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乳制品摄入与绝经后日本女性骨质疏松性骨折风险的关系:来自日本基于人群的骨质疏松症(JPOS)队列研究 15 年随访数据的二次分析。

Association between Dairy Product intake and Risk of Osteoporotic Fractures in Postmenopausal Japanese Women: Secondary Analysis of 15-Year Follow-Up data from the Japanese Population-Based Osteoporosis (JPOS) Cohort Study.

机构信息

Junko Tamaki, Department of Hygiene and Public Health, Faculty of Medicine, Osaka Medical and Pharmaceutical University, 2-7 Daigaku-Machi, Takatsuki, Osaka 569-8686, Japan, Telephone: +81-72-683-1221, E-mail:

出版信息

J Nutr Health Aging. 2023;27(3):228-237. doi: 10.1007/s12603-023-1898-1.

Abstract

OBJECTIVES

Few prospective cohort studies have evaluated the relationship between dairy product intake frequency and risk of osteoporotic fractures in Asians. This study aimed to investigate the association between habitual dairy product intake and risk of osteoporotic fractures.

DESIGN

Secondary analysis of prospective cohort study.

SETTING

Five municipalities of Japan.

PARTICIPANTS

This study included 1,429 postmenopausal Japanese women (age ≥45 years at baseline).

MEASUREMENTS

Baseline milk-intake frequency was obtained using nurse-administered questionnaires. Intakes of yogurt and cheese, and estimated calcium intake, were assessed using a validated food frequency questionnaire. Osteoporotic fracture was defined as a clinical fracture diagnosed using radiography. Hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated using Cox proportional hazards models.

RESULTS

Over a median follow-up period of 15.1 years (interquartile range [IQR], 10.1-15.4 years; total, 18,118 person-years), 172 women sustained at least one osteoporotic fracture. The proportions of participants with milk intakes <1, 1, and ≥2 cups/d were 34.4%, 48.0%, and 17.6%, respectively. After adjustment for age, frequency of yogurt intake, frequency of cheese intake, body mass index, history of osteoporotic fractures, and frequency of natto intake, the HRs compared with that for milk intake <1 cup/d were 0.71 (95% CI: 0.51-0.98) and 0.57 (95% CI: 0.35-0.92) for 1 cup/d and ≥2 cups/d, respectively. After adjustment for bone mineral density, HR significance for milk intakes ≥2 cups/d remained significant. Yogurt and cheese intakes were not related to the risk of osteoporotic fractures.

CONCLUSION

High habitual milk intake, but not a habitual yogurt or cheese intake is associated with a decreased risk of osteoporotic fractures, independent of bone mineral density, in postmenopausal Japanese women.

摘要

目的

鲜有前瞻性队列研究评估亚洲人群中乳制品摄入频率与骨质疏松性骨折风险之间的关系。本研究旨在调查习惯性乳制品摄入与骨质疏松性骨折风险之间的关联。

设计

前瞻性队列研究的二次分析。

地点

日本五个城市。

参与者

本研究纳入了 1429 名绝经后日本女性(基线时年龄≥45 岁)。

测量方法

使用护士管理的问卷获取基线时牛奶摄入频率。使用经过验证的食物频率问卷评估酸奶和奶酪的摄入量以及估计的钙摄入量。骨质疏松性骨折定义为通过影像学诊断的临床骨折。使用 Cox 比例风险模型估计风险比(HR)及其 95%置信区间(CI)。

结果

在中位随访期 15.1 年(四分位距 [IQR],10.1-15.4 年;总随访 18118 人年)期间,172 名女性发生至少 1 次骨质疏松性骨折。摄入牛奶<1 杯/d、1 杯/d 和≥2 杯/d 的参与者比例分别为 34.4%、48.0%和 17.6%。在校正年龄、酸奶摄入频率、奶酪摄入频率、体重指数、骨质疏松性骨折史和纳豆摄入频率后,与摄入牛奶<1 杯/d 相比,摄入 1 杯/d 和≥2 杯/d 的 HR 分别为 0.71(95%CI:0.51-0.98)和 0.57(95%CI:0.35-0.92)。在校正骨密度后,摄入牛奶≥2 杯/d 与骨质疏松性骨折风险的相关性仍具有统计学意义。酸奶和奶酪的摄入量与骨质疏松性骨折风险无关。

结论

在绝经后日本女性中,习惯性大量摄入牛奶而不是习惯性摄入酸奶或奶酪与降低骨质疏松性骨折风险相关,且与骨密度无关。

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