Место кальция, витамина D, микро- и макроэлементов в первичной профилактике остеопороза и переломов
Место кальция, витамина D, микро- и макроэлементов в первичной профилактике остеопороза и переломов
Никитинская О.А., Алексеева Л.И. Место кальция, витамина D, микро- и макроэлементов в первичной профилактике остеопороза и переломов. Consilium Medicum. Хирургия (Прил.). 2015; 2: 28–32.
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Nikitinskaia O.A., Alekseeva L.I. Place of calcium, vitamin D, micro and macro-elements in the primary prevention of osteoporosis and fractures. Consilium Medicum. Surgery (Suppl.). 2015; 2: 28–32.
Место кальция, витамина D, микро- и макроэлементов в первичной профилактике остеопороза и переломов
Никитинская О.А., Алексеева Л.И. Место кальция, витамина D, микро- и макроэлементов в первичной профилактике остеопороза и переломов. Consilium Medicum. Хирургия (Прил.). 2015; 2: 28–32.
________________________________________________
Nikitinskaia O.A., Alekseeva L.I. Place of calcium, vitamin D, micro and macro-elements in the primary prevention of osteoporosis and fractures. Consilium Medicum. Surgery (Suppl.). 2015; 2: 28–32.
В настоящее время весьма актуальной является проблема профилактики остеопороза и связанных с ним переломов, в патогенезе которых существенную роль играют недостаточное потребление кальция и дефицит витамина D. В обзоре рассмотрены результаты клинических исследований и данные метаанализов по применению препаратов кальция и витамина D с целью снижения риска переломов, освещены вопросы безопасности использования этих препаратов, а также роль и терапевтическая эффективность отдельных макро- и микроэлементов в комплексной профилактике остеопороза.
Ключевые слова: препараты кальция и витамина D, остеопороз, профилактика.
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The problem of preventing the osteoporosis and related fractures in the pathogenesis of whichThe problem of preventing the osteoporosis and related fractures in the pathogenesis of which play an important role insufficient intake of calcium and vitamin D is considered urgent. In the deficiency review covers the results of clinical trials and meta-analyzes of data on the use of calcium and vitamin D to reduce the risk of fractures , address the issues of security of these drugs, as well as the role and therapeutic efficacy of certain macro- and microelements in comprehensive prevention of osteoporosis.
Key words: calcium supplements and vitamin D, osteoporosis, prevention play an important role insufficient intake of calcium and vitamin D is considered urgent. In the deficiency review covers the results of clinical trials and meta-analyzes of data on the use of calcium and vitamin D to reduce the risk of fractures , address the issues of security of these drugs, as well as the role and therapeutic efficacy of certain macro- and microelements in comprehensive prevention of osteoporosis.
Key words: calcium supplements and vitamin D, osteoporosis, prevention
1. Reid IR, Ames R, Mason B et al. Randomized controlled trial of calcium supplementation in healthy, nonosteoporotic, older men. Arch Intern Med 2008; 168 (20): 2276–82.
2. Peacock M, Liu G, Carey M et al. Effect of calcium or 25OH vitamin D3 dietary supplementation on bone loss at the hip in men and women over the age of 60. J Clin Endocrinol Metab 2000; 85 (9): 3011–9.
3. Warensjo E, Byberg L, Melhus H et al. Dietary calcium intake and risk of fracture and osteoporosis: prospective longitudinal cohort study. BMJ 2011; 342: d1473.
4. Tang BM, Eslick GD, Nowson C et al. Use of calcium or calcium in combination with vitamin D supplementation to prevent fractures and bone loss in people aged 50 years and older: a meta-analysis. Lancet 2007; 370 (9588): 657–66.
5. Khan B, Nowson CA, Daly RM et al. Higher Dietary Calcium Intakes Are Associated With Reduced Risks of Fractures, Cardiovascular Events, and Mortality: A Prospective Cohort Study of Older Men and Women. JBMR 2015; 30 (10): 1758–66.
6. Novaković R, Cavelaars A, Bekkering G et al. Micronutrient intake and status in Central and Eastern Europe compared with other European countries, results from the EURRECA network. Public Health Nutr 2013; 16 (5): 824–40.
7. Оглоблин Н.А., Спиричев В.Б., Батурин А.К. О потреблении населением России кальция с пищей. Вопр. питания. 2005; 5: 14–7. / Ogloblin N.A., Spirichev V.B., Baturin A.K. O potreblenii naseleniem Rossii kal'tsiia s pishchei. Vopr. pitaniia. 2005; 5: 14–7. [in Russian]
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9. Bailey RL, Dodd KW, Goldman JA et al. Estimation of total usual calcium and vitamin D intakes in the United States. J Nutr 2010; 140 (4): 817–22.
10. Von Domarus C, Brown J, Barvencik F et al. How much vitamin D do we need for skeletal health? Clin Orthop Relat Res 2011; 469 (11): 1–7.
11. Holick MF. Evaluation, Treatment, and Prevention of Vitamin D deficiency: an Endocrine society clinical practice guideline. J Clin Metab 2011; 9: 1911–30.
12. Weaver CM. Calcium supplementation: is protecting against osteoporosis counter to protecting against cardiovascular disease? Curr Osteoporos Rep 2014; 12: 211–8.
13. Abrahamsen B, Masud T, Avenell A et al. DIPART (Vitamin D Individual Patient Analysis of Randomized Trials) Group. Patient level pooled analysis of 68,500 patients from seven major vitamin D fracture trials in US and Europe. BMJ 2010; 340: b5463.
14. Tang BM, Eslick GD, Nowson C et al. Use of calcium or calcium in combination with vitamin D supplementation to prevent fractures and bone loss in people aged 50 years and older: a meta-analysis. Lancet 2012; 380 (9844): 806.
15. Chung M, Lee J, Terasawa T, Lau J, Trikalinos TA. Vitamin D with or without calcium supplementation for prevention of cancer and fractures: an updated meta-analysis for the U.S. Preventive Services Task Force. Ann Intern Med 2011; 155 (12): 827–38. doi: 10.7326/0003-4819-155-12-201112200-00005
16. Jackson RD, LaCroix AZ, Gass M et al. Women’s Health Initiative Investigators. Сalcium plus vitamin D supplementation and the risk of fractures. N Engl J Med 2006; 354: 669–83.
17. US Preventive Services Task Force. Vitamin D and calcium supplementation to prevent fractures. 2013. http://www. uspreventiveservicestaskforce.org/uspstf/uspsvitd.htm
18. Prentice RL, Pettinger MB, Jackson RD et al. Health risks and benefits from calcium and vitamin D supplementation: Women’s Health Initiative clinical trial and cohort study. Osteoporos Int 2013; 24: 567–80.
19. Cauley JA, Chlebowski RT, Wactawski-Wende J et al. Calcium plus vitamin D supplementation and health outcomes five years after active intervention ended: the Women's Health Initiative. J Womens Health (Larchmt) 2013; 22 (11): 915–29. doi: 10.1089/jwh.2013.4270
20. Avenell A, Mak JC, O'Connell D. Vitamin D and vitamin D analogues for preventing fractures in post-menopausal women and older men. Cochrane Database Syst Rev 2014; 4: CD000227. doi: 10.1002/14651858
21. Weaver CM, Alexander DD, Boushey CJ et al. Calcium plus vitamin D supplementation and risk of fractures: an updated meta-analysis from the National Osteoporosis Foundation. Osteoporos Int 2015. doi: 10.1007/s00198-015-3386-5 PMID: 26510847
22. Bolland MJ, Barber PA, Doughty RN et al. Vascular events in healthy women receiving calcium supplementation: randomized controlled trial. BMJ 2008; 336: 262–6.
23. Bolland MJ, Avenel A, Baron JA et al. Effects of calcium supplementation on risk of myocardial infarction and cardiovascular events: meta-analysis. BMJ 2010; 341: c3691.
24. Bhakta M, Bruce C, Messika-Zeitoun D et al. Oral calcium supplements do not affect the progression of aortic valve calcification or coronary artery calcification. J Am Board Fam Med 2009; 22: 610–6.
25. Bostick RM, Kushi LH, Wu Y et al. Relation of calcium, Vitamin D, and dairy food intake to ischemic heart disease mortality among postmenopausal women. Am J Epidemiol 1999; 149: 151–61.
26. Iso H, Stampfer MJ, Manson JE et al. Prospective study of calcium, potassium, and magnesium intake and risk of stroke in women. Stroke 1999; 30: 1772–9.
27. Paik JM, Curhan GC, Sun Qi et al. Calcium Supplement Intake and Risk of Cardiovascular Disease in Women. Osteoporos Int 2014; 25 (8): 2047–56. doi: 10.1007/s00198-014-2732-3
28. Lewis JR, Radavelli-Bagatini S, Rejnmark L et al. The Effects of Calcium Supplementation on Verified Coronary Heart Disease Hospitalization and Death in Postmenopausal Women: A Collaborative Meta-Analysis of Randomized Controlled Trials. JBMR 2014. doi: 10.1002/jbmr.2311
29. Ford JA, MacLennan GS, Avenell A et al for the RECORD Trial Group. Cardiovascular disease and vitamin D supplementation: trial analysis, systematic review, and meta-analysis. Am J Clin Nutr 2014; 100: 746–55.
30. Rude RK, Singer FR, Gruber HE. Skeletal and hormonal effects of magnesium deficiency. J Am Coll Nutr 2009; 28: 131–41.
31. Song CH, Barrett-Connor E, Chung JH et al. Associations of calcium and magnesium in serum and hair with bone mineral density in premenopausal women. Biol Trace Elem Res 2007; 118: 1–9.
32. New SA, Robins SP, Campbell MK et al. Dietary influences on bone mass and bone metabolism: further evidence of a positive link between fruit and vegetable consumption and bone health? Am J Clin Nutr 2000; 71: 142–51.
33. Mutlu M, Kilic E. Magnesium, Zinc and Copper Status in Osteoporotic, Osteopenic and Normal Post-menopausal Women. J Int Med Res 2007; 35: 692–5.
34. Tranquilli AL, Lucino E, Garzetti GG, Romanini C. Calcium, phosphorus and magnesium intakes correlate with bone mineral content in postmenopausal women. Gynecol Endocrinol 1994; 8: 55–8.
35. Tucker KL, Hannan MT, Chen H et al. Potassium, magnesium, and fruit and vegetable intakes are associated with greater bone mineral density in elderly men and women. Am J Clin Nutr 1999; 69: 727–36.
36. Ryder KM, Shorr RI, Bush AJ et al. Magnesium intake from food and supplements is associated with bone mineral density in healthy older white subjects. J Am Geriatr Soc 2005; 53: 1875–80.
37. Okyay E, Ertugrul C, Acar B et al. Comparative evaluation of serum levels of main minerals and postmenopausal osteoporosis. Maturitas 2013; 76 (4): 320–5. doi: 10.1016/j.maturitas.2013.07.015
38. Orchard TS, Larson JC, Alghothani N et al. Magnesium intake, bone mineral density, and fractures: results from the Women’s Health Initiative Observational Study. Am J Clin Nutr 2014; 99: 926–33.
39. Farsinejad-Marj M, Saneei P, Esmaillzadeh A. Dietary magnesium intake, bone mineral density and risk of fracture: a systematic review and meta-analysis. Osteoporos Int 2015. [Epub ahead of print].
40. Nielsen FH. Studies on the relationship between boron and magnesium which possibly affects the formation and maintenance of bones. Magnes Trace Elem 1990; 9: 61–9.
41. Stendig-Lindberg G, Tepper R, Leichter I. Trabecular bone density in a two year controlled trial of peroral magnesium in osteoporosis. Magnes Res 1993; 6: 155–63.
42. Strause L, Saltman P, Smith KT et al. Spinal bone loss in postmenopausal women supplemented with calcium and trace minerals. J Nutr 1994; 124: 1060–4.
43. Nieves JW. Skeletal effects of nutrients and nutraceuticals, beyond calcium and vitamin D. Osteoporos Int 2013; 24 (3): 771–86. doi: 10.1007/s00198-012-2214-4
44. Zheng J, Mao X, Ling J et al. Low serum levels of zinc, copper, and iron as risk factors for osteoporosis: a meta-analysis. Biol Trace Elem Res 2014; 160 (1): 15–23. doi: 10.1007/s12011-014-0031-7
45. Hill T, Meunier N, Andriollo-Sanchez M et al. The relationship between the zinc nutritive status and biochemical markers of bone turnover in older European adults: the ZENITH study. Eur J Clin Nutr 2005; 59 (Suppl. 2): 73–8.
46. Nielsen FH, Hunt CD, Mullen LM, Hunt JR. Effect of dietary boron on mineral, estrogen, and testosterone metabolism in postmenopausal women. FASEB 1987; J1: 394–7.
47. Hunt CD, Herbel JL, Nielsen FH. Metabolic responses of postmenopausal women to supplemental dietary boron and aluminum during usual and low magnesium intake: boron, calcium, and magnesium absorption and retention and blood mineral concentrations. Am J Clin Nutr 1997; 65: 803–13.
48. Никитинская О.А., Торопцова Н.В., Беневоленская Л.И. Фармакологическая профилактика первичного остеопороза. РМЖ. 2008; 16 (6): 409–13. / Nikitinskaia O.A., Toroptsova N.V., Benevolenskaia L.I. Farmakologicheskaia profilaktika pervichnogo osteoporoza. RMZh. 2008; 16 (6): 409–13. [in Russian]
________________________________________________
1. Reid IR, Ames R, Mason B et al. Randomized controlled trial of calcium supplementation in healthy, nonosteoporotic, older men. Arch Intern Med 2008; 168 (20): 2276–82.
2. Peacock M, Liu G, Carey M et al. Effect of calcium or 25OH vitamin D3 dietary supplementation on bone loss at the hip in men and women over the age of 60. J Clin Endocrinol Metab 2000; 85 (9): 3011–9.
3. Warensjo E, Byberg L, Melhus H et al. Dietary calcium intake and risk of fracture and osteoporosis: prospective longitudinal cohort study. BMJ 2011; 342: d1473.
4. Tang BM, Eslick GD, Nowson C et al. Use of calcium or calcium in combination with vitamin D supplementation to prevent fractures and bone loss in people aged 50 years and older: a meta-analysis. Lancet 2007; 370 (9588): 657–66.
5. Khan B, Nowson CA, Daly RM et al. Higher Dietary Calcium Intakes Are Associated With Reduced Risks of Fractures, Cardiovascular Events, and Mortality: A Prospective Cohort Study of Older Men and Women. JBMR 2015; 30 (10): 1758–66.
6. Novaković R, Cavelaars A, Bekkering G et al. Micronutrient intake and status in Central and Eastern Europe compared with other European countries, results from the EURRECA network. Public Health Nutr 2013; 16 (5): 824–40.
7. Ogloblin N.A., Spirichev V.B., Baturin A.K. O potreblenii naseleniem Rossii kal'tsiia s pishchei. Vopr. pitaniia. 2005; 5: 14–7. [in Russian]
8. Nikitinskaia O.A., Toroptsova N.V. Sotsial'naia programma «Osteoskrining Rossiia» v deistvii. Farmateka. 2012; 6: 90–3. [in Russian]
9. Bailey RL, Dodd KW, Goldman JA et al. Estimation of total usual calcium and vitamin D intakes in the United States. J Nutr 2010; 140 (4): 817–22.
10. Von Domarus C, Brown J, Barvencik F et al. How much vitamin D do we need for skeletal health? Clin Orthop Relat Res 2011; 469 (11): 1–7.
11. Holick MF. Evaluation, Treatment, and Prevention of Vitamin D deficiency: an Endocrine society clinical practice guideline. J Clin Metab 2011; 9: 1911–30.
12. Weaver CM. Calcium supplementation: is protecting against osteoporosis counter to protecting against cardiovascular disease? Curr Osteoporos Rep 2014; 12: 211–8.
13. Abrahamsen B, Masud T, Avenell A et al. DIPART (Vitamin D Individual Patient Analysis of Randomized Trials) Group. Patient level pooled analysis of 68,500 patients from seven major vitamin D fracture trials in US and Europe. BMJ 2010; 340: b5463.
14. Tang BM, Eslick GD, Nowson C et al. Use of calcium or calcium in combination with vitamin D supplementation to prevent fractures and bone loss in people aged 50 years and older: a meta-analysis. Lancet 2012; 380 (9844): 806.
15. Chung M, Lee J, Terasawa T, Lau J, Trikalinos TA. Vitamin D with or without calcium supplementation for prevention of cancer and fractures: an updated meta-analysis for the U.S. Preventive Services Task Force. Ann Intern Med 2011; 155 (12): 827–38. doi: 10.7326/0003-4819-155-12-201112200-00005
16. Jackson RD, LaCroix AZ, Gass M et al. Women’s Health Initiative Investigators. Сalcium plus vitamin D supplementation and the risk of fractures. N Engl J Med 2006; 354: 669–83.
17. US Preventive Services Task Force. Vitamin D and calcium supplementation to prevent fractures. 2013. http://www. uspreventiveservicestaskforce.org/uspstf/uspsvitd.htm
18. Prentice RL, Pettinger MB, Jackson RD et al. Health risks and benefits from calcium and vitamin D supplementation: Women’s Health Initiative clinical trial and cohort study. Osteoporos Int 2013; 24: 567–80.
19. Cauley JA, Chlebowski RT, Wactawski-Wende J et al. Calcium plus vitamin D supplementation and health outcomes five years after active intervention ended: the Women's Health Initiative. J Womens Health (Larchmt) 2013; 22 (11): 915–29. doi: 10.1089/jwh.2013.4270
20. Avenell A, Mak JC, O'Connell D. Vitamin D and vitamin D analogues for preventing fractures in post-menopausal women and older men. Cochrane Database Syst Rev 2014; 4: CD000227. doi: 10.1002/14651858
21. Weaver CM, Alexander DD, Boushey CJ et al. Calcium plus vitamin D supplementation and risk of fractures: an updated meta-analysis from the National Osteoporosis Foundation. Osteoporos Int 2015. doi: 10.1007/s00198-015-3386-5 PMID: 26510847
22. Bolland MJ, Barber PA, Doughty RN et al. Vascular events in healthy women receiving calcium supplementation: randomized controlled trial. BMJ 2008; 336: 262–6.
23. Bolland MJ, Avenel A, Baron JA et al. Effects of calcium supplementation on risk of myocardial infarction and cardiovascular events: meta-analysis. BMJ 2010; 341: c3691.
24. Bhakta M, Bruce C, Messika-Zeitoun D et al. Oral calcium supplements do not affect the progression of aortic valve calcification or coronary artery calcification. J Am Board Fam Med 2009; 22: 610–6.
25. Bostick RM, Kushi LH, Wu Y et al. Relation of calcium, Vitamin D, and dairy food intake to ischemic heart disease mortality among postmenopausal women. Am J Epidemiol 1999; 149: 151–61.
26. Iso H, Stampfer MJ, Manson JE et al. Prospective study of calcium, potassium, and magnesium intake and risk of stroke in women. Stroke 1999; 30: 1772–9.
27. Paik JM, Curhan GC, Sun Qi et al. Calcium Supplement Intake and Risk of Cardiovascular Disease in Women. Osteoporos Int 2014; 25 (8): 2047–56. doi: 10.1007/s00198-014-2732-3
28. Lewis JR, Radavelli-Bagatini S, Rejnmark L et al. The Effects of Calcium Supplementation on Verified Coronary Heart Disease Hospitalization and Death in Postmenopausal Women: A Collaborative Meta-Analysis of Randomized Controlled Trials. JBMR 2014. doi: 10.1002/jbmr.2311
29. Ford JA, MacLennan GS, Avenell A et al for the RECORD Trial Group. Cardiovascular disease and vitamin D supplementation: trial analysis, systematic review, and meta-analysis. Am J Clin Nutr 2014; 100: 746–55.
30. Rude RK, Singer FR, Gruber HE. Skeletal and hormonal effects of magnesium deficiency. J Am Coll Nutr 2009; 28: 131–41.
31. Song CH, Barrett-Connor E, Chung JH et al. Associations of calcium and magnesium in serum and hair with bone mineral density in premenopausal women. Biol Trace Elem Res 2007; 118: 1–9.
32. New SA, Robins SP, Campbell MK et al. Dietary influences on bone mass and bone metabolism: further evidence of a positive link between fruit and vegetable consumption and bone health? Am J Clin Nutr 2000; 71: 142–51.
33. Mutlu M, Kilic E. Magnesium, Zinc and Copper Status in Osteoporotic, Osteopenic and Normal Post-menopausal Women. J Int Med Res 2007; 35: 692–5.
34. Tranquilli AL, Lucino E, Garzetti GG, Romanini C. Calcium, phosphorus and magnesium intakes correlate with bone mineral content in postmenopausal women. Gynecol Endocrinol 1994; 8: 55–8.
35. Tucker KL, Hannan MT, Chen H et al. Potassium, magnesium, and fruit and vegetable intakes are associated with greater bone mineral density in elderly men and women. Am J Clin Nutr 1999; 69: 727–36.
36. Ryder KM, Shorr RI, Bush AJ et al. Magnesium intake from food and supplements is associated with bone mineral density in healthy older white subjects. J Am Geriatr Soc 2005; 53: 1875–80.
37. Okyay E, Ertugrul C, Acar B et al. Comparative evaluation of serum levels of main minerals and postmenopausal osteoporosis. Maturitas 2013; 76 (4): 320–5. doi: 10.1016/j.maturitas.2013.07.015
38. Orchard TS, Larson JC, Alghothani N et al. Magnesium intake, bone mineral density, and fractures: results from the Women’s Health Initiative Observational Study. Am J Clin Nutr 2014; 99: 926–33.
39. Farsinejad-Marj M, Saneei P, Esmaillzadeh A. Dietary magnesium intake, bone mineral density and risk of fracture: a systematic review and meta-analysis. Osteoporos Int 2015. [Epub ahead of print].
40. Nielsen FH. Studies on the relationship between boron and magnesium which possibly affects the formation and maintenance of bones. Magnes Trace Elem 1990; 9: 61–9.
41. Stendig-Lindberg G, Tepper R, Leichter I. Trabecular bone density in a two year controlled trial of peroral magnesium in osteoporosis. Magnes Res 1993; 6: 155–63.
42. Strause L, Saltman P, Smith KT et al. Spinal bone loss in postmenopausal women supplemented with calcium and trace minerals. J Nutr 1994; 124: 1060–4.
43. Nieves JW. Skeletal effects of nutrients and nutraceuticals, beyond calcium and vitamin D. Osteoporos Int 2013; 24 (3): 771–86. doi: 10.1007/s00198-012-2214-4
44. Zheng J, Mao X, Ling J et al. Low serum levels of zinc, copper, and iron as risk factors for osteoporosis: a meta-analysis. Biol Trace Elem Res 2014; 160 (1): 15–23. doi: 10.1007/s12011-014-0031-7
45. Hill T, Meunier N, Andriollo-Sanchez M et al. The relationship between the zinc nutritive status and biochemical markers of bone turnover in older European adults: the ZENITH study. Eur J Clin Nutr 2005; 59 (Suppl. 2): 73–8.
46. Nielsen FH, Hunt CD, Mullen LM, Hunt JR. Effect of dietary boron on mineral, estrogen, and testosterone metabolism in postmenopausal women. FASEB 1987; J1: 394–7.
47. Hunt CD, Herbel JL, Nielsen FH. Metabolic responses of postmenopausal women to supplemental dietary boron and aluminum during usual and low magnesium intake: boron, calcium, and magnesium absorption and retention and blood mineral concentrations. Am J Clin Nutr 1997; 65: 803–13.
48. Nikitinskaia O.A., Toroptsova N.V., Benevolenskaia L.I. Farmakologicheskaia profilaktika pervichnogo osteoporoza. RMZh. 2008; 16 (6): 409–13. [in Russian]
Авторы
О.А.Никитинская*, Л.И.Алексеева
ФГБНУ НИИ ревматологии им. В.А.Насоновой. 115522, Россия, Москва, Каширское ш., д. 34а
*nikitinskayaox@yandex.ru
________________________________________________
O.A.Nikitinskaia*, L.I.Alekseeva
V.A.Nasonova Research Institute of Rheumatology. 115522, Russian Federation, Moscow, Kashirskoe sh., d. 34a
*nikitinskayaox@yandex.ru