美国老年人饮食抗氧化剂摄入量与骨密度和骨质疏松症风险的独立和联合关联。
Independent and combined associations of dietary antioxidant intake with bone mineral density and risk of osteoporosis among elderly population in United States.
机构信息
Central Laboratory, The People's Hospital of Baoan Shenzhen, The Second Affiliated Hospital of Shenzhen University, Shenzhen, China.
Science and Education Department, Shenzhen Baoan Shiyan People's Hospital, Shenzhen, China.
出版信息
J Orthop Sci. 2024 Jul;29(4):1064-1072. doi: 10.1016/j.jos.2023.07.014. Epub 2023 Aug 1.
BACKGROUND
The influence of dietary antioxidant intake on the occurrence and progression of osteoporosis may be significant. However, to date, evidence on the link between combined effect of dietary antioxidants on bone mineral density (BMD) level and risk of osteoporosis is limited. We aimed to assess the independent and combined association of dietary antioxidant intake with BMD level and risk of osteoporosis among elderly population in United States through analysis of data in the National Health and Nutrition Examination Survey.
METHODS
The dietary antioxidant intake was assessed based on six antioxidants, including vitamin A, vitamin C, vitamin E, zinc, selenium, and total carotenoid. A composite dietary antioxidant index (CDAI) was used to evaluate the combined exposure of dietary antioxidant intake.
RESULTS
A total of 5618 participants were included. Higher dietary vitamin A, vitamin C, vitamin E, zinc, selenium, and total carotenoid, were positively associated with BMD level. Compared with participants in the first quartile, those in the higher quartile of vitamin E (Q4: OR 0.652; 95% CI 0.463-0.918), zinc (Q4: OR 0.581; 95% CI 0.408-0.826), and selenium (Q3: OR 0.673; 95% CI 0.503-0.899) were associated with decreased risk of overall osteoporosis. Furthermore, compared to those in the first quartile, participants in the highest quartile of CDAI were associated with increased total femur (β 0.019; 95% CI 0.007-0.032), femur neck (β 0.020; 95% CI 0.009-0.032), trochanter (β 0.012; 95% CI 0.001-0.023), and intertrochanter BMD level (β 0.022; 95% CI 0.007-0.037); participants in the highest quartile of CDAI were associated with decreased risk of overall osteoporosis (OR 0.536; 95% CI 0.376-0.763). Furthermore, the associations of CDAI with the BMD level and osteoporosis risk were more significant among female participants.
CONCLUSION
Our study provides evidence that a combination of dietary antioxidants intake was associated increased BMD level and decreased osteoporosis risk.
背景
饮食抗氧化剂的摄入对骨质疏松症的发生和发展可能有重要影响。然而，迄今为止，关于饮食抗氧化剂的综合作用与骨矿物质密度（BMD）水平和骨质疏松症风险之间关系的证据有限。我们旨在通过分析美国国家健康和营养检查调查的数据，评估饮食抗氧化剂摄入与老年人 BMD 水平和骨质疏松症风险的独立和综合关联。
方法
根据六种抗氧化剂（包括维生素 A、维生素 C、维生素 E、锌、硒和总类胡萝卜素）评估饮食抗氧化剂的摄入。使用复合饮食抗氧化指数（CDAI）评估饮食抗氧化剂摄入的综合暴露情况。
结果
共纳入 5618 名参与者。较高的饮食维生素 A、维生素 C、维生素 E、锌、硒和总类胡萝卜素与 BMD 水平呈正相关。与第一四分位组相比，维生素 E 四分位组较高的参与者（四分位组 4：比值比 0.652；95%置信区间 0.463-0.918）、锌（四分位组 4：比值比 0.581；95%置信区间 0.408-0.826）和硒（三分位组 3：比值比 0.673；95%置信区间 0.503-0.899）与总体骨质疏松症风险降低相关。此外，与第一四分位组相比，CDAI 最高四分位组的参与者与全股骨（β 0.019；95%置信区间 0.007-0.032）、股骨颈（β 0.020；95%置信区间 0.009-0.032）、转子（β 0.012；95%置信区间 0.001-0.023）和转子间 BMD 水平（β 0.022；95%置信区间 0.007-0.037）升高有关；CDAI 最高四分位组与总体骨质疏松症风险降低相关（比值比 0.536；95%置信区间 0.376-0.763）。此外，CDAI 与 BMD 水平和骨质疏松症风险的关联在女性参与者中更为显著。
结论
我们的研究提供了证据表明，饮食抗氧化剂的综合摄入与 BMD 水平升高和骨质疏松症风险降低有关。
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