膳食钙不足对香港青少年先天性脊柱侧凸全身骨质密度偏低的影响(英文)

青少年先天性脊柱侧凸 (AIS)是一种主要影响女孩的脊柱严重三维畸形病。在香港有 3 %～ 4%的发病率 ,AIS的病人同时发现患有全身性的骨密度偏低现象。本文试图研究是否低骨矿物质密度 (BMD)与AIS病人钙摄入量有关。以 11～ 16岁 582名AIS患者和 2 0 6名健康对照人群为研究对象。面积骨矿物质密度 (aBMD)和体积骨矿物质密度 (vBMD)分别用DXA(Norland XR 3 6)和PQCT(Densiscan 10 0 0 )检测。钙和其它营养素摄入量用食物频率法评价。受试者钙绝对摄入量低 (<50 0mg d)。患AIS少女平均钙摄入量显著高于对照组少女 (441± 3 4 4 )mg dvs.(3 90± 2 81)mg d ,P =0 0 15] ,11～ 16岁AIS患者大多数骨骼测定点BMD显著低于同龄对照组 (P≤ 0 0 5)。AIS患者与对照组BMD的差异程度随着年龄的增长而增加。 15～ 16岁年龄组AIS患者中钙摄入量与在大多数骨骼测定点测得的BMD有显著相关性 ,而在对照组中没有发现这种相关性。经多因素分析 ,在控制干扰变量的情况下 ,预测BMD的变化 ,钙摄入量是一个非依从性决定因素。结果提示 ,AIS患者绝对钙摄入量低 ,在各年龄组青少年中各个骨骼测定点测得的BMD ,AIS患者组均低于对照组。只有在AIS患者中钙摄入量与BMD有相关性 ,而健康的对照中没有相关性。这表明钙摄入量对AIS患者

Inadequate calcium intake is a significant determinant on generalised osteopenia in Hong Kong Chinese adolescents with idiopathic scoliosis

Adolescent idiopathic scoliosis (AIS) is a serious 3-dimentional deformity of the spine affecting mostly girls. The prevalence rate is 3%-4% in Hong Kong. Generalised osteopenia are found in AIS patients. This study attempted to study whether low bone mineral density (BMD) is related to calcium intake in AIS. 582 AIS patients & 206 healthy controls aged 11-16 years were enrolled. Areal BMD (aBMD) and volumetric BMD (vBMD) were evaluated by DXA (Norland-XR-36) and pQCT (Densiscan-1000) respectively. Calcium and other nutrients intakes were assessed by a food-frequency method. The results showed that absolute calcium intake of the subjects were low (< 500 mg/d). Mean calcium intake of AIS girls was significantly higher than that of controls(441 +/- 344) mg/d vs. (390 +/- 281) mg/d, P = 0.015]. BMD of AIS was significantly lower than that of controls at most skeletal sites from age 11-16 years (P < or = 0.05). The percentage difference in BMD increased with age between the AIS and control group. Furthermore, calcium intake was significantly correlated with BMD at most skeletal sites from age 15-16 years. However, this association was not found in the controls. Calcium intake was an independent determinant to predict variation of BMD after controlling for confounding variables in multivariate analysis. It is suggested that absolute calcium intake of AIS was low. BMD at various skeletal sites of the AIS was consistently lower than those of controls across different adolescent years, and that the correlation between calcium intake and BMD occurs only in AIS but not in healthy control girls implying the importance of calcium in bone mineral gain among the AIS, and it also reflected an abnormal mechanism of calcium homeostasis and bone turnover in AIS. Further calcium interventional study is warranted to confirm the effect of calcium on BMD acquisition in AIS.