乳制品补充对儿童四肢骨骼获得的影响：一项为期 12 个月的整群随机对照试验和荟萃分析。

Impact of dairy supplementation on bone acquisition in children's limbs: a 12-month cluster-randomized controlled trial and meta-analysis.

机构信息

Inner Mongolia Yili Industrial Group Co., Ltd., Hohhot, China.

Inner Mongolia Dairy Technology Research Institute Co. Ltd., Hohhot, China.

出版信息

Arch Osteoporos. 2024 Jul 24;19(1):65. doi: 10.1007/s11657-024-01422-2.

DOI:10.1007/s11657-024-01422-2

PMID:39043915

Abstract

UNLABELLED

The impact of milk on bone health in rural preschoolers is under-researched. This study, through a clinical trial and a meta-analysis, finds that milk supplementation enhances forearm and calcaneus bone acquisition in children, supporting the benefits of daily milk consumption.

PURPOSE

This study evaluated the impact of dairy supplementation on bone acquisition in children's limbs through a cluster-randomized controlled trial and a meta-analysis.

METHODS

The trial involved 315 children (4-6 year) from Northwest China, randomized to receive either 390 ml of milk daily (n = 215) or 20-30 g of bread (n = 100) over 12 months. We primarily assessed bone mineral density (BMD) and content (BMC) changes at the limbs, alongside bone-related biomarkers, measured at baseline, the 6th and 12th months. The meta-analysis aggregated BMD or BMC changes in the forearm/legs/calcaneus from published randomized trials involving children aged 3-18 years supplemented with dairy foods (vs. control group).

RESULTS

Of 278 completed the trial, intention-to-treat analysis revealed significant increases in BMD (4.05% and 7.31%) and BMC (4.69% and 7.34%) in the left forearm at the 6th and 12th months in the milk group compared to controls (P < 0.001). The calcaneus showed notable improvements in BMD (2.01%) and BMC (1.87%) at 6 months but not at 12 months. Additionally, milk supplementation was associated with beneficial changes in bone resorption markers, parathyroid hormone (- 12.70%), insulin-like growth factor 1 (6.69%), and the calcium-to-phosphorus ratio (2.22%) (all P < 0.05). The meta-analysis, encompassing 894 children, indicated that dairy supplementation significantly increased BMD (SMD, 0.629; 95%CI: 0.275, 0.983) and BMC (SMD, 0.616; 95%CI: 0.380, 0.851) (P < 0.05) in the arms, but not in the legs (P > 0.05).

CONCLUSION

Milk supplementation significantly improves bone health in children's forearms, underscoring its potential as a strategic dietary intervention for bone development. Trial registration NCT05074836.

摘要

未注明

牛奶对农村学龄前儿童骨骼健康的影响尚未得到充分研究。本研究通过临床试验和荟萃分析发现，牛奶补充剂可增强儿童前臂和跟骨的骨质获取，支持每日饮用牛奶的益处。

目的

本研究通过一项整群随机对照试验和荟萃分析评估了乳制品补充对儿童四肢骨获取的影响。

方法

该试验涉及中国西北部的 315 名 4-6 岁儿童（n=315），随机分为每天接受 390ml 牛奶（n=215）或 20-30g 面包（n=100），持续 12 个月。我们主要评估了四肢的骨矿物质密度（BMD）和骨矿物质含量（BMC）变化，同时还在基线、第 6 个月和第 12 个月测量了与骨骼相关的生物标志物。荟萃分析汇总了来自 3-18 岁儿童的随机试验中，补充乳制品食物（vs. 对照组）的前臂/腿部/跟骨的 BMD 或 BMC 变化。

结果

在完成试验的 278 名儿童中，意向治疗分析显示，与对照组相比，牛奶组左前臂的 BMD（4.05%和 7.31%）和 BMC（4.69%和 7.34%）在第 6 个月和第 12 个月均显著增加（P<0.001）。跟骨在第 6 个月时 BMD（2.01%）和 BMC（1.87%）有显著改善，但第 12 个月时没有。此外，牛奶补充与骨吸收标志物甲状旁腺激素（-12.70%）、胰岛素样生长因子 1（6.69%）和钙磷比（2.22%）的有益变化相关（均 P<0.05）。荟萃分析包括 894 名儿童，表明乳制品补充可显著增加 BMD（SMD，0.629；95%CI：0.275，0.983）和 BMC（SMD，0.616；95%CI：0.380，0.851）（均 P<0.05），但对腿部无影响（P>0.05）。