Abstract
The effect of calcium on prevention of osteoporosis and related fracture which are aging issues is unclear. The aim of this study is to explore the association of calcium intake with vertebral fracture. This study enrolled 3,457 participants from China Action on Spine and Hip Status (CASH) study from 2013 and 2017. Dietary calcium intake was collected using validated food frequency questionnaires (FFQ). Vertebral fracture of CT images was defined as the primary outcome. The mean calcium intake of men and women were 522.75mg/day and 507.21mg/day, respectively. 6% reduction in the odds of fracture risk was observed per 100 unit increase of calcium intake from food among females (OR, 0.94; 95% CI, 0.89-0.99), but results among males were not significant. We divided calcium intake into quintiles when modelling its associations with fracture risk, negative associations of fracture risk with calcium intake were found among females. In a population with low usual calcium intake, higher dietary calcium intake was associated with fewer vertebral fracture in women and that no such association was seen in men.
Highlights
Osteoporotic fractures are a global public health challenge associated with aging, and commonly occur in the spine, hip, forearm and other skeletal sites [1]
We report data for subjects enrolled in the China Action on Spine and Hip (CASH) study China cohort with low dietary calcium intake at baseline, who had spinal quantitative computed tomography (QCT) volumetric bone mineral density measurements and vertebral fracture assessment at their median of 10 years visit to examine whether calcium intake in food is associated with vertebral fracture
The most common location was at the 12th thoracic vertebra (TV) (6.11%, n=206), the 1st lumbar vertebra (LV) (5.75%, n=188), and the thirdly the 11th TV (4.73%, n=154) (Supplementary Figure 2A). 76.0% of thoracic fracture occurred with only one vertebrae, while 82.5% of lumber fracture occurred with one site (Supplementary Figure 2B)
Summary
Osteoporotic fractures are a global public health challenge associated with aging, and commonly occur in the spine, hip, forearm and other skeletal sites [1]. Other studies have raised concerns about the safety of calcium supplements, including cardiovascular events, urinary tract stones, gastrointestinal symptoms, and hospital admissions for acute gastrointestinal problems [7,8,9,10]. These reports have led to suggestions that calcium intake should be increased through food rather than by taking supplements, the effect of increasing dietary calcium intake on bone health is uncertain [11].
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