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乳源蛋白的骨骼安全性:一项随机对照试验的荟萃分析。

The skeletal safety of milk-derived proteins: A meta-analysis of randomized controlled trials.

机构信息

Department of Nutrition and Food Hygiene, School of Public Health, Soochow University, Suzhou, 215123, China.

Laboratory Center, Medical College of Soochow University, Suzhou, 215123, China.

出版信息

Osteoporos Int. 2023 Nov;34(11):1937-1949. doi: 10.1007/s00198-023-06840-5. Epub 2023 Aug 1.

Abstract

PURPOSE

There has been a persistent claim that dairy products contain calcium-leaching proteins, although the soundness of such a claim has been challenged. A meta-analysis of randomized controlled trials (RCTs) on the effects of milk-derived protein supplementation on bone health indices in adults was performed to reconcile the controversy surrounding the potential skeletal safety concerns of proteins of dairy origin.

METHODS

The PubMed and Web of Science databases were searched for relevant RCTs. A random-effects model was used to generate pooled effect sizes and 95% confidence intervals.

RESULTS

Milk-derived protein supplementation did not significantly affect whole-body BMD (n = 7 RCTs) and BMD at the lumbar spine (n = 10), hip (n = 8), femoral neck (n = 9), trochanter (n = 5), intertrochanter (n = 2), and ultradistal radius (n = 2). The concentrations of bone formation markers (bone-specific alkaline phosphatase [n = 11], osteocalcin [n = 6], procollagen type 1 amino-terminal propeptide [n = 5]), bone resorption markers (N-terminal telopeptide of type 1 collagen [n = 7], C-terminal telopeptide of type 1 collagen [n = 7], deoxypyridinoline [n = 4]), and parathyroid hormone (n = 7) were not significantly affected. However, increased insulin-like growth factor-1 (IGF-1) concentrations (n = 13) were observed. Reduced IGF-1 concentrations were observed when soy protein was used as a comparator, and increased IGF-1 concentrations were observed when carbohydrate was used.

CONCLUSION

Our findings do not support the claim that proteins of dairy origin are detrimental to bone health.

摘要

目的

一直有人声称乳制品中含有导致钙流失的蛋白质,尽管这一说法的合理性受到了质疑。本研究对乳制品蛋白补充剂对成年人骨骼健康指标影响的随机对照试验(RCT)进行了荟萃分析,以调和围绕乳制品来源蛋白潜在骨骼安全性问题的争议。

方法

在 PubMed 和 Web of Science 数据库中检索相关 RCT。使用随机效应模型生成汇总效应大小和 95%置信区间。

结果

乳制品蛋白补充剂对全身骨密度(n=7 项 RCT)和腰椎骨密度(n=10)、髋部骨密度(n=8)、股骨颈骨密度(n=9)、大转子骨密度(n=5)、转子间区骨密度(n=2)和桡骨远端骨密度(n=2)均无显著影响。骨形成标志物(骨碱性磷酸酶[n=11]、骨钙素[n=6]、I 型前胶原氨基端前肽[n=5])、骨吸收标志物(I 型胶原 N 端肽[n=7]、I 型胶原 C 端肽[n=7]、脱氧吡啶啉[n=4])和甲状旁腺激素(n=7)的浓度也没有显著影响。然而,胰岛素样生长因子-1(IGF-1)浓度增加(n=13)。当使用大豆蛋白作为对照时,IGF-1 浓度降低,当使用碳水化合物作为对照时,IGF-1 浓度增加。

结论

我们的研究结果不支持乳制品蛋白对骨骼健康有害的说法。

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