Lee Wan-Ping, Lin Li-Wei, Yeh Shu-Hui, Liu Rosa Huang, Tseng Cheun-Fen
School of Nursing, Tajen Institute of Technoogy, Taiwan, ROC.
J Nurs Res. 2002 Mar;10(1):65-72. doi: 10.1097/01.jnr.0000347584.00705.b8.
This study correlates serum vitamin D levels to related hormones and dietary intakes among 57 elderly Chinese above the age of 65 who were living in the same community in rural Southern Taiwan (Pingtung) and who had no conditions or drug intake known to interfere with the metabolism of vitamin D. Demographic characteristics, past medical history, medications, and dietary intake were collected via questionnaires. Venous blood samples were collected for analyses of serum 25-hydroxyvitamin D (25(OH)D), parathyroid hormone (PTH) and calcium levels. Our results showed subjects in this study to have normal mean values of serum 25(OH)D, PTH and calcium levels. The mean serum 25(OH)D level was 36.21 (+/- 6.37) ng/ml, the mean serum PTH level 29.24 (+/- 18.62) pg/ml and the mean serum calcium level 9.14 (+/- 0.52) mg/dl. While the mean serum 25(OH)D and calcium values were not found to be significantly different between men and women, the mean serum PTH level was significantly higher in women (33.42 +/- 20.00 pg/ml) than in men (23.07 +/- 14.66 pg/ml) (p <.05), and serum PTH levels were significantly negatively correlated to serum calcium (r = -.33, p <.05) but not 25(OH)D (r = -.21). A higher intake of calcium was significantly associated with higher serum calcium levels (r =.29, p <.05), but not with serum 25(OH)D levels. Results from this study suggested that the elderly people living in Pingtung, a particularly sunny region, had normal serum 25(OH)D levels. The fact that the elderly women studied had higher serum PTH levels and that these levels were negatively correlated to serum calcium levels suggests that a higher PTH level in the elderly women may be related to susceptibility for osteoporosis. In an effort to provide optimal nursing care for the elderly by minimizing hip fractures and related morbidity, further nursing studies are needed to study the effects of the environment, dietary intake and bone metabolism.
本研究对57名年龄在65岁以上、居住在台湾南部农村(屏东)同一社区、且无已知会干扰维生素D代谢的疾病或药物摄入情况的中国老年人,进行血清维生素D水平与相关激素及饮食摄入量之间的相关性分析。通过问卷调查收集人口统计学特征、既往病史、用药情况及饮食摄入量。采集静脉血样,用于分析血清25-羟维生素D(25(OH)D)、甲状旁腺激素(PTH)和钙水平。我们的研究结果显示,本研究中的受试者血清25(OH)D、PTH和钙水平的平均值均正常。血清25(OH)D水平的平均值为36.21(±6.37)ng/ml,血清PTH水平的平均值为29.24(±18.62)pg/ml,血清钙水平的平均值为9.14(±0.52)mg/dl。虽然未发现血清25(OH)D和钙的平均值在男性和女性之间存在显著差异,但女性的血清PTH平均水平(33.42±20.00 pg/ml)显著高于男性(23.07±14.66 pg/ml)(p<.05),且血清PTH水平与血清钙显著负相关(r = -.33,p<.05),但与25(OH)D无相关性(r = -.21)。较高的钙摄入量与较高的血清钙水平显著相关(r =.29,p<.05),但与血清25(OH)D水平无关。本研究结果表明,居住在阳光充足地区屏东的老年人血清25(OH)D水平正常。所研究的老年女性血清PTH水平较高且这些水平与血清钙水平负相关,这一事实表明老年女性较高的PTH水平可能与骨质疏松易感性有关。为了通过尽量减少髋部骨折及相关发病率为老年人提供最佳护理,需要进一步开展护理研究,以研究环境、饮食摄入和骨代谢的影响。