适量补充钙和维生素D是防治骨质疏松症的基础措施——评新英格兰医学杂志Jackson等"补充钙和维生素D与骨折危险"一文

对2006年2月16日新英格兰医学杂志(NEJM)发表的“补充钙和维生素D与骨折危险”一文进行评述。这是一项大样本的随机、对照临床试验,评价绝经后妇女长期补充钙和维生素D对预防骨质疏松性骨折的效果。结果显示,在健康的绝经后妇女中补充钙和维生素D后髋部骨密度少量增加,但未能显著减少髋部骨折的发生,而肾结石的危险增加。由于该研究在研究设计、人群的选择、依从性等方面存在明显的局限与缺陷,影响了研究结果的真实性、科学性和推广价值。本文的结论是:该研究没有提供充分可靠的证据否定补充钙和维生素D对防治骨质疏松的益处。基于以往的众多研究证据,继续推荐以钙和维生素D的适量补充作为防治骨质疏松的基础措施。

Adequate supplementation of calcium and vitamin D is the essential strategy for prevention and treatment of osteoporosis

Comments were made on the paper titled "Calcium Plus Vitamin D Supplementation and the Risk of Fracture" published recently in the New England Journal of Medicine.It is a large randomized controlled trail to evaluate the efficacy of calcium with vitamin D supplementation for preventing hip and other fractures in healthy postmenopausal women.The results of this trail showed that among health postmenopausal women,calcium with vitamin D supplementation resulted in a small but significant improvement on bone density at hip,did not significantly reduce hip fracture,and increased the risk of kidney stones.However,the results were obviously affected by several limitations of this study,such as the design of the study,population selected and compliance of the trail.We concluded that due to these limitations of this trail,no solid evidence was offered to deny the benefit of calcium plus vitamin D supplementation to bone health.Therefore,it is still recommended that adequate supplementation of calcium and vitamin D is the essential strategy for prevention and treatment of osteoporosis.