Inderjeeth C A, Nicklason F, Al-Lahham Y, Greenaway T M, Jones G, Parameswaran V V, David R
Department of Geriatric Medicine, Royal Hobart Hospital, Tasmania.
Aust N Z J Med. 2000 Apr;30(2):209-14. doi: 10.1111/j.1445-5994.2000.tb00809.x.
To determine the prevalence and associations of vitamin D (25-OHD) deficiency in a sample of older Tasmanian subjects.
A cross-sectional survey of: 109 patients with a mean age of 79 years (range 60-101 years) consecutively admitted to a short stay geriatric rehabilitation ward; 52 community dwelling subjects with a mean age of 75 years (range 64-88 years). Subjects answered a questionnaire, had anthropometric measurements and underwent venepuncture.
The main outcome measure was 25 hydroxy vitamin D (25-OHD) level with deficiency defined as <28 nmol/L. Vitamin D deficiency was found in 67% and secondary hyperparathyroidism in 49% of the hospitalised group. Vitamin D deficiency was also found in 17% of the community group, in particular one in three residents of Independent Living Units was deficient. Subjects who were deficient were older (80 years vs 76 years [p<0.001]), had lower body mass index (23.7 kg/m2 vs 25.9 kg/m2 [p<0.001]) and had a lower serum albumin (35 gm/L vs 39 gm/L [p<0.001]). Deficient subjects had poorer physical functional status (p=0.02) and lower activity levels (p<0.001) and reported less habitual sun exposure (p<0.001). Biochemical measures such as parathyroid hormone, alkaline phosphatase and calcium were weakly predictive of vitamin D levels. By stepwise multiple regression analysis, the only significant predictors of vitamin D levels were the Frenchay Activity Index, albumin and calcium.
Vitamin D deficiency and secondary hyperparathyroidism is common in community living older people who are hospitalised in Southern Tasmania and is associated with increasing age, poor physical function and activity and low reported sun exposure.
确定塔斯马尼亚老年受试者样本中维生素D（25-OHD）缺乏症的患病率及其相关因素。
进行一项横断面调查，对象为：109例平均年龄79岁（范围60 - 101岁）的患者，他们连续入住短期老年康复病房；52例平均年龄75岁（范围64 - 88岁）的社区居住者。受试者回答问卷，进行人体测量并接受静脉穿刺。
主要观察指标为25羟维生素D（25-OHD）水平，缺乏定义为<28 nmol/L。住院组中67%存在维生素D缺乏，49%存在继发性甲状旁腺功能亢进。社区组中17%也存在维生素D缺乏，特别是独立生活单元中三分之一的居民缺乏。缺乏维生素D的受试者年龄更大（80岁对76岁[p<0.001]），体重指数更低（23.7 kg/m²对25.9 kg/m²[p<0.001]），血清白蛋白更低（35 g/L对39 g/L[p<0.001]）。缺乏维生素D的受试者身体功能状态较差（p = 0.02），活动水平较低（p<0.001），且报告的日常阳光暴露较少（p<0.001）。甲状旁腺激素、碱性磷酸酶和钙等生化指标对维生素D水平的预测作用较弱。通过逐步多元回归分析，维生素D水平的唯一显著预测因素是法国ay活动指数、白蛋白和钙。
维生素D缺乏和继发性甲状旁腺功能亢进在塔斯马尼亚南部住院的社区老年人群中很常见，且与年龄增长、身体功能和活动较差以及报告的阳光暴露较少有关。
