Aguado P, del Campo M T, Garcés M V, González-Casaús M L, Bernad M, Gijón-Baños J, Martín Mola E, Torrijos A, Martínez M E
Rheumatology and Clinical Biochemistry Divisions, H.U. La Paz, Madrid, Spain.
Osteoporos Int. 2000;11(9):739-44. doi: 10.1007/s001980070052.
To evaluate a possible relationship between vitamin D levels and bone mineral density (BMD) and the prevalence of hypovitaminosis in a population of postmenopausal women from a rheumatologic outpatient clinic in Madrid, Spain, 171 postmenopausal women (aged 47-66 years) divided into two groups (osteoporotic and nonosteoporotic, according to WHO criteria) were studied between November and June. Liver and kidney function were normal in all subjects. Serum parathyroid hormone (PTH) and calcidiol levels were determined and bone densitometry carried out at the lumbar spine and hip level. PTH and calcidiol serum levels did not show any correlation. Serum PTH was inversely related to BMD at both hip and lumbar spine in the total group, and at the hip with calcidiol levels lower than 37 nmol/l. Calcidiol was directly related to hip BMD only when levels were lower than 37 nmol/l. Results of a stepwise multiple regression analysis showed that the single factor which affected BMD at the hip was calcidiol in the subgroup with serum calcidiol levels below 37 nmol/l, while in the subgroup with serum calcidiol levels above 37 nmol/l, the main factor affecting hip BMD was serum PTH. The prevalence of vitamin D deficiency at a cutoff of 37 nmol/l was 64%. In summary, calcidiol serum levels below 37 nmol/l seem to affect bone mass, regardless of the effect of PTH. Vitamin D deficiency is a frequent finding in the postmenopausal women who attend a rheumatology outpatient clinic in Madrid. Vitamin D supplementation should therefore be considered in this population during the winter season.
为评估西班牙马德里一家风湿病门诊绝经后女性人群中维生素D水平与骨矿物质密度（BMD）之间的可能关系以及维生素缺乏症的患病率，于11月至6月期间对171名绝经后女性（年龄47 - 66岁）进行了研究，这些女性根据WHO标准分为两组（骨质疏松组和非骨质疏松组）。所有受试者的肝肾功能均正常。测定血清甲状旁腺激素（PTH）和骨化二醇水平，并在腰椎和髋部进行骨密度测定。PTH和骨化二醇血清水平未显示出任何相关性。在整个研究组中，血清PTH与髋部和腰椎的BMD均呈负相关，在骨化二醇水平低于37 nmol/l时，与髋部BMD也呈负相关。仅当骨化二醇水平低于37 nmol/l时，骨化二醇与髋部BMD呈正相关。逐步多元回归分析结果显示，在血清骨化二醇水平低于37 nmol/l的亚组中，影响髋部BMD的单一因素是骨化二醇，而在血清骨化二醇水平高于37 nmol/l的亚组中，影响髋部BMD的主要因素是血清PTH。以37 nmol/l为临界值时，维生素D缺乏症的患病率为64%。总之，无论PTH的影响如何，血清骨化二醇水平低于37 nmol/l似乎都会影响骨量。在马德里一家风湿病门诊就诊的绝经后女性中，维生素D缺乏是常见现象。因此，在该人群冬季时应考虑补充维生素D。
