35 岁以下人群补充钙剂的效果：随机对照试验的系统评价和荟萃分析。
The effect of calcium supplementation in people under 35 years old: A systematic review and meta-analysis of randomized controlled trials.
机构信息
Department of Epidemiology and Biostatistics, School of Public Health and Management, Wenzhou Medical University, Wenzhou, China.
Department of Nutrition and Food Hygiene, School of Public Health and Management, Wenzhou Medical University, Wenzhou, China.
出版信息
Elife. 2022 Sep 27;11:e79002. doi: 10.7554/eLife.79002.
BACKGROUND
The effect of calcium supplementation on bone mineral accretion in people under 35 years old is inconclusive. To comprehensively summarize the evidence for the effect of calcium supplementation on bone mineral accretion in young populations (≤35 years).
METHODS
This is a systematic review and meta-analysis. The Pubmed, Embase, ProQuest, CENTRAL, WHO Global Index Medicus, Clinical Trials.gov, WHO ICTRP, China National Knowledge Infrastructure (CNKI), and Wanfang Data databases were systematically searched from database inception to April 25, 2021. Randomized clinical trials assessing the effects of calcium supplementation on bone mineral density (BMD) or bone mineral content (BMC) in people under 35 years old.
RESULTS
This systematic review and meta-analysis identified 43 studies involving 7,382 subjects. Moderate certainty of evidence showed that calcium supplementation was associated with the accretion of BMD and BMC, especially on femoral neck (standardized mean difference [SMD] 0.627, 95% confidence interval [CI] 0.338-0.915; SMD 0.364, 95% CI 0.134-0.595; respectively) and total body (SMD 0.330, 95% CI 0.163-0.496; SMD 0.149, 95% CI 0.006-0.291), also with a slight improvement effect on lumbar spine BMC (SMD 0.163, 95% CI 0.008-0.317), no effects on total hip BMD and BMC and lumbar spine BMD were observed. Very interestingly, subgroup analyses suggested that the improvement of bone at femoral neck was more pronounced in the peripeak bone mass (PBM) population (20-35 years) than the pre-PBM population (<20 years).
CONCLUSIONS
Our findings provided novel insights and evidence in calcium supplementation, which showed that calcium supplementation significantly improves bone mass, implying that preventive calcium supplementation before or around achieving PBM may be a shift in the window of intervention for osteoporosis.
FUNDING
This work was supported by Wenzhou Medical University grant [89219029].
背景
钙补充对 35 岁以下人群骨矿物质积累的影响尚无定论。本研究旨在全面总结钙补充对年轻人群（≤35 岁）骨矿物质积累影响的证据。
方法
本研究为系统评价和荟萃分析。系统检索了 Pubmed、Embase、ProQuest、CENTRAL、WHO 全球医学索引、ClinicalTrials.gov、WHO ICTRP、中国知网（CNKI）和万方数据等数据库，检索时间从数据库建立至 2021 年 4 月 25 日。纳入评估钙补充对 35 岁以下人群骨密度（BMD）或骨矿物质含量（BMC）影响的随机临床试验。
结果
本系统评价和荟萃分析共纳入 43 项研究，涉及 7382 名受试者。中等质量证据表明，钙补充与 BMD 和 BMC 的积累相关，尤其是在股骨颈（标准化均数差 [SMD] 0.627，95%置信区间 [CI] 0.338-0.915；SMD 0.364，95%CI 0.134-0.595）和全身（SMD 0.330，95%CI 0.163-0.496；SMD 0.149，95%CI 0.006-0.291），对腰椎 BMC 也有轻微改善作用（SMD 0.163，95%CI 0.008-0.317），但对总髋部 BMD 和 BMC 及腰椎 BMD 无影响。有趣的是，亚组分析表明，在峰值前骨量（PBM）人群（20-35 岁）中，股骨颈骨改善更为明显，而在 PBM 前人群（<20 岁）中则不明显。
结论
本研究结果为钙补充提供了新的见解和证据，表明钙补充可显著改善骨量，提示在达到 PBM 之前或前后进行预防性钙补充可能是骨质疏松干预窗口期的转变。
基金
本工作得到温州医科大学资助[89219029]。
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