Meyer H E, Pedersen J I, Løken E B, Tverdal A
National Health Screening Service, Oslo, Norway.
Am J Epidemiol. 1997 Jan 15;145(2):117-23. doi: 10.1093/oxfordjournals.aje.a009082.
Dietary data from a prospective study were used to relate factors influencing calcium balance (estimates of dietary calcium intake, protein intake from nondairy animal sources (meat, fish, and eggs), and coffee consumption) to the incidence of hip fracture. During the years 1977-1983, women and men born between 1925 and 1940 and living in one of three Norwegian counties were invited to a cardiovascular screening that included a dietary survey. The attendance rate at screening was 91.1%, and 90.7% of these persons (19,752 women and 20,035 men) filled in and returned a semiquantitative dietary questionnaire. This cohort was followed for an average of 11.4 years (range, 0.01-13.8 years) with respect to hip fracture, defined as cervical or trochanteric fracture. During follow-up, 213 hip fractures were identified, excluding fractures associated with high-energy trauma and metastatic bone disease. There was no clear association between calcium intake or nondairy animal protein intake and hip fracture in this cohort. However, an elevated risk of fracture was found in women with a high intake of protein from nondairy animal sources in the presence of low calcium intake (relative risk = 1.96 (95% confidence interval 1.09-3.56) for the highest quarter of nondairy protein intake and the lowest quarter of calcium intake vs. the three lower quarters of protein intake and the three higher quarters of calcium intake). Women who drank nine or more cups of coffee per day also had an increased risk of fracture, while there was no association between coffee consumption and hip fracture in men. Although these findings do not necessarily imply causal relations, they suggest the presence of risk factors for hip fracture that act through a negative calcium balance in this population.
一项前瞻性研究的饮食数据被用于探究影响钙平衡的因素（膳食钙摄入量估计值、非乳类动物来源的蛋白质摄入量（肉类、鱼类和蛋类）以及咖啡摄入量）与髋部骨折发生率之间的关系。在1977年至1983年期间，邀请了出生于1925年至1940年且居住在挪威三个郡之一的女性和男性参加一项心血管筛查，其中包括一项饮食调查。筛查的出勤率为91.1%，这些人中的90.7%（19752名女性和20035名男性）填写并返还了一份半定量饮食问卷。该队列就髋部骨折（定义为颈椎或转子骨折）进行了平均11.4年的随访（范围为0.01至13.8年）。在随访期间，共确诊213例髋部骨折，排除了与高能量创伤和转移性骨病相关的骨折。在该队列中，钙摄入量或非乳类动物蛋白摄入量与髋部骨折之间没有明显关联。然而，在低钙摄入量的情况下，非乳类动物来源蛋白质摄入量高的女性骨折风险升高（非乳类蛋白摄入量最高四分位数和钙摄入量最低四分位数与蛋白质摄入量较低的三个四分位数和钙摄入量较高的三个四分位数相比，相对风险 = 1.96（95%置信区间1.09 - 3.56））。每天饮用九杯或更多咖啡的女性骨折风险也增加，而男性的咖啡摄入量与髋部骨折之间没有关联。尽管这些发现不一定意味着存在因果关系，但它们表明在该人群中存在通过负钙平衡起作用的髋部骨折风险因素。
