钙摄入量对骨密度影响的研究

[目的 ]　探讨膳食营养与骨质疏松的关系。 [方法 ]　应用膳食营养调查方法调查某厂女工的膳食营养情况 ,并在 40岁以上 3个年龄组女工中分成平时注意补钙和不注意补钙的 2组人群 ,分别对这 2组人群的钙摄入量和骨密度进行比较。 [结果 ]　各年龄组女工的钙摄入量不足 ;40岁以上各年龄组女工中 ,平时注意补充钙摄入的女工每日钙的摄入量均高于未注意补充钙组 ,骨密度也高于未补充钙组。 [结论 ]　膳食钙摄入不足 ,易致骨密度下降。骨质疏松与低钙饮食有关。     

The effect of high salt and high protein intake on calcium metabolism, bone composition and bone resorption in the rat

The effects of salt (NaCl) supplementation of rat diets (50 g/kg diet), with normal (200 g/kg) or high (500 g/kg) dietary casein content, were studied in 3-week-old male rats over a 3-week period. Weight gain was reduced by dietary salt but was unaffected by dietary casein. Salt-supplemented rats exhibited a two- and three-fold increase in urinary Mg and Ca excretion respectively, irrespective of dietary casein content. Dietary casein had no effect on urinary Ca or Mg. Salt reduced femoral mass but not femoral mass expressed relative to body weight, but neither variable was affected by dietary casein. Femoral Mg and P contents and concentrations were unaffected by dietary salt or casein. While femoral Ca concentration was unaffected by dietary salt, the Ca content was reduced by salt supplementation, irrespective of dietary casein content. Neither the content nor concentration of Ca in femora was affected by dietary casein. Urinary pyridinoline and deoxypyridinoline levels were increased by salt supplementation, irrespective of dietary casein content, but were unaffected by casein. Net Ca absorption was unaffected by dietary salt or casein. In conclusion, these results show that salt supplementation over the short-term increased the rate of bone resorption in rats. This was as a consequence of Na-induced calciuria. On the other hand, a high dietary protein intake had no effect on Ca metabolism, bone composition or bone resorption, nor did it augment the Na-induced calciuria or increased rate of bone resorption.     

Investigation of the relationship between low environmental exposure to metals and bone mineral density,bone resorption and renal function

Environmental exposure to metals has been linked to adverse health outcomes. Exposure to cadmium has been associated with decreased bone density, an increased risk of osteoporotic fracture and possible renal dysfunction. Older women are a group at risk of renal and bone density impacts and exposure to metals may be an important risk factor for these health outcomes. This study was a cross sectional study of 77 women aged 50 years and above examining the relationship between metals exposure and renal and bone health. Urinary and blood metals concentrations, plasma creatinine, iron, ferritin and transferrin were measured in these subjects. Bone biomarkers assessed included the pyridinium crosslinks, pyridinoline and deoxypyridinoline measured by ELISA. Renal function was assessed using eGFR and KIM-1. Whole body, hip and lumbar spine bone mineral density was assessed using DEXA. Blood and urinary metals concentrations were generally low in the subjects, with a median urinary cadmium concentration of 0.26 μg/g creatinine (range <0.065–1.03 μg/g). Urinary cadmium was found to be a significant predictor of bone mineral density at whole body, lumber spine, total hip and femoral neck, with increasing urinary Cd concentrations associated with decreased bone density. Urinary cadmium and aluminium concentrations were positively correlated with bone resorption whilst blood zinc and mercury concentrations were negatively correlated. Urinary aluminium was positively correlated with KIM-1 concentrations, a marker of early kidney damage, however blood zinc concentrations were significantly negatively correlated with this biomarker. This study provides additional support for low cadmium exposure being of concern for the health of older women. Further investigation into the role of exposure to other metals on bone and renal health is warranted.     

The relationship of bone mass and fracture history to fluoride and calcium intake: a study of three communities

Stimulated by the suggestion that water fluoride greater than 1 mg/L may protect against osteoporosis, we studied bone mass of women in three rural communities with differing mineral content of the water supply. Mean fluoride and calcium of community drinking waters were 4 mg/L and 16 mg/L, respectively, high fluoride community; 1 mg/L and 375 mg/L, respectively, high calcium community; and 1 mg/L and 65 mg/L, respectively, low calcium community. Bone mass was measured by single photon absorptiometry, and women were interviewed about fracture history, dietary intake, and other important covariates. We observed no protective effect with higher fluoride intake. Bone mass was lower in older women from the high fluoride community though not statistically so; these women reported significantly more fractures. There was no observed community difference in young women's bone mass or fracture history. Young women in the high fluoride community consuming calcium and vitamin D in excess of 800 mg/day and 400 IU/day, respectively, had significantly better bone mass (p less than 0.05) than their peers.     

食盐摄入量与成人血压关系的横断面研究

目的了解食盐摄入量与成人血压的关系。方法采用多阶段整群随机抽样方法,对徐州市20个社区的9 788名≥18岁居民进行问卷调查和体格检查,运用线性回归探索食盐摄入量与血压的关系。结果高血压新发现率8.80%,调查对象食盐日均摄入量(10.00±7.60)g/d,高血压患者每日食盐摄入量高于其他两组人群,正常血压、正常高值血压和高血压人群食盐摄入量的差异具有统计学意义(P0.01)。不同性别不同食盐摄入量调查对象收缩压(F男=15.567,F女=42.026,P值均0.01)、舒张压(F男=8.201,F女=22.420,P值均0.01)差异均具有统计学意义。与食盐摄入量≤6g/d人群比较,未调整混杂因素前,食盐摄入量≥12g/d、6g/d的调查对象收缩压分别增加了2.389倍(95%CI:1.933~2.845)、3.078倍(95%CI:2.309~3.847),调整混杂因素后,分别增加了1.919倍(95%CI:1.470~2.368)、2.927倍(95%CI:2.206~3.648)。结论减少每日食盐摄入量是罹患高血压的保护因素。     

中老年人膳食硒与高血压关系的横断面研究

目的 探讨膳食硒摄入量与高血压的关系。方法 从湖南湘雅医院健康体检中心随机选取被体检人员为研究对象,测量身高、体重、血压等身体指标,利用食物频率调查问卷间接测量膳食硒摄入情况。采用t检验、χ²检验进行单因素分析,Logistic回归模型分析膳食硒与高血压的关系。结果 分析显示,性别、年龄、体质指数、糖尿病患病情况及膳食纤维摄入情况在高血压患者与非高血压患者间的差异均有统计学意义（均有P<0.05）。校正年龄、性别、吸烟、饮酒状况等相关因素后,结果显示：以硒摄入水平的最低分类（<27.51 mg/d）作为参照,最高分类（>55.81 mg/d）的OR（95% CI）为0.715（0.528~0.968）,高血压的患病率随着膳食硒摄入水平的升高而降低。结论 增加膳食硒摄入可以降低高血压的患病风险。     

The effect of calcium intake on bone composition and bone resorption in the young growing rat

A low Ca intake by both rats and man increases bone resorption, decreases bone mass and increases the risk of osteoporosis. The skeletal effect of high Ca intakes is less clear, particularly during periods of bone mineral accrual. Twenty-four female 5-week-old rats, Wistar strain, were randomized by weight into three groups of eight rats each and fed ad libitum a semi-purified diet containing 2 (Ca-restricted), 5 (normal) or 20 (Ca-supplemented) g Ca/kg for 3 weeks. When compared with the normal Ca diet, urinary Ca excretion was unaffected by the dietary restriction of Ca for 3 weeks, but was greater (P<0.001) in Ca-supplemented rats. Urinary pyridinoline (Pyr) and deoxypyridinoline (Dpyr) levels were significantly greater during weeks 2 (Pyr P<0.05, Dpyr P<0.001) and 3 (Pyr P<0.01, Dpyr, P<0.001) of dietary Ca restriction, but were unaffected by Ca supplementation. Femoral dry weight and the concentration of Mg and P in femora were unaffected by dietary Ca concentration. Femoral Ca concentration was reduced (P<0.05) in the Ca-restricted group compared with the other two groups. In conclusion, these results suggest that increasing dietary Ca intake, well above the recommended level, had no effect on bone mineral composition or bone resorption (as assessed with urinary pyridinium crosslinks) in young growing female rats. In addition, these results confirm the findings of previous studies which have shown that bone Ca content in young growing rats was reduced by dietary Ca restriction and that this reduction results, at least in part, from an increased rate of bone resorption.     

体质指数与体重控制知信行的关系研究

目的：了解城市不同体质指数（BMI ）人群对控制体重的健康认识、主动意识及相关行为。方法采用随机整群抽样的方法调查杭州市2个区18～45岁的公务员、企业管理人员和事业单位人员共1175人,分析不同BMI值职业人群对体重控制的知识、态度和行为。结果杭州市城市职业人群超重率为21.70％,肥胖率为6.04％。体重过轻、正常、超重和肥胖等BMI 值人群自评超重肥胖对身体健康有影响知晓率分别为98.95％、98.81％、96.08％和95.77％,对心理健康有影响知晓率分别为90.53％、92.44％、83.92％和81.69％,对控制体重有信心分别占82.11％、79.18％、72.94％和50.70％,呈随体重增高而降低的趋势,差异均有统计学意义（P＜0.05）。不同BMI值人群在体重控制行为方面,差异无统计学意义（P＞0.05）。在累积体重控制行为方面差异无统计学意义（P＞0.05）。结论不同BMI值人群在超重肥胖对个人的健康影响、控制体重的主动意识方面有差异,在采取体重控制行为方面无差异。     

Calcium intake, physical activity and bone mass in pre-menopausal women

Thirty pre-menopausal women aged 35–40 years were assessed with respect to dietary calcium intake, physical activity and other factors related to bone loss (by questionnaire); bone mass in the mid and distal femur measured by computerized tomography; and leg strength and muscle size. Cortical thickness at mid-femur was negatively associated with breast-feeding (r=-0.40). Bone mass in the distal femur was negatively associated with age (r=-0.46) and positively associated with activity (r=0.44) and leg strength (r=0.42). There was no association of bone mass at either site with current dietary calcium intake (range 198–1511 mg/day), nor with body mass index (BMI), hand-grip strength, parity, oral contraceptive use, smoking, or alcohol intake. Thus, in older pre-menopausal women, activity apparently helps to maintain bone mass at the distal femur, a site of high trabecular bone content, while current dietary-calcium intake has no effect on bone mass in the femur. Activity was most strongly associated with bone mass in the distal femur when it was defined as the total number of hours spent standing or moving (i.e. other than sitting or lying down), regardless of the intensity of activity.
The strong negative association between bone mass in the distal femur and age in older pre-menopausal women is of concern in relation to long-term risk of osteoporotic related fracture, suggesting that factors relating to bone loss in this age-group should be studied longitudinally. The apparent loss of cortical bone in breast-feeders warrants further investigation.     

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.     

中老年人营养素摄入量与骨密度关系的研究

目的 探讨中老年人营养素摄入量与骨密度的关系.方法 对200名在北京协和医院健康体检者进行膳食调查及测量腰椎(L)2～4、股骨大粗隆及股骨颈的骨密度,并分为中青年男女组、老年前期男女组和老年男女组,各组及性别间进行比较.结果 男性老年组平均每日蛋白质、碳水化合物、热量的摄入量分别为(71.4±11.7)g、(294.2±54.7)g和(2196.9±311.3)kcal,显著低于男性中青年组;男性中青年组平均每日蛋白质、碳水化合物、热量的摄入量分别为(91.7±19.5)g、(81.8±85.2)g和(2716.0±451.7)kcal.钙摄入量以女性老年组为最低,平均每日摄入量为(362.0±167.1)mg;男性老年组L2～4、股骨大粗隆及股骨颈的骨密度异常发生率显著高于男性中青年组(P＜0.05)及男性老年前期组(P＜0.05);女性各组L2～4、股骨大粗隆及股骨颈的骨密度异常发生率的差异均有统计学意义(P＜0.05),尤以老年组和中青年组显著(P＜0.0001);男性老年前期组和老年组骨密度异常发生率显著低于女性老年前期组(P＜0.05)和女性老年组(P＜0.05).结论 影响老年女性骨密度异常的因素之一可能为钙摄入的减少,脂肪摄入量的增加可能是影响骨健康的因素之一.     

老年人轻度认知功能障碍患病调查

  目的  探讨社区老年人居住方式与认知功能障碍的关系。  方法  采用现况研究、系统抽样方法,于2014年8月 — 2016年8月在湖北省武汉市武昌区4个社区共调查了1 818名老年人,以蒙特利尔认知评估量表评分作为认知功能的评价指标,数据分析采用χ²检验、方差分析、SNK检验和多因素非条件logistic回归。  结果  仅与配偶居住、与配偶/子女居住是老年人认知功能的保护因素（OR = 0.57,95 % CI = 0.41～0.79;OR = 0.66,95 % CI =0.45～0.98）。调整年龄、性别、教育程度、职业、锻炼、吸烟饮酒、社会网络（规模、复杂性）后,OR = 0.62,95 % CI = 0.45～0.88;OR = 0.73,95 % CI = 0.46～0.98。  结论  老年人的认知功能与居住方式有关,与配偶居住能减缓认知功能的损伤。     

咖啡摄入量与心血管死亡率关系的剂量-反应Meta分析

目的 探讨咖啡每日摄入量与心血管死亡率的关系。方法 计算机检索PubMed、EMbase、The Cochrane、CBM、WanFang Data和CNKI 数据库,搜集有关咖啡摄入量与心血管疾病的相关研究,检索时限均从建库至2020年4月。由两名研究者独立筛选文献、提取文献并评价纳入研究的偏倚风险后,采用Stata 14.0进行剂量反应meta分析,并对纳入的文献进行方法学质量评价。结果 共纳入26篇队列研究,包括2 046 690例受试者。剂量-反应meta分析结果显示,咖啡摄入量每天每增加1杯心血管死亡率下降约3%（RR = 0.97,95%CI:0.96～0.98）,差异具有统计学意义,且存在一种非线性剂量反应关系（P for non - linearity:＜0.01）。与不喝咖啡的人群相比,每天喝1～8杯咖啡的人群相对死亡率分别为（RR = 0.90,95%CI:0.87～0.92）、（RR = 0.84,95%CI:0.81～0.87)、（RR = 0.82,95%CI:0.79～0.84）、（RR = 0.81,95%CI:0.78～0.84）、（RR = 0.81,95%CI:0.78～0.84）、（RR = 0.81,95%CI:0.78～0.84）、（RR = 0.82,95%CI:0.79～0.85）、（RR = 0.83,95%CI:0.80～0.87）。与不喝咖啡人群相比,meta分析结果显示喝咖啡人群的相对死亡率平均为（RR = 0.83,95%CI:0.81～0.85）,可以降低17%的死亡率,差异具有统计学意义。结论 饮用咖啡可以降低心血管死亡率,每日饮用2～4杯最佳。     

The relationship between negative life events,psychological distress and life satisfaction: a population-based study

Purpose

Negative life events may increase psychological distress and reduce life satisfaction (LS). This study investigates associations between negative life events and both positive and negative indicators of mental health and explores the extent to which these associations are buffered by sense of mastery and perceived social support.

Methods

Data were obtained from a large (N = 4,823), nationally representative sample of Norwegians aged 16 and older. Psychological distress was measured by The Hopkins Symptom Check List (HSCL-25), LS by a single question on overall satisfaction with life and negative life events by a 12-item list of threatening experiences. Moderating variables, sense of mastery and social support, were measured using standard instruments.

Results

Adjusting for age, sex, education and income, all of the negative life events were significantly associated with both psychological distress and LS, with the exception of events pertinent to bereavement. Of the life events examined, financial strain constituted the strongest predictor. Overall, negative life events were more closely associated with psychological distress than LS. Altogether, negative life events explained 22.3 and 11.4 % of the variance in psychological distress and LS, respectively. Sense of mastery, but not perceived social support, emerged as a moderating factor between financial strain and both psychological distress and LS.

Conclusion

Negative life events are associated with higher psychological distress and lower LS, but the strength of the associations varies across events. The impact of financial strain and conflict appears particularly strong, but may be moderated by self-perceived mastery.     

绝经后妇女体力活动水平与骨量的关系研究

目的探讨日常性体力活动对绝经后妇女骨量的影响。方法将222名绝经后妇女(平均年龄56.51±8.33岁)按体力活动水平分为3类:体力不足、体力活跃、体力高度活跃,比较3组之间腰椎骨密度、骨矿含量和腰椎骨面积。结果不同体力水平之间平均腰椎和第1~4腰椎骨密度值不同(F=10.818,P=0.000;F=11.060,P=0.000;F=7.309,P=0.001;F=11.703,P=0.000;F=12.347,P=0.000),体力高度活跃组平均腰椎和第1~4腰椎骨密度值高于体力不足组和体力活跃组(P分别为0.003、0.006;0.009、0.000;0.015、0.001;0.002、0.000;0.000、0.000),而体力活跃组与体力不足组间差异无统计学意义(P分别为0.986、0.579、0.967、0.942、0.520)。骨矿含量L1、骨矿含量L4在不同体力活动水平间不同(F=4.172,P=0.017;F=3.690,P=0.027),体力不足组骨矿含量L1低于高度活跃组(P=0.006),骨矿含量L4明显低于体力活跃组和高度活跃组(P分别为0.017、0.009)。除L3骨面积无差异(F=2.844,P=0.060)外,其余腰椎L1,L2,L4骨面积在不同体力活动水平间有差异(F=6.478,P=0.002;F=5.370,P=0.005;F=6.197,P=0.002),体力活跃组腰椎L1,L2,L4骨面积均大于体力不足组和高度活跃组(P分别为0.001、0.005;0.028、0.002;0.028、0.001)。结论体力活动水平与绝经后妇女骨量有关。     

Saturated fatty acids intake in relation to C-reactive protein,adiponectin, and leptin: A population-based study

ObjectiveEvidence on the relation of saturated fatty acids (SFA) with inflammatory markers and adipokines is scarce and inconsistent. This study aimed to evaluate the association of the intake of total SFA, their subtypes (lauric, myristic, palmitic, and stearic acids), and SFA to polyunsaturated fatty acids (PUFA) ratio (SFA/PUFA ratio) with serum concentrations of high-sensitivity C-reactive protein (hs-CRP), adiponectin, and leptin among Portuguese adults.MethodsWe studied 395 non-institutionalized inhabitants of Porto (52.2% women; age range: 26–64 y) who were evaluated in 2010–2011, as part of EPIPorto study. Fatty acids intake was assessed with a validated semi-quantitative food frequency questionnaire. Blood was sampled after an overnight fast and serum concentrations of hs-CRP (through particle-enhanced immunonephelometry), adiponectin, and leptin (through radioimmunoassay) were determined. Regression coefficients (β) and 95% confidence intervals (CI) were obtained from linear regression models, stratified by sex.ResultsAfter adjusting for age, education, regular physical exercise, smoking, and central body fat percentage, hs-CRP was significantly and positively associated with lauric (β = 0.218; 95% CI, 0.071–0.365) and myristic acids (β = 0.220; 95% CI, 0.073–0.368) and with SFA/PUFA ratio (β = 0.171; 95% CI, 0.022–0.320) in men, but not in women. For adiponectin and leptin, no significant associations with SFA intake were observed in either sex.ConclusionsA detrimental role of lauric and myristic acids and of high SFA/PUFA ratio is suggested by their association with elevated hs-CRP concentrations in men. Our findings may be helpful in the planning of dietary modifications aimed at the modulation of inflammatory activity that could be an intermediate step to coronary events.