钙片——进入骨骼还是动脉？

„人们死于心血管疾病的原因，通常始于炎症和逐渐加重的钙化，而不是胆固醇水平。炎症、钙化与心血管疾病（CVD）死亡之间的相关性，远强于胆固醇水平与心血管疾病死亡之间的相关性（Bolland et al, 2008）。遵循美国心脏协会（AHA）的指南，或许有助于规避责任、保障商业利益，但并不总有助于维持最佳健康状态。要了解身体内部发生了什么，只需看看血管钙化的图像。”The reason people die of cardiovascular disease usually begins with inflammation and progressive calcification, not cholesterol levels. The correlations between inflammation, calcification and death by cardiovascular disease (CVD) are much stronger than for correlations between cholesterol levels and death by CVD (Bolland et al, 2008). Following the guidelines of the American Heart Association (AHA) may be useful for liability and good business, but is not always useful for maintaining optimal health. To understand what's going on inside of the body, just take a look at the images of vascular calcification.

„（2010）《雌激素通过血管RANKL系统抑制血管钙化：骨质疏松与血管钙化的共同机制》。《循环研究》107:466-475。Das UN（2002）《一氧化氮作为雌激素、他汀类药物和必需脂肪酸抗骨质疏松作用的介质》。《实验生物学与医学》。”(2010) Estrogen inhibits vascular calcification via vascular RANKL system: common mechanism of osteoporosis and vascular calcification. Circ Res. 107:466-475. Das UN (2002) Nitric oxide as the mediator of the antiosteoporotic actions of estrogen, statins, and essential fatty acids. Exp Biol Med.

„其他临床观察也进一步支持这一假设：骨骼健康反映的是更广泛的代谢、营养、激素和血管生理状况，而不只是钙代谢。这些观察包括作者及其他几位患者长期保持出色的骨密度，同时冠状动脉钙负荷较低。我们诊疗中的典型临床观察总结于表1。这些病例显示，骨密度改善的同时，血管健康指标也有所改善，包括颈动脉内中膜厚度（IMT）和冠状动脉钙化（CAC）评分。”Additional clinical observations, including long-term maintenance of excellent bone density and low coronary calcium burden in the author and several other patients, further support the hypothesis that bone health reflects broader metabolic, nutritional, hormonal, and vascular physiology rather than calcium metabolism alone. Representative clinical observations from our practice are summarized in Table 1. These cases demonstrate improvement in bone density occurring concurrently with improvement in vascular health markers, including carotid intima-media thickness (IMT) and coronary artery calcium (CAC) scores.