Effect of calcium supplementation on bone mineral density in healthy juveniles: systemic review of randomized controlled trials

doi:10.3877/cma.j.issn.1674-134X.2018.03.012

Abstract

Abstract:

Objective

To determine whether calcium supplementation could improve the bone mineral density(BMD) in healthy children.

Methods

Search strategies (calcium supplementation, bone density, randomized controlled trials) was applied to the following databases: Pubmed, Medline, Embase, CINAHL, AMED, MANTIS, ISI Web of Science, CENTRAL. The researches that had randomized placebo controlled trials of calcium supplementation in healthy children lasted at least three months and had BMD outcomes measured after at least six months follow-up from 1966-2017 were seletced. Data were extracted from the text, two reviewers independently exracted data and analysis.

Results

Twenty-one eligible studies of 3072 healthy children were included. There was no effect on BMD on femoral neck[SMD=0.09, 95%CI(-0.06, 0.21)] or lumbar spine[SMD=0.07, 95%CI(-0.03, 0.22)] when treated with calcium supplementation (P>0.05). Calcium supplementation had persistent effect on upper limb BMD after stopping supplementation [SMD=0.14, 95%CI(0.01, 0.28), P<0.05], while total body BMD content changed little[SMD=0.00, 95%CI(-0.40, 0.40), P>0.05]. Female children were sensitive to the calcium compared with male children. There was no correlation of bone mineral content between pubertal stage, baseline calcium intake or ethnicity.

Conclusion

Healthy children who treated on calcium supplementation is impossible to reduce the risk of bone fracture.

Key words: Calcium, Minors, Bone density

Jinfeng Wu. Effect of calcium supplementation on bone mineral density in healthy juveniles: systemic review of randomized controlled trials[J]. Chinese Journal of Joint Surgery(Electronic Edition), 2018, 12(03): 368-373.

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References 31

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研究者	钙剂(mg/d)	补钙时间/随访时间	数量	种族/青春期阶段	女性(%)	年龄(岁)	钙基线(mg/d)	测量位置
Bonjour 1995^[4]	牛奶，850	1/8	149	白种人/青春期前	100	7.93(6.6～9.4)	752	桡骨，髋部，腰椎
Cameron2004 ^[5]	碳酸钙，1200	2/2	128	NS/青春期前	100	10.3(8～13)	719	髋部，前臂，腰椎，全身骨
Chevalley2005^[6]	牛奶，850	1/2	235	白种人/青春期前	0	7.44(6.5～8.5)	752	桡骨，髋部，腰椎，全身骨
Courteix 2005^[7]	磷酸钙，800	1/1	113	白种人/青春期前	100	9.91(8～13)	994	桡骨，髋，腰椎，全身骨
Dibba 2000^[8]	碳酸钙，1000	1/3	160	冈比亚人/混合	50	10.3(8.3～11.9)	338	桡骨
Vatanparast 2005^[9]	牛奶，400	0.7/0.7	72	黄种人/青春期前	100	8.86(7～11)	674	全身骨，上下肢，腰椎
Johnston 1992^[10]	果酸钙，1000	3/6	140	白种人/混合	61	10(6～14)	919	桡骨，髋部，腰椎
Lee 1994^[11]	碳酸钙，300	1.5/2.5	163	华人/青春期前	46	7.18(NS)	277	桡骨
Lee 1995^[12]	碳酸钙，300	1.5/3	109	华人/青春期前	43	7(NS)	567	桡骨，髋部，腰椎
Vatanparast 2010^[13]	果酸钙，500	2/2	112	白种人/混合	100	11.9(NS)	976	骨盆，腰椎，全身骨
Matkovic2004^[14]	果酸钙，1000	7/7	354	白种人/青春期前	100	10.8(NS)	837	桡骨，全身骨
Molgaard2004^[15]	碳酸钙，300	1/2	113	白种人/混合	100	13.2/(12～14)	841	全身骨
Nowson1997^[16]	碳酸钙，1000	1.5/1.5	110	NS/混合	100	14(10～17)	734	前臂，髋部，全身骨
Prentice2005^[17]	碳酸钙，1000	1/1	150	白种人/青春期后	0	16.8(16～18)	1198	桡骨，髋部，全身骨
Tylavsky 1992^[18]	碳酸钙，1200	4/4	93	华人，白种人/NS	100	N.S.(10～12)	NS	全身骨，腰椎
Rozen2003^[19]	碳酸钙，1000	1/4.5	112	犹太人/青春期后	100	14.85(12～17)	582	髋部，腰椎，全身骨
Specker2003^[20]	碳酸钙，1000	1/1	239	白种人/青春期前	47	3.92(3～5)	946	全身骨，上臂，下肢
Stear 2003^[21]	碳酸钙，1000	1.3/1.3	144	NS/青春期后	100	17.3(16～18)	938	桡骨，髋部，腰椎，全身骨
Fang 2017^[22]	碳酸钙，300	1.5/1.5	163	华人/青春期前	46	7.2(NS)	277	桡骨
Julián 2017^[23]	碳酸钙，1000	1/1	75	白种人/青春期前	60	9.8(8.2～11.4)	1018	胫骨，桡骨，腰椎，全身骨
Tasian 2017^[24]	碳酸钙，1000，	1/1	138	白种人/青春期前	68	10.7(NS)	934	髋部，腰椎，全身骨

研究者	钙剂(mg/d)	补钙时间/随访时间	数量	种族/青春期阶段	女性(%)	年龄(岁)	钙基线(mg/d)	测量位置
Bonjour 1995^[4]	牛奶，850	1/8	149	白种人/青春期前	100	7.93(6.6～9.4)	752	桡骨，髋部，腰椎
Cameron2004 ^[5]	碳酸钙，1200	2/2	128	NS/青春期前	100	10.3(8～13)	719	髋部，前臂，腰椎，全身骨
Chevalley2005^[6]	牛奶，850	1/2	235	白种人/青春期前	0	7.44(6.5～8.5)	752	桡骨，髋部，腰椎，全身骨
Courteix 2005^[7]	磷酸钙，800	1/1	113	白种人/青春期前	100	9.91(8～13)	994	桡骨，髋，腰椎，全身骨
Dibba 2000^[8]	碳酸钙，1000	1/3	160	冈比亚人/混合	50	10.3(8.3～11.9)	338	桡骨
Vatanparast 2005^[9]	牛奶，400	0.7/0.7	72	黄种人/青春期前	100	8.86(7～11)	674	全身骨，上下肢，腰椎
Johnston 1992^[10]	果酸钙，1000	3/6	140	白种人/混合	61	10(6～14)	919	桡骨，髋部，腰椎
Lee 1994^[11]	碳酸钙，300	1.5/2.5	163	华人/青春期前	46	7.18(NS)	277	桡骨
Lee 1995^[12]	碳酸钙，300	1.5/3	109	华人/青春期前	43	7(NS)	567	桡骨，髋部，腰椎
Vatanparast 2010^[13]	果酸钙，500	2/2	112	白种人/混合	100	11.9(NS)	976	骨盆，腰椎，全身骨
Matkovic2004^[14]	果酸钙，1000	7/7	354	白种人/青春期前	100	10.8(NS)	837	桡骨，全身骨
Molgaard2004^[15]	碳酸钙，300	1/2	113	白种人/混合	100	13.2/(12～14)	841	全身骨
Nowson1997^[16]	碳酸钙，1000	1.5/1.5	110	NS/混合	100	14(10～17)	734	前臂，髋部，全身骨
Prentice2005^[17]	碳酸钙，1000	1/1	150	白种人/青春期后	0	16.8(16～18)	1198	桡骨，髋部，全身骨
Tylavsky 1992^[18]	碳酸钙，1200	4/4	93	华人，白种人/NS	100	N.S.(10～12)	NS	全身骨，腰椎
Rozen2003^[19]	碳酸钙，1000	1/4.5	112	犹太人/青春期后	100	14.85(12～17)	582	髋部，腰椎，全身骨
Specker2003^[20]	碳酸钙，1000	1/1	239	白种人/青春期前	47	3.92(3～5)	946	全身骨，上臂，下肢
Stear 2003^[21]	碳酸钙，1000	1.3/1.3	144	NS/青春期后	100	17.3(16～18)	938	桡骨，髋部，腰椎，全身骨
Fang 2017^[22]	碳酸钙，300	1.5/1.5	163	华人/青春期前	46	7.2(NS)	277	桡骨
Julián 2017^[23]	碳酸钙，1000	1/1	75	白种人/青春期前	60	9.8(8.2～11.4)	1018	胫骨，桡骨，腰椎，全身骨
Tasian 2017^[24]	碳酸钙，1000，	1/1	138	白种人/青春期前	68	10.7(NS)	934	髋部，腰椎，全身骨

位置	研究数量	参与者(例)	补钙时SMD(95%CI)	P值	研究数量	参与者(例)	补钙后SMD(95%CI)	P值
股骨颈(g/cm²)	11	1211	0.09(－0.06，0.21)	>0.05	5	617	0.10(－0.06，0.26)	>0.05
腰椎(g/cm²)	13	1377	0.07(－0.03，0.22)	>0.05	5	617	－0.01(－0.16，0.17)	>0.05
全身骨(g)	11	1166	0.14(0.01，0.28)	<0.05	1	36	0.00(－0.40，0.40)	>0.05
上肢(g/cm²)	13	1654	0.15(0.06，0.25)	<0.01	6	840	0.14(0.01，0.28)	<0.05

位置	研究数量	参与者(例)	补钙时SMD(95%CI)	P值	研究数量	参与者(例)	补钙后SMD(95%CI)	P值
股骨颈(g/cm²)	11	1211	0.09(－0.06，0.21)	>0.05	5	617	0.10(－0.06，0.26)	>0.05
腰椎(g/cm²)	13	1377	0.07(－0.03，0.22)	>0.05	5	617	－0.01(－0.16，0.17)	>0.05
全身骨(g)	11	1166	0.14(0.01，0.28)	<0.05	1	36	0.00(－0.40，0.40)	>0.05
上肢(g/cm²)	13	1654	0.15(0.06，0.25)	<0.01	6	840	0.14(0.01，0.28)	<0.05

位置		研究数量	男性	SMD(95%CI)	P值	研究数量	女性	SMD(95%CI)	P值
补钙时	股骨颈(g/cm²)	3	424	－0.04(－0.24,0.14)	>0.05	7	592	0.18(0.03,0.39)	<0.05
	腰椎(g/cm²)	3	424	0.05(－0.13,0.27)	>0.05	8	683	0.10(－0.04,0.28)	>0.05
	全身骨(g)	2	192	0.07(－0.28,0.38)	>0.05	8	700	0.19(0.03,0.33)	<0.05
	上肢(g/cm²)	3	459	0.03(－0.15,0.21)	>0.05	6	624	0.15(－0.01,0.31)	>0.05
补钙后	股骨颈(g/cm²)	1	226	－0.03(－0.29,0.23)	>0.05	2	221	0.31(0.04,0.58)	<0.05
	腰椎(g/cm²)	1	226	0.05(－0.22,0.31)	>0.05	2	221	0.04(－0.22,0.31)	>0.05
	上肢(g/cm²)	2	310	0.08(－0.32,0.49)	>0.05	2	200	0.30(0.02,0.58)	<0.05

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