| OBJECTIVE Calcium and vitamin D are the essential nutrients to maintain the bone health and normal weight, osteoporosis resulting from deficiency of calcium and vitamin D of Chinese postmonapausal older women was prevalence. A large number of studies abroad have shown that supplement of calcium and vitamin D can effectively improve the bone health and overweight or obesity of older women. However, domestic researches were relatively deficient and there are large differences between race and diatery habits of east and west, so it is very necessary to perform such a research in our country.This paper aimes at studying the role of supplying calcium and vitamin D to the bone mineral composition and body composition of urban postmonapausal women in Beijing, and providing the experience to the prevention and treatment of osteoporosis, overweight and obesity of Chinese older women, postponing the bone loss, reducing the bone fracture rate, restrainting the excessive growth of body fat, preventing the relative chronic diseases, improving the quality of older women life, releasing the burden of state, society and family.METHODS A total of 400 community-dwelling women were selected randomly from 17 community of 3 districts in Beijing with cluster random sampling methods. Cross-section survey used questionnaire and physical examination. In intervention study,305 women were randomly chosed from 400 objects of cross-section survey, which were divided into two groups randomly. Calcium group(A group) and calcium adding vitamin D group(B group), who took supplemention of calcium and calcium adding vitamin D for one year respectively. We observe if the bone mineral density and body composition improved after controlling confounding factors, and the range. RESULTS 1,Cross-section survey results.The mean age of urban older women of Beijing were (68.7±5.6), mean serum calcium level was 2.087mg, mean serum 25(OH)D was (14.4±5.7) ng/ml. Vitamin D deficiency rate was 62.4%, insufficient rate was 21.8%, and the vitamin D in normal was only 15.8%. Mean BMI of the subject was (25.9±3.6)kg/m2, mean value of PBF was (39.2±5.3)%, and the overweight rate was up to 17.4% and 48.5%, obesity rate was 76.7% and 22.3%, which were calculated by PBF and BMI. BMD of subjects at total, lumbar spine(L2-4) and femneck were respectively (0.829±0.090), (0.916±0.125) and (0.679±0.106)g/cm2, The rate of osteoporosis at lumbar spine(L2-4) and femneck of of urban postmonapausal women in Beijing were respectively 14.2%.and 12.3%, and bone loss rate were 41.8% and 38.5%.Serum 25(OH)D level was not correlated with height and weight(r=0.04, r=-0.06, P>0.05), and were positively correlated with PBF at total, pelvis and lower limbs, and with BF at pelvis and lower limbs(r=-0.14～-0.10,P<0.05). Serum 25(OH)D level was positively correlated with BMD at total and femneck(r=0.165, r=0.184, P<0.05). PBF of subjects with 25(OH)D normal group was significantly higher than that of subjects with vitamin D insufficient or vitamin D deficiency at total, pelvis and right lower limb, with 2.4% or 5.8% lower at total. BMD of subjects with 25(OH)D normal group is significantly higher than that of subjects with vitamin D insufficient or vitamin D deficiency in all parts except midriff, with 4.7% or 6.4% higher at total body, and 7.3% or 8.9% more at femneck.2,Intervention trial resultsThe mean serum calcium level of older women of A and B group were respectively 2.25mg and 2.28mg, the serum 25(OH)D concentration of A and B group were 14.66ng/m/ and 23.98ng/ml respectively, serum 25(OH)D concentration of B group was higher than A group significantly(P<0.05), with 63.66% higher. The weight and BMI of group A increased, while B group decreased. BMD of the B groups at total, lumbar spine, lower limb and pelvis were significantly higher than A group, with 3.4%,5.8%,4.5%,5.8% and 3.8% higher respective.BF and PBF at toal, midriff and left lower limb of the two group all decreased after intervention, and the difference were significant(P<0.05). BF and PBF at total of A and B group were respectively 4.8%m,3.5% and 5.3%,5.2% lower than preintervention. LBM at total and bi-upper limbs were increased, and were 2.3% and 1.5%higher than preintervention(P<0.05). BMD at Wards', norland and bi-upper limbs of A group increased, BMD of Wards'and bi-upper limbs were 7.5%,3.5%and 1.9% higher than preintervention(P<0.05). BMD at total, lumbar spine(L2-4), femneck, norland, Wards'and bi-upper limbs all increased, and 1.0%,2.7%,8.9%,3.8% and 2.6% higher than preintervention.CONCLUTIONS The level of serum 25(OH)D of urban postmonapausal women in Beijing were insufficient widely, the women who have higher serum 25(OH)D level have lower BF and PBF. There was closely correlation between vitamin D status and BMD at total, lumbar spine, proximal femneck, pelvis and four limbs, which relealed that good nutrition status of vitamin D is very important to maintain normal weight and bone health of Chinese postmonapausal older women.Suppling calcium and vitamin D at the same time can release the bone loss of older women effectively, increase their bone mineral density, and help to reduce body fat and control weight. So the supplemention of calcium and vitamin D is likely to prevent obesity and ostesporosis of older women, which effects was better than simple adding calcium. |
