Looker A C, Harris T B, Madans J H, Sempos C T
Division of Health Examination Statistics, Centers for Disease Control, Hyattsville, MD 20782.
Osteoporos Int. 1993 Jul;3(4):177-84. doi: 10.1007/BF01623673.
The effect of dietary calcium on hip fracture risk was examined prospectively using the NHANES I Epidemiologic Follow-Up Study cohort, which is derived from a nationally representative sample of the United States population. A cohort of 4342 white men and postmenopausal women ages 50-74 years at baseline (1971-1975) were observed through 1987 for up to 16 years of follow-up. Quantitative estimates of calcium intake were obtained at baseline from a 24-h recall, while weekly frequency of dairy food consumption was obtained from a qualitative food frequency. By 1987, 44 men and 122 women had experienced a hip fracture according to hospital records or death certificates. In the total sample of women the risk of hip fracture was only slightly lower for the highest quartile compared with the lowest. However, although not statistically significant, the age-adjusted risk of hip fracture was approximately 50% lower in the highest quartile of calcium intake compared with the lowest quartile in the subgroup of women who were at least 6 years postmenopausal and not taking postmenopausal hormone. The low relative risk observed among men, although interesting, must be interpreted cautiously due to small sample size. Adjusting for other risk factors did not appreciably change the results for either sex. The pattern of relative risks for calcium quartiles and by selected cutpoints was not consistent with a dose-response effect of calcium. Our results suggest that calcium may lower hip fracture risk in late menopausal women.
利用美国国家健康与营养检查调查（NHANES）I流行病学随访研究队列，对膳食钙对髋部骨折风险的影响进行了前瞻性研究，该队列源自美国人口的全国代表性样本。对4342名基线时（1971 - 1975年）年龄在50 - 74岁的白人男性和绝经后女性进行队列研究，随访至1987年，最长随访16年。通过24小时回忆法在基线时获得钙摄入量的定量估计值，同时从定性食物频率问卷中获取乳制品消费的每周频率。根据医院记录或死亡证明，到1987年，有44名男性和122名女性发生了髋部骨折。在女性总样本中，最高四分位数组的髋部骨折风险仅比最低四分位数组略低。然而，在至少绝经6年且未服用绝经后激素的女性亚组中，尽管差异无统计学意义，但钙摄入量最高四分位数组的年龄调整后髋部骨折风险比最低四分位数组低约50%。男性中观察到的低相对风险虽然有趣，但由于样本量小，必须谨慎解释。对其他风险因素进行调整后，两性的结果均无明显变化。钙四分位数和选定切点的相对风险模式与钙的剂量反应效应不一致。我们的结果表明，钙可能会降低绝经后期女性的髋部骨折风险。
