Dawson-Hughes B, Harris S S, Krall E A, Dallal G E
Jean Mayer U.S. Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston, MA 02111, USA.
N Engl J Med. 1997 Sep 4;337(10):670-6. doi: 10.1056/NEJM199709043371003.
Inadequate dietary intake of calcium and vitamin D may contribute to the high prevalence of osteoporosis among older persons.
We studied the effects of three years of dietary supplementation with calcium and vitamin D on bone mineral density, biochemical measures of bone metabolism, and the incidence of nonvertebral fractures in 176 men and 213 women 65 years of age or older who were living at home. They received either 500 mg of calcium plus 700 IU of vitamin D3 (cholecalciferol) per day or placebo. Bone mineral density was measured by dual-energy x-ray absorptiometry, blood and urine were analyzed every six months, and cases of nonvertebral fracture were ascertained by means of interviews and verified with use of hospital records.
The mean (+/-SD) changes in bone mineral density in the calcium-vitamin D and placebo groups were as follows: femoral neck, +0.50+/-4.80 and -0.70+/-5.03 percent, respectively (P=0.02); spine,+2.12+/-4.06 and +1.22+/-4.25 percent (P=0.04); and total body, +0.06+/-1.83 and -1.09+/-1.71 percent (P<0.001). The difference between the calcium-vitamin D and placebo groups was significant at all skeletal sites after one year, but it was significant only for total-body bone mineral density in the second and third years. Of 37 subjects who had nonvertebral fractures, 26 were in the placebo group and 11 were in the calcium-vitamin D group (P=0.02).
In men and women 65 years of age or older who are living in the community, dietary supplementation with calcium and vitamin D moderately reduced bone loss measured in the femoral neck, spine, and total body over the three-year study period and reduced the incidence of nonvertebral fractures.
钙和维生素D的膳食摄入量不足可能是导致老年人骨质疏松症高发的原因之一。
我们研究了为期三年的钙和维生素D膳食补充剂对176名65岁及以上居家男性和213名65岁及以上居家女性的骨矿物质密度、骨代谢生化指标以及非椎骨骨折发生率的影响。他们每天服用500毫克钙加700国际单位维生素D3（胆钙化醇）或安慰剂。通过双能X线吸收法测量骨矿物质密度，每六个月分析一次血液和尿液，并通过访谈确定非椎骨骨折病例，并利用医院记录进行核实。
钙 - 维生素D组和安慰剂组骨矿物质密度的平均（±标准差）变化如下：股骨颈分别为+0.50±4.80%和 - 0.70±5.03%（P = 0.02）；脊柱分别为+2.12±4.06%和+1.22±4.25%（P = 0.04）；全身分别为+0.06±1.83%和 - 1.09±1.71%（P < 0.001）。一年后，钙 - 维生素D组和安慰剂组在所有骨骼部位的差异均有统计学意义，但在第二年和第三年仅全身骨矿物质密度差异有统计学意义。在37例发生非椎骨骨折的受试者中，26例在安慰剂组，11例在钙 - 维生素D组（P = 0.02）。
在社区居住的65岁及以上男性和女性中，钙和维生素D的膳食补充剂在三年的研究期内适度减少了股骨颈、脊柱和全身的骨质流失，并降低了非椎骨骨折的发生率。
