Calcium Intake, Vitamin D and Bone Health Status of Post-menopausal Chinese Women in Kuala Lumpur

Bone health status was investigated in 178 free-living Chinese post-menopausal women in Kuala Lumpur. Body mass index (BMI), body composition (using whole body DXA), calcium intake and serum 25-OH vitamin D status were measured along with biochemical markers of bone turnover, that is, pro-collagen Type 1 N-terminal peptide (P1NP), osteocalcin (OC) and C-telopeptide β cross link of Type 1 collagen (CTX- β). Bone mineral density (BMD) was measured using DXA (Hologic, USA) at the lumbar spine, femoral neck and total hip. Results showed that osteopenia was present in 50% of the subjects at the spine and 57.9% at the femoral neck. Osteoporosis was diagnosed in 10% of the subjects at both the femoral neck and spine. A total of 29.3% of the subjects had high levels of CTX- β. Mean serum level of 25-OH vitamin D was 60.4+15.6 nmol/L and 50.6% of the subjects had hypovitaminosis D (defined as < 50 nmol/l). Mean total calcium intake of the subjects was 497 + 233 mg, of which only 14% met the RNI for calcium with the additional intake of calcium supplements. Body fat was also significantly correlated (r=0.181, p< 0.05) with BMD at the spine but not BMD at the femoral neck. Lean body mass was positively correlated with BMD at the spine (r=0.289, p< 0.001) and femoral neck (r=0.295, p< 0.001). CTX-β was negatively correlated with BMD at the spine (r= -0.235, p< 0.001), whereas P1NP (r=-0.215, p< 0.001) and osteocalcin (r=-0.265, p< 0.001) were both negatively correlated with BMD at the femoral neck. Generally, the study found that women with osteopenia had higher levels of bone turnover markers, less lean body mass and lower calcium intake than women with normal BMD. In conclusion, this study demonstrated that the majority of free living Chinese post-menopausal women in Kuala Lumpur have low calcium intake, low 25-OH vitamin D status and low bone mass and elevated biochemical markers of bone turnover.     

Influence of Using Different Sources of Carotenoid Data in Epidemiologic Studies

Objective This study compared distributions of carotenoid intake and diet-serum correlations using two sources of carotenoid data: the US Department of Agriculture-National Cancer Institute (USDA-NCI) carotenoid food composition database and values accompanying the Block-NCI Health Habits and History Questionnaire (HHHQ).

Design and subjects A 100-item food frequency questionnaire was used to collect dietary data from 2,152 adults, aged 43 to 85 years, who were participating in the Nutritional Factors in Eye Disease Study, a population-based study designed to evaluate nutritional factors associated with age-related eye disease. Blood samples were collected from a random sample of 400 nonfasting participants in the study.

Results Median carotenoid intakes using HHHQ vs USDA-NCI data were alpha carotene (229 vs 223 μg/day), beta carotene (1,321 vs 1,325 μg/day), beta cryptoxanthin (72 vs 21 μg/day), lutein + zeaxanthin (653 vs 811 μg/day), and lycopene (593 vs 1,615 μg/day). All paired differences in carotenoid intake were significantly different from zero (Wilcoxon signed-rank, P<.0001). Despite these differences, the two databases similarly ranked individuals according to carotenoid intake: Spearman correlations ranged from .71 (lycopene) to .93 (alpha carotene). Differences between diet-serum correlations (adjusted for energy, body mass index, high density lipoprotein, and total cholesterol) using HHHQ vs USDA-NCI data were minor and not significant (P>.05): alpha carotene (r=.33 vs .32), beta carotene (r=.27 vs .32), beta cryptoxanthin (r=48 vs .53), lutein + zeaxanthin (r=.28 vs .24), and lycopene (r=.29 vs .25).

Conclusions Although estimates of carotenoid intake differed significantly, only minor differences in carotenoid rankings and diet-serum correlations were observed using either data source in this population. J Am Diet Assoc. 1996; 96:1271-1275.     

The relationship between habitual dietary phosphorus and calcium intake, and bone mineral density in young Japanese women: a cross-sectional study

Phosphorus and calcium are essential for bone health. There is a concern that a low calcium/phosphorus intake ratio resulting from low calcium intake coupled with high phosphorus intake may have a negative effect on bone mineral status, especially in Western countries. The objective of this study was to examine cross-sectionally the influence of habitual phosphorus and calcium intake and the calcium/phosphorus intake ratio on the bone mineral density (BMD) in 441 young Japanese women (aged 18-22) whose calcium/phosphorus intake ratio was assumed to be lower than young Western women. We also ascertained the relationship between dietary intake and serum or urinary measurements of phosphorus and calcium. Parathyroid hormone (PTH) and 25-hydroxy vitamin D (25(OH)D) were also examined for 214 of the 441 subjects. Phosphorus and calcium intake and the calcium/phosphorus intake ratio had significant positive correlations with urinary phosphorus. Calcium intake and the calcium/phosphorus intake ratio independently had positive and significant associations with BMD in the distal radius adjusted for postmenarcheal age, body mass index, and physical activity. There were no significant associations with BMD in the lumbar spine and femoral neck. These results indicate that in young Japanese women, phosphorus intake did not have a significantly negative effect on bone mineral density, and calcium intake and calcium/phosphorus intake ratio had a small but significant association only in a site-specific manner with BMD.     

Bone mineral density in young active females: the case of dancers

The aim of the study was to evaluate the combined effect of several environmental factors on bone mineral density (BMD) in a group of highly active young women. Body composition, total body and regional (arms, legs and trunk) BMD, dietary intake, menstrual status, training habits, and eating attitudes were assessed in 37 professional dance students, aged 18 to 26 years. Dancers had higher BMD values compared to age- and weight-matched reference population (mean total body BMD: 1.185 g/cm2, 9% higher than reference values). No differences were detected between currently eumenorrheic and noneumenorrheic dancers; subjects who encountered menstrual problems during adolescence had significantly lower BMD values compared to counterparts who did not. Regarding dietary intake, dancers in the highest quartile of calcium intake (1323 +/-113 mg/d) exhibited significantly higher total BMD values than subjects in the other 3 quartiles (p =.04). A moderate inverse relationship was found between protein intake and total BMD, after controlling for energy and calcium intake (r = - 0.37). Fat-free soft mass was the only significant predictor of total BMD, explaining 20% of the variance. High levels of calcium intake were associated with high total BMD values. These results confirm the beneficial role of long-term and intensive physical activity on BMD and further suggest that dancers are not at a greater risk compared to the general population for developing osteoporosis, despite their menstrual and eating problems.     

对长期低钙摄入幼鼠的骨骼的研究——Ⅲ 低钙时幼鼠的骨钙素水平

本文研究低钙摄入、维生素D供给正常时幼鼠血中骨钙素水平,以了解低钙时成骨细胞活性。实验采用60只21～23日Wistar断乳幼鼠,随机分为四组:A组,正常钙与VitD摄X组;B组,中度低钙组;C组,重度低钙组;D组,VitD缺乏组。定期监测血25-(OH)D_3水平。于实验中期(3周),末期(6周)分别处死1/2幼鼠,取血与左股骨标本。测血骨钙素水平,以股骨钙与股骨长计算股骨含钙指数。实验建立低钙与低VitD动物模型。结果发现严重低钙幼鼠股骨生长显著落后,VitD缺乏幼鼠股骨生长与正常组相似。低钙与VitD缺乏幼鼠股骨含钙指数均明显低于正常组,低钙组更严重。低钙组幼鼠血骨钙素水平略高于正常组,VitD缺乏幼鼠血骨钙素有增高趋势;提示低钙时股骨增生的成骨细胞活性低下,VitD缺乏幼鼠骨生长受阻程度不如低钙组明显,推测VitD缺乏与低钙时对成骨细胞的作用机理不同。本文研究证实低钙对生长期骨骼的影响远远超过临床估计。     

Growth hormone favorably affects bone turnover and bone mineral density in patients with short bowel syndrome undergoing intestinal rehabilitation

BACKGROUND: Patients with short bowel syndrome (SBS) have a high prevalence of metabolic bone disease due to nutrient malabsorption and potential effects of parenteral nutrition (PN). Human growth hormone (hGH) has been shown in some studies to have anabolic effects on bone, but hGH effects on bone in patients with SBS are unknown. METHODS: Adults with PN-dependent SBS underwent a 7-day period of baseline studies while receiving usual oral diet and PN and then began receiving modified diets designed to improve nutrient absorption and daily oral calcium/vitamin D supplements (1500 mg elemental calcium and 600 IU vitamin D, respectively). Subjects were randomized to receive in a double-blind manner either subcutaneous (sc) saline placebo as the control or hGH (0.1 mg/kg/d for 3 weeks, then 0.1 mg/kg 3 days a week for 8 subsequent weeks). Open-label hGH was given from week 13 to week 24 in subjects who required PN after completion of the 12-week double-blind phase. Markers of bone turnover (serum osteocalcin and urinary N-telopeptide [NTX]), vitamin D nutriture (serum calcium, 25-hydroxyvitamin D [25-OH D] and parathyroid hormone [PTH] concentrations), and intestinal calcium absorption were measured at baseline and at weeks 4 and 12. Dual x-ray absorptiometry (DXA) of the hip and spine was performed to determine bone mineral density (BMD) at baseline and weeks 12 and 24. RESULTS: The majority of subjects in each group exhibited evidence of vitamin D deficiency at baseline (25-OH D levels<30 ng/mL; 78% and 79% of control and hGH-treated subjects, respectively). Subjects treated with hGH demonstrated a significant increase from baseline in serum osteocalcin levels at 12 weeks (+62%; p<.05). The levels of NTX were increased over time in the hGH-treated group; however, this did not reach statistical significance. Both NTX and osteocalcin remained unchanged in control subjects. BMD of the spine and total hip was unchanged in subjects treated with placebo or hGH at 24 weeks. However, femoral neck BMD was slightly but significantly decreased in the placebo group at this time point but remained unchanged from baseline in the hGH-treated subjects. CONCLUSIONS: hGH therapy significantly increased markers of bone turnover during the initial 3 months of therapy and stabilized femoral neck bone mass over a 6-month period in patients with severe SBS undergoing intestinal rehabilitation.     

慢性肾脏病患者饮食磷摄入现状及与钙磷代谢相关性研究

目的 探讨慢性肾脏病患者饮食磷摄入情况,并分析饮食中磷摄入量对血营养指标及钙磷代谢相关指标的影响。方法 以2018年12月至2019年11月成都市某医院诊治的慢性肾脏病患者为研究对象,进行基本资料收集、3 d 24 h膳食调查、营养状态评估及血生化指标检测,采用描述流行病学分析方法对慢性肾脏病患者饮食磷摄入量进行分析。结果 共对151例慢性肾脏病患者进行研究,患者年龄25~75岁,以60~75岁为主,占64.9%,男女性别比为1.25∶ 1,疾病分期以3期为主,占49.0%,原发病以肾小球肾炎为主,占70.9%,主观营养评估（SGA）法评定结果以B级（可疑营养不良）为主,占86.1%。饮食磷摄入量以中等水平（600~800 mg/d）为主,占58.6%,其次是高水平（>800 mg/d）,占23.6%,摄入量低水平（<600 mg/d）的占17.8%。不同饮食磷摄入量的慢性肾脏病患者白蛋白、前白蛋白、血磷、血磷钙乘积指标差异均有统计学意义（均P<0.01）,转铁蛋白、血钙水平在不同饮食磷摄入量慢性肾脏病患者中的差异均无统计学意义（均P>0.05）。血磷及血钙磷乘积与饮食磷摄入量呈正相关（r_s=0.736、0.809,均P<0.05）。结论 饮食磷摄入量对慢性肾脏病患者的营养状况和磷代谢有一定影响,慢性肾脏病患者应注意按营养师的指导注意挑选钾含量较低的食物,在保证机体生理需求前提下,有效控制磷的摄入量,预防高磷血症的发生。     

Influence of inhaled glucocorticoids on bone mineral density and bone metabolism]

Inhaled glucocorticoids (IGs) are today the first-line treatment for bronchial asthma. The systemic effects of inhaled glucocorticoids, such as suppressing the hypothalamic-pituitary-adrenal axis, are generally less than those with oral glucocorticoids. However, there is a long-term risk of adverse effects on bone. The objective of this piece was to review the published data on the effects of IGs on bone metabolism markers and bone mineral density in adults and in pediatric patients. The reviewed studies do not provide uniform results. Nevertheless, in general they suggest that IGs can affect metabolism and bone mineral density, especially: 1) when high doses are administered (more than 400 micrograms/day in children and more than 800 micrograms/day in adults), 2) in pediatric patients, in whom growth in stature can also be affected, 3) in patients whose intake of calcium and vitamin D is inadequate, and 4) in postmenopausal women not undergoing hormone replacement therapy. In general, at therapeutically equivalent doses, beclomethasone has a greater deleterious effect on bone than does budesonide, which in turn has more of an effect than does fluticasone. In addition to the obvious precaution of using the lowest effective dose, other proposed preventive measures include: 1) adequate instruction on the use of aerosols, 2) the use of large volume spacer devices, 3) rinsing the mouth after administering IGs, and 4) dietary adjustments or supplements in order to ensure an adequate intake of calcium and vitamin D.     

血清钙、磷、锌元素及骨碱性磷酸酶在佝偻病患儿中的水平分析

【目的】 分析不同病情佝偻病(different rickets,DR)患儿血清中钙、磷、锌及骨碱性磷酸酶的水平。 【方法】 选择广州市地区DR患儿60例,并按不同病情分轻度、中、重度组,同时选择60例同期体检健康儿童一同进行血清钙、磷、锌及骨碱性磷酸酶的双盲检测。 【结果】 中、重度DR 组的血清钙、磷和锌水平均明显低于对照组,轻度DR组与对照组差异无统计学意义;DR组骨碱性磷酸酶均明显高于对照组(P均<0.05)。在DR组内,中、重度DR 组的外周血清钙、磷和锌水平均明显低于轻度DR 组,骨碱性磷酸酶亦明显高于后者(P均<0.05)。 【结论】 骨碱性磷酸酶结合血清钙、磷、锌水平是反映佝偻病病情的敏感指标。     

Vegetable and fruit intake and its relevance with serum osteocalcin and urinary deoxypyridinoline in Korean adults

The purpose of this study was to evaluate the daily vegetable and fruit intake status of Korean adults and to examine the relationship of vegetable and fruit intake with bone metabolism. The vegetable and fruit intake of 542 healthy male and female adults was analyzed. Then, by selecting 51 targets from the subjects, the relation of vegetable and fruit intake with serum calcium, osteocalcin and deoxypyridinoline (DPD) excretion in urine was examined. The total vegetable intake per day was 397.7 g and 333.5 g by men and women respectively for the age group of 20-29, 366.9 g and 309.2 g respectively for the age group of 30-49, 378.4 g and 325.9 g respectively for the age group of 50-64. Of vegetable varieties, leafy and stem vegetables displayed the highest intake. The order of major intake items of vegetables and fruits was found to be Chinese cabbage kimchi, onion, radish, cucumber, and welsh onion for the age group of 20-29, watermelon, Chinese cabbage kimchi, peach, potato, and onion for the age group of 30-49 and watermelon, Chinese cabbage kimchi, tomato, potato, and peach for the age group of 50-64. Of 51 targets, β-carotene intake displayed a significantly negative correlation with serum osteocalcin. While caloric intake as well as protein, carbohydrate, calcium, phosphorous, zinc and total food intake displayed a significantly negative correlation with DPD excretion in urine, tuber vegetable intake displayed a significantly positive correlation with DPD excretion in urine. In the future, a study will be necessary to accurately explain the relevance of vegetable and fruit intake with bone mineral density and bone metabolism. Also, efforts will be required to increase vegetable and fruit intake.     

围生期妇女骨量和骨代谢及其影响因素研究

目的:探讨围生期妇女骨量和骨代谢及其影响因素。方法:选取2008～2009年100例孕产妇为研究对象,将其设为观察组,选取同期的100例未孕妇女为对照组,将观察组孕早期、孕中期及孕后期和对照组的血清磷、钙、骨碱性磷酸酶、骨钙素、尿钙/肌酐及抗酒石酸酸性磷酸酶、雌二醇等进行检测及比较。结果:经研究比较发现,随着孕周的增加,观察组孕后期血清磷、钙、骨钙素降低,而则尿钙/肌酐、骨碱性磷酸酶、抗酒石酸酸性磷酸酶、雌二醇升高,孕后期与孕中期、孕前期及对照组比较,P0.05或P0.01,有统计学差异。结论:对于围生期妇女进行监测骨量和骨代谢较为重要,以便及时采取补钙措施。     

Lack of relationship between calcium intake and body size in an obesity-prone population

OBJECTIVE: Dietary calcium intake, especially from dairy products, may have a protective effect against obesity. This study aimed to determine if calcium intake is associated with body weight and adiposity in Pima Indians, an obesity-prone population. RESEARCH METHODS AND PROCEDURES: Subjects were 65 Pima Indian adults (35 men/30 women, age 33+/-8 years [mean+/-standard deviation]) participating in a study of eating behavior and 78 Pima Indian children (36 boys/42 girls, age 10.4+/-0.3 years) participating in a study of childhood obesity. Height and weight were measured, and body composition was determined by dual-energy x-ray absorptiometry. Food intake in adults was assessed using the Block 1998 Food Questionnaire; food intake in children was assessed using a 24-hour recall with parental assistance. RESULTS: In adults, mean energy intake was 3,163+/-1,037 kcal/day, mean percentage of energy from fat was 41%+/-7%, and calcium intake was 914+/-333 mg/day. In children, mean energy intake was 1,988+/-733 kcal/day, mean percentage of energy from fat was 36%+/-9%, and calcium intake was 637+/-352 mg/day, half the recommended daily intake for this age group. There were no significant associations between calcium intake and body weight (r=0.05, P=.71; r=0.04, P=.73), body fat (r=0.16, P=.19; r=0.12, P=.42), or body mass index (r=0.01, P=.97; r=0.04, P=.77) in either adults or children, respectively. DISCUSSION: One explanation for the lack of association between reported calcium intake and body size in Pima Indians may be that the high-fat, high-energy diet consumed by the population overwhelmed the "anti-obesigenic" effect of calcium. CONCLUSIONS: We were unable to find an association between calcium intake and body size or adiposity in Pima Indian adults and children. Although the essentiality of calcium to bone health is well established, the role of calcium and dairy product intake in obesity and weight management remains uncertain.     

维生素D缺乏性佝偻病实验室指标的诊断价值探讨

目的 探讨血25-(OH)D₃、骨碱性磷酸酶等临床常用的实验室检查对维生素D缺乏性佝偻病的诊断价值。 方法 对1 190名0~4岁儿童进行临床体检,随机选取部分儿童抽取静脉血测定骨碱性磷酸酶、血25-(OH)D₃、钙、磷、碱性磷酸酶及骨密度、左手腕骨X片。比较其检测佝偻病的灵敏度、特异度。通过ROC曲线对25-(OH)D₃、骨密度诊断价值进行评价。结果 佝偻病患儿血25-(OH)D₃明显低于对照组,25-(OH)D₃的ROC线下面积为0.633(95%CI:0.581~0.684),具有中度诊断性。针对西昌人群,维生素D不足诊断浓度最合适诊断点为72.86 nmol/L。利用该界值点诊断佝偻病的灵敏度为65.35% ,特异度56.02%。骨密度、钙、磷、碱性磷酸酶、骨碱性磷酸酶多种检查指标可做为佝偻病的辅助检查手段,诊断性稍差,联合25-(OH)D₃和骨碱性磷酸酶诊断早期、活动期佝偻病灵敏度提高至76.67%,特异度90.91%。 结论血25-(OH)D₃浓度为诊断佝偻病的良好指标。骨碱性磷酸酶灵敏度、特异度相比优于其他指标,可用于人群筛查。骨碱性磷酸酶和25-(OH)D₃项目的条件下联合辅助诊断,提高对维生素D缺乏性佝偻病的识别性。     

Relationships between usual nutrient intake and bone-mineral content of women 35-65 years of age: longitudinal and cross-sectional analysis

In a 4-yr clinical trial, effect on single-photon absorptiometric measurements of arm bones of usual intakes of energy and 14 nutrients plus vitamin-mineral supplements was studied in 99 women, aged 35-65, randomly assigned to placebo (NS) or calcium-supplemented (1.5 g)(S) groups. Cross-sectional analysis of initial bone measurements showed vitamin C (r = 0.313, p less than 0.05) and niacin (r = 0.353, p less than 0.01) correlated with ulna in postmenopausal subjects (n = 67). Longitudinal analysis of bone-change rates of postmenopausal subjects (NS + S) showed higher calcium intakes associated with lower loss rates of humerus bone-mineral content (BMC) (r = 0.360, p less than 0.01). In postmenopausal NS but not S subjects, energy, protein, calcium, phosphorus, zinc, and folate correlate significantly with change in radius BMC; high levels of intake correlated with slower loss (p less than 0.05). Several nutrients besides calcium are related to bone loss in women.     

Nutrient intake and bone health status of Korean male college students as related to smoking situations

The purpose of this study was to compare the dietary habits, nutrient intake, bone mineral density (BMD) and bone metabolism in Korean male collegians as related to smoking situation. One hundred sixty one young adult males at the age of 20-26 participated in this study. The subjects were divided into four groups: non smoker (n=42), light smoker (n=34), moderate smoker (n=49) and heavy smoker (n=36). The anthropometric characteristics, smoking situations, dietary habits and nutrient intakes were observed. Bone status of the calcaneus was measured by using quantitative ultrasound (QUS). Bone metabolism markers including serum alkaline phosphatase activity (ALP) and N-mid osteocalcin (OC) were analyzed. There were no significant differences in height, weight, BMI, energy and calcium intake among the four groups. Iron intake of moderate and heavy smoker was significantly lower than that of light smoker. Heavy smokers consumed significantly lower vitamin C than moderate smokers, and their coffee consumption and lifetime alcohol consumption were significantly highest among the 4 groups. QUS parameters and serum ALP were not significantly different among the four groups. Serum OC levels were significantly lower in heavy and non smoker group compared to the moderate smoker group. In conclusion, heavy smokers in young male collegians had undesirable lifestyle and dietary habits, like as high consumption of coffee and alcohol, and low intake of Fe and vitamin C. Although, there was no significant difference in their current bone status from the other groups, these undesirable factors with heavy smoking may affect their bone health in the long term.     

Body mass index and disease duration are predictors of disturbed bone turnover in anorexia nervosa. A case-control study

OBJECTIVE: To characterize the influence of body mass index (BMI), body composition, hormonal factors and disease duration on bone metabolism markers in anorexia nervosa (AN) patients. DESIGN: Case-control study with 51 AN patients and 51 controls matched for age, sex and body height. Assessment of anthropometric and bioimpedance data, and of biochemical serum parameters and of oral contraceptives use. RESULTS: Patients had a lower BMI, lower fat mass, lower fat-free mass and lower muscle mass (MM) compared to the controls (all P values <0.001). Moreover, serum levels of osteocalcin (bone formation marker) were lower while serum C-telopeptide concentrations (CTx; bone resorption marker) and the CTx/osteocalcin ratio (an index reflecting the balance of bone remodeling) were higher in the AN patients compared to the controls (P<0.01-0.001). In addition, patients had enhanced serum calcium and cortisol levels and reduced serum levels of thyroid hormones, insulin, and leptin (P values <0.05-0.001). Mean disease duration was 91+/-13 months. In a multiple regression analysis, BMI (P<0.0001), MM (P<0.005) and duration of the disease (P<0.005) were independent predictors of the CTx/osteocalcin ratio in the AN patients. There was a nonlinear association between BMI and the CTx/osteocalcin ratio of r=-0.72 (P<0.001) in the AN patients, but only a weak relation of r=-0.27 (P<0.05) between these parameters in the control subjects. Use of oral contraceptives had no effect on the CTx/osteocalcin ratio, neither in AN patients nor in controls. CONCLUSIONS: Data indicate an uncoupling of bone formation and bone resorption in AN, which is primarily the result of a low BMI and influenced by the duration of the disease.     

口服碳酸钙制剂对孕产妇骨密度的影响

目的探讨孕产妇补充碳酸钙制剂对其骨密度的影响。方法36例孕第一胎妇女从孕20周开始通过膳食、膳食干预及碳酸钙补充摄入不同剂量的钙至产后45天。监测并比较孕中、孕末及产后期的血钙、碱性磷酸酶、尿羟脯氨酸、骨钙素及产后骨密度的差异。结果(1)传统膳食加40g／d奶粉补充的孕产妇产后骨密度虽优于传统膳食组,但明显低于奶粉加碳酸钙组;(2)奶粉加碳酸钙补充组的产妇腰椎骨密度明显高于奶粉组和传统膳食组,并维持至正常非常非孕同龄妇女的水平;(3)奶粉加碳酸钙补充组在孕末期、产后期的碱性磷酸酶活性、尿羟脯氨酸水均明显低于传统膳食组而骨钙素含量明显高于传统膳食组。结论(1)我国传统膳食钙摄入量约450mg／d,孕期的低钙摄入可导致产后骨密度下降;(2)孕期在传统膳食基础上补充40g奶粉／d,可使其产后骨密度优于传统膳食组,但不能维持骨密度至正常的水平;(3)奶粉加碳酸钙的联合补充,可使孕产妇产后骨密度明显高于传统膳食组和奶粉补充组,并维持其骨密度至正常水平。     

Antiosteoporotic effect of Polycan, beta-glucan from Aureobasidium, in ovariectomized osteoporotic mice

ObjectiveWe investigated the anti-osteoporotic effects of Polycan, a β-glucan from Aureobasidium pullulans, in ovariectomized mice at doses of 31.25, 62.5, and 125 mg/kg.MethodsPolycan was administered orally once a day for 28 d to bilateral ovariectomized mice, beginning 4 wk after surgery. Changes in body weight, bone weight, bone mineral content, bone mineral density, failure load, histologic profiles, and histomorphometric analyses were determined, in addition to serum osteocalcin, calcium, and phosphorus levels. Alendronate was used as a reference drug.ResultsPolycan significantly and dose-dependently suppressed decreases in bone weight, bone mineral content, failure load, bone mineral density, and serum calcium and phosphorus levels and the increase in serum osteocalcin levels. In addition, Polycan significantly suppressed decreases in histomorphometric parameters such as volume, length, and thickness of trabecular bone and thickness of cortical bone and the increase in osteoclast cells in the femur and tibia.ConclusionAlthough the effects of Polycan were generally modest and smaller than those of alendronate, the effects on cortical bone thickness were more favorable for Polycan than for alendronate. In addition, Polycan exhibited favorable effects on ovariectomy-induced osteoporosis. However, more long-term studies are needed to confirm the effects of Polycan on osteoporosis.     

Body fat, caloric intake, and plasma leptin levels in women with anorexia nervosa.

OBJECTIVE: To measure serum leptin concentrations in women with anorexia nervosa (AN) and to identify independent predictors of leptin levels, thereby allowing hormone levels to be modeled using regression analysis. METHODS: A cross-sectional study of 15 AN inpatients and 16 healthy control subjects. Age, height, weight, percent body fat, total caloric intake, fat intake, and fasting plasma leptin levels were recorded. Stepwise forward regression analysis was carried out to identify predictors of leptin levels. RESULTS: Circulating leptin concentrations in AN were 3.5+/-0.5 versus 7.6+/-1.2 ng/ml in control subjects. Percent body fat correlated best with leptin levels in anorexic and control subjects (r =.63; p =.0002), with caloric intake showing only a moderate correlation (r = .47; p = .008). Only percent body fat was a significant predictor of plasma leptin levels in our regression model. DISCUSSION: Leptin levels are proportionately lower in AN as compared to healthy controls. It appears that physiological regulation of plasma levels with respect to percent body fat is maintained in individuals with little body fat.     

Relationship between vitamin K status, bone mineral density, and hs-CRP in young Korean women

Vitamin K intake has been reported as an essential factor for bone formation. The current study was conducted under the hypothesis that insufficient vitamin K intake would affect inflammatory markers and bone mineral density in young adult women. The study was a cross-sectional design that included 75 women in their 20s. Physical assessments, bone mineral density measurements, 24-hr dietary recalls, and biochemical assessments for high sensitivity C-reactive protein (hs-CRP) and percentages of undercarboxylated osteocalcin (%ucOC) were performed. An analysis of vitamin K nutritional status was performed comparing first, second, and third tertiles of intake based on %ucOC in plasma. Vitamin K intake levels in the first, second, and third tertiles were 94.88 ± 51.48 µg, 73.85 ± 45.15 µg, and 62.58 ± 39.92 µg, respectively (P < 0.05). The T-scores of the first and third tertiles were 1.06 and -0.03, respectively, indicating that bone mineral density was significantly lower in the group with lower vitamin K intake (P < 0.05). There was a tendency for different serum hs-CRP concentrations between the first (0.04 ± 0.02) and third tertiles (0.11 ± 0.18), however this was not statistically significant. Regression analysis was performed to identify the correlations between vitamin K nutritional status, inflammatory markers, and bone mineral density after adjusting for age and BMI. Serum hs-CRP concentrations were positively correlated with vitamin K deficiency status (P < 0.05). And bone mineral density, which was represented by speed, was negatively correlated with vitamin K deficiency status (P < 0.05). In conclusion, status of vitamin K affects inflammatory status and bone formation. Therefore, sufficient intake of vitamin K is required to secure peak bone mass in young adult women.