饮奶与单纯补钙对儿童骨密度和生长发育影响的Meta分析

目的根据已公开发表的随机对照研究,综合评价饮用牛奶和单纯补充钙剂对儿童身高、体重和骨骼密度增长的影响。方法采用Meta分析,对国内外有关儿童饮奶或补充钙剂后测量骨密度和身高及体重增长效果的随机对照研究进行定量综合分析。结果检索出从1993年到2006年间已发表的29篇相关文献,经过筛选最后收集到11篇符合本次Meta分析的纳入标准。评价骨密度共15项研究2205例研究对象入选。其中饮奶试验9项,单纯补充钙剂的试验6项,各项研究的方差齐性检验有统计学意义,采用Meta分析的随机效应模型,饮奶试验和补钙试验的干预组与对照组骨密度增长率差值的合并均值及95％可信区间分别为2．01（0．92—3．09）和1．05（0．66—1．43）。评价身高、体重共11项研究1673例研究对象入选。其中饮奶试验6项,单纯补充钙剂试验5项,各项研究的方差齐性检验有统计学意义,采用Meta分析的随机效应模型,饮奶试验和补钙试验的干预组与对照组的身高增长率的差值的合并均值及95％可信区间分别为0．25（0．09—0．41）和-0．10（-0．25—0．05）,体重增长率差值的合并均值及95％可信区间分别为0．63（0．33～0．93）和-0．75（-1．98—0．49）。结论补充钙剂仅对儿童骨密度的增长有显著影响,饮用牛奶对儿童的身高、体重和骨密度的增长均有显著影响。

Evaluation of milk intake and calcium supplement on bone mineral density and growth in children through Meta-analysis

OBJECTIVE: Based on peer-reviewed random-control studies, effects of calcium supplement and intake of milk on bone mineral density (BMD) and growth in children were evaluated. METHODS: Meta-analysis was applied to review published data in random-control studies related to the effects of calcium supplement and milk consumption on BMD, body height and body weight in children. RESULTS: Eleven peer-reviewed papers published during 1993 to 2006 were selected in this study. Homogeneity test showed that random effect model should be selected for weighting and pooling data. The combined means of improvement in BMD, height and body weight in children with milk intervention were 2.01 (0.92 - 3.09), 0.25 (0.09 - 0.41) and 0.63 (0.33 - 0.93), respectively, and the data from children with calcium intervention were 1.05 (0.66 - 1.43), -0.10 (-0.25 - 0.05) and -0.75 (-1.98 - 0.49), respectively. CONCLUSION: Both milk and calcium intakes could improve BMD of children significantly, and the difference in BMD gain through milk intake was the same as that with calcium intervention, however, compared with the control group, increasing milk intake did significantly promote growth and development of children compared to the calcium supplement group.