Oliveri M B, Wittich A, Mautalen C, Chaperon A, Kizlansky A
Sección Osteopatías Médicas, Hospital de Clínicas, Universidad de Buenos Aires, Córdoba 2351 (1120) Buenos Aires, Argentina.
Calcif Tissue Int. 2000 Sep;67(3):220-4. doi: 10.1007/s002230001133.
Low vitamin D levels in elderly people are associated with reduced bone mass, secondary hyperparathyroidism, and increased fracture risk. Its effect on the growing skeleton is not well known. The aim of this study was to evaluate the possible influence of chronic winter vitamin D deficiency and higher winter parathyroid hormone (PTH) levels on bone mass in prepubertal children and young adults. The study was carried out in male and female Caucasian subjects. A total of 163 prepubertal children (X age +/- 1 SD: 8.9 +/- 0.7 years) and 234 young adults (22.9 +/- 3.6 years) who had never received vitamin D supplementation were recruited from two areas in Argentina: (1)Ushuaia (55 degrees South latitude), where the population is known to have low winter 25OHD levels and higher levels of PTH in winter than in summer, and (2)Buenos Aires (34 degrees S), where ultraviolet (UV) radiation and vitamin D nutritional status in the population are adequate all year round. Bone mineral content (BMC) and bone mineral density (BMD) of the ultradistal and distal radius were measured in the young adults. Only distal radius measurements were taken in the children. Similar results were obtained in age-sex matched groups from both areas. The only results showing significant difference corresponded to comparison among the Ushuaian women: those whose calcium (Ca) intake was below 800 mg/day presented lower BMD and BMC values than those whose Ca intake was above that level (0.469 +/- 0.046 versus 0.498 +/- 0.041 g/cm(2), P < 0.02; 3.131 +/- 0.367 versus 3.339 +/- 0.386 g, P < 0.05, respectively). In conclusion, peripheral BMD and BMC were similar in children and young adults from Ushuaia and Buenos Aires in spite of the previously documented difference between both areas regarding UV radiation and winter vitamin D status. BMD of axial skeletal areas as well the concomitant effect of a low Ca diet and vitamin D deficiency on the growing skeleton should be studied further.
老年人维生素D水平低与骨量减少、继发性甲状旁腺功能亢进及骨折风险增加有关。其对正在生长的骨骼的影响尚不清楚。本研究的目的是评估青春期前儿童和年轻成年人慢性冬季维生素D缺乏及冬季较高的甲状旁腺激素（PTH）水平对骨量的可能影响。该研究在白种男性和女性受试者中进行。从阿根廷的两个地区招募了总共163名未接受过维生素D补充的青春期前儿童（平均年龄±1标准差：8.9±0.7岁）和234名年轻成年人（22.9±3.6岁）：（1）乌斯怀亚（南纬55度），已知该地区人群冬季25OHD水平低，且冬季PTH水平高于夏季；（2）布宜诺斯艾利斯（南纬34度），该地区人群全年紫外线（UV）辐射和维生素D营养状况充足。测量了年轻成年人尺骨超远端和远端的骨矿物质含量（BMC）和骨矿物质密度（BMD）。儿童仅测量了远端桡骨。两个地区年龄和性别匹配的组获得了相似的结果。唯一显示出显著差异的结果是乌斯怀亚女性之间的比较：钙（Ca）摄入量低于800毫克/天的女性的BMD和BMC值低于摄入量高于该水平的女性（分别为0.469±0.046与0.498±0.041克/平方厘米，P<0.02；3.131±0.367与3.339±0.386克，P<0.05）。总之，尽管之前记录了乌斯怀亚和布宜诺斯艾利斯在紫外线辐射和冬季维生素D状况方面的差异，但来自这两个地区的儿童和年轻成年人的外周BMD和BMC相似。应进一步研究轴向骨骼区域的BMD以及低钙饮食和维生素D缺乏对生长中骨骼的联合影响。
