Journal
JOURNAL OF INTERNAL MEDICINE
Volume 284, Issue 3, Pages 254-269Publisher
WILEY
DOI: 10.1111/joim.12753
Keywords
bone mineral density; dairy; fractures; lactase persistence; mendelian randomization; milk
Categories
Funding
- Danish Heart Foundation
- Danish Council for Independent Research
- Medical Sciences (FSS)
- Herlev Hospital, Copenhagen University Hospital
- Copenhagen County Foundation
- Chief Physician Johan Boserup and Lise Boserup's Fund, Denmark
- Region Zealand Foundation
- Naestved Hospital Foundation
- Edith and Henrik Henriksen's Memorial Scholarship
- Johan and Lise Boserup Foundation
- TrygFonden
- Johannes Fog's Foundation
- Region Zealand
- Naestved Hospital
- National Board of Health
- Local Government Denmark Foundation
- Danish Dairy Research Foundation
- Research Unit at Naestved Hospital, Denmark
- Regional Research Unit in Region Zealand, Denmark
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BackgroundWhether a causal relationship exists between milk intake and reduced risk of fractures is unclear. ObjectivesWe tested the hypothesis that genetically determined milk intake reduces the risk of fractures and increases bone mineral density (BMD). MethodsWe investigated the association between milk intake, LCT-13910 C/T (rs4988235), which is associated with lactase persistence (TT/TC) in Northern Europeans, and hip fractures in three Danish prospective studies (N = 97 811, age 20 years). We added meta-analyses of LCT-13910 and fractures and BMD from five published Northern European population studies. ResultsIn the Danish studies, the adjusted hazard ratio (HR) for hip fracture per one glass per week higher milk intake was 1.00 (95% CI: 0.99-1.01). The per T-allele milk intake was 0.58 (0.49-0.68) glasses per week, but HR was 1.01 (0.94-1.09) for hip fracture. In meta-analyses of Danish studies with published Northern European population studies, the random effects odds ratio for any fracture was 0.86 (0.61-1.21; I-2 = 73%) for TT vs. CC and 0.90 (0.68-1.21; I-2 = 63%) for TC vs. CC. The standardized mean difference in femoral neck BMD was 0.10 (0.02-0.18; I-2 = 0%) g cm(-2) for TT vs. CC and 0.06 (-0.04 to 0.17; I-2 = 17%) g cm(-2) for TC vs. CC. There were no differences in lumbar spine or total hip BMD comparing TT or TC with CC. ConclusionGenetically lifelong lactase persistence with high milk intake was not associated with hip fracture in Danish population-based cohorts. A meta-analysis combining Danish studies with published Northern European population studies also showed that lactase persistence was not associated with fracture risk. Genetic lactase persistence was associated with a higher femoral neck BMD, but not lumbar spine or total hip BMD.
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