Cross-sectional and prospective associations between dietary and plasma vitamin C, heel bone ultrasound, and fracture risk in men and women in the European Prospective Investigation into Cancer in Norfolk cohort

被引:16
作者
Finck, Henriette [1 ]
Hart, Andrew R. [2 ]
Lentjes, Marleen A. H. [4 ]
Jennings, Amy [3 ]
Luben, Robert N. [4 ]
Khaw, Kay-Tee [4 ]
Welch, Ailsa A. [1 ]
机构
[1] Univ E Anglia, Norwich Med Sch, Dept Populat Hlth & Primary Care, Norwich NR4 7TJ, Norfolk, England
[2] Univ E Anglia, Norwich Med Sch, Dept Med, Norwich NR4 7TJ, Norfolk, England
[3] Univ E Anglia, Norwich Med Sch, Dept Nutr, Norwich NR4 7TJ, Norfolk, England
[4] Univ Cambridge, Strangeways Res Labs, Dept Publ Hlth & Primary Care, Cambridge, England
基金
英国医学研究理事会;
关键词
ascorbic acid; collagen; fracture risk; osteoporosis; vitamin C; MINERAL DENSITY; POSTMENOPAUSAL WOMEN; EPIC-NORFOLK; QUANTITATIVE ULTRASOUND; OSTEOPOROTIC FRACTURES; WEIGHED RECORDS; ASCORBIC-ACID; ELDERLY-WOMEN; HEALTH; EPIDEMIOLOGY;
D O I
10.3945/ajcn.115.111971
中图分类号
R15 [营养卫生、食品卫生]; TS201 [基础科学];
学科分类号
100403 ;
摘要
Background: Vitamin C sufficiency may help prevent osteoporosis and fractures by mediating osteoclastogenesis, osteoblastogenesis, and bone collagen synthesis. Objective: We determined whether dietary intakes and plasma concentrations of vitamin C were associated with a heel ultrasound and hip and spine fracture risks in older men and women. Design: Participants were recruited from the European Prospective Investigation into Cancer in Norfolk study with 7-d diet diary estimates of vitamin C intake and plasma concentrations. A random subset (4000 of 25,639 subjects) was available for the cross-sectional (ultrasound) study of broadband ultrasound attenuation (BUA) and velocity of sound (VOS), which were determined during the second health examination. The prospective (fracture) study was a case-cohort sample of all participants with a fracture up to March 2009 and the random subset (n = 5319). ANCOVA-determined associations between quintiles of vitamin C intake and plasma status with adjusted BUA and VOS and adjusted Prentice-weighted Cox proportional HRs were calculated for fracture risk. Results: Women were 58% of the population (39-79 y old), and the median follow-up was 12.6 y (range: 0-16 y). Positive associations across all quintiles of vitamin C intake but not plasma status were significant for VOS in men (beta = 2.47 m/s, P = 0.008) and BUA in women (beta = 0.82 dB/MHz, P = 0.004). Vitamin C intake was not associated with fracture risk, but there was an inverse association with plasma concentrations in men, with quintile 4 having significantly lower risks of hip fractures (HR: 0.35; 95% CI: 0.16, 0.80) and spine fractures (HR: 0.26; 95% CI: 0.10, 0.69) than quintile 1. Conclusions: Higher vitamin C intake was significantly associated with higher heel ultrasound measures in men and women, and higher plasma vitamin C concentrations were significantly associated with reduced fracture risk in men only. Our findings that vitamin C intake and status were inconsistently associated with bone health variables suggest that additional research is warranted.
引用
收藏
页码:1416 / 1424
页数:9
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