Mezquita-Raya P, Muñoz-Torres M, Luna J D, Luna V, Lopez-Rodriguez F, Torres-Vela E, Escobar-Jiménez F
Endocrinology Division, University Hospital San Cecilio, Granada, Spain.
J Bone Miner Res. 2001 Aug;16(8):1408-15. doi: 10.1359/jbmr.2001.16.8.1408.
Although only few postmenopausal women exhibit biochemical signs of hypovitaminosis D, vitamin D insufficiency has been shown to have adverse effects on bone metabolism and could be an important risk factor for osteoporosis and fracture. We determined serum levels of 25-hydroxyvitamin D [25(OH)D], intact parathyroid hormone (iPTH), bone turnover markers, dietary calcium intake, and bone mineral density (BMD; measured by dual X-ray absorptiometry) in 161 consecutive ambulatory women, healthy except for osteoporosis, referred to a bone metabolic unit. The prevalence of vitamin D insufficiency [25(OH)D < or = 15 ng/ml] was 39.1%. 25(OH)D was lower in the osteoporotic subjects (15.7 +/- 5.3 ng/ml vs. 21.8 +/- 9.7 ng/ml; p < 0.001). After controlling for all other variables, lumbar spine (LS) BMD was found to be significantly associated with 25(OH)D, body mass index (BMI), and years after menopause (YSM) (R2 = 0.253; p < 0.001). For femoral neck (FN), significant independent predictors of BMD were YSM, BMI, iPTH, and 25(OH)D (R2 = 0.368; p < 0.001). The probability of meeting osteoporosis densitometric criteria was higher in the vitamin D insufficiency group (odds ratio [OR], 4.17, 1.83-9.48) after adjusting by YSM, BMI, iPTH, and dietary calcium intake. Our study shows that vitamin D insufficiency in an otherwise healthy postmenopausal population is a common risk factor for osteoporosis associated with increased bone remodeling and low bone mass.
尽管仅有少数绝经后女性表现出维生素D缺乏的生化指标，但维生素D不足已被证明会对骨代谢产生不良影响，并且可能是骨质疏松症和骨折的重要危险因素。我们测定了161名连续前来骨代谢科就诊的非卧床女性的血清25-羟维生素D [25(OH)D]、全段甲状旁腺激素(iPTH)、骨转换标志物、膳食钙摄入量以及骨密度（BMD；采用双能X线吸收法测量），这些女性除骨质疏松外均健康。维生素D不足[25(OH)D≤15 ng/ml]的患病率为39.1%。骨质疏松患者的25(OH)D水平较低（15.7±5.3 ng/ml对21.8±9.7 ng/ml；p<0.001）。在对所有其他变量进行校正后，发现腰椎（LS）骨密度与25(OH)D、体重指数（BMI）以及绝经后年限（YSM）显著相关（R2 = 0.253；p<0.001）。对于股骨颈（FN），骨密度的显著独立预测因素为YSM、BMI、iPTH和25(OH)D（R2 = 0.368；p<0.001）。在对YSM、BMI、iPTH和膳食钙摄入量进行校正后，维生素D不足组达到骨质疏松骨密度标准的概率更高（优势比[OR]为4.17，1.83 - 9.48）。我们的研究表明，在其他方面健康的绝经后人群中，维生素D不足是与骨重塑增加和低骨量相关的骨质疏松症的常见危险因素。
