0.1360.828）]与髋部骨折风险呈剂量反应关系降低（所有趋势 p 值<0.05）。女性摄入较高的硫氨基酸[OR：0.464（0.2860.753）]和芳香族氨基酸[0.537（0.3260.884）]髋部骨折风险降低，而男性则没有。亚组分析表明，这些关联在体重指数较低和膳食钙摄入量低于 400 mg/d 的老年人中更为明显。
较高水平的蛋白质摄入，甚至用脂肪替代，与降低髋部骨折风险有关。
