Breitling, L. P. (2015) Calcium intake and bone mineral density as an example of non-linearity and threshold analysis. OSTEOPOROSIS INTERNATIONAL, 26 (4). pp. 1271-1281. ISSN 0937-941X, 1433-2965
Full text not available from this repository. (Request a copy)Abstract
Non-linearity is a likely phenomenon in bone metabolism, but is often ignored in pertinent epidemiological studies. Using NHANES III data on calcium intake and bone mineral density, the most important non-linear methods are introduced and discussed. The results should motivate researchers to consider non-linearity in this field more frequently. Introduction Many relationships in bone metabolism and homeostasis are likely to follow non-linear patterns. Detailed dose-response analyses allowing for non-linear associations nonetheless remain scarce in this field. Methods A detailed analysis of NHANES III data on dietary calcium intake and bone mineral density was used to demonstrate the application and some of the challenges of the most important dose-response methods, including LOESS, categorical analysis, fractional polynomials, restricted cubic splines, and segmented regression. Results The spline estimate suggested increasing bone mineral density up to a calcium intake of about 1 g/day and a plateau thereafter. In segmented regression, the break-point marking the beginning of the plateau was placed at an intake of 0.58 (95 % confidence interval, 0.33 to 0.82) g/day. Sensitivity analyses suggested a less curved dose-response in women. Conclusions Knowing about the possibilities and limitations of non-linear dose-response approaches should encourage researchers to consider these methods more frequently in studies on bone health and disease. The example analysis suggested bone mineral density to reach a plateau slightly below current calcium intake recommendations, with fairly pronounced differences of the dose-response shape by sex and menopausal status.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | SERUM 25-HYDROXYVITAMIN D; DOSE-RESPONSE ANALYSES; DIETARY CALCIUM; FRACTIONAL POLYNOMIALS; POSTMENOPAUSAL WOMEN; CANCER INCIDENCE; US ADULTS; RISK; REGRESSION; HEALTH; Broken-line regression; Dose-response; Joinpoint regression; Piecewise regression; Spline regression |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Innere Medizin I |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 22 Jul 2019 13:36 |
| Last Modified: | 22 Jul 2019 13:36 |
| URI: | https://pred.uni-regensburg.de/id/eprint/5753 |
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