加拿大西部健康人群中的维生素D缺乏情况。
Vitamin D insufficiency in a population of healthy western Canadians.
作者信息
Rucker Diana, Allan Jane A, Fick Gordon H, Hanley David A
机构信息
Department of Medical Science, University of Calgary, Alta.
出版信息
CMAJ. 2002 Jun 11;166(12):1517-24.
BACKGROUND
People with low levels of vitamin D and its metabolites are at increased risk for osteoporotic fractures. We wished to ascertain levels of vitamin D in a representative sample of adult western Canadians, to help assess the level of risk. We evaluated the prevalence of vitamin D insufficiency, defined as 25-hydroxyvitamin D [25(OH)D] less than 40 nmol/L, and seasonal variations in 25(OH)D, parathyroid hormone and related biochemical indices in a community-dwelling population of healthy Canadians living in Calgary (latitude 51 degrees 07'N).
METHODS
During calendar year 1999, we collected fasting overnight blood samples every 3 months from 60 men and 128 women (age range 27 to 89 years) who had volunteered to participate in another study. We used commercial radioimmunoassay kits to measure calciotrophic hormones and other biochemical indices. Regression models for longitudinal data were used to assess the effect of season and other potential predictors on individual parameters.
RESULTS
For a total of 64 participants (34%), vitamin D insufficiency, defined as 25(OH)D less than 40 nmol/L, was recorded at least once out of the 4 sampling times. After adjustment for age, body mass index and holiday travel, we observed the anticipated rise in serum 25(OH)D from a mean of 57.3 (standard deviation [SD] 21.3) nmol/L in the winter to 62.9 (SD 28.8) nmol/L in spring (p = 0.001) and 71.6 (SD 23.6) nmol/L in summer (p < 0.001), with a subsequent decline to 52.9 (SD 17.2) nmol/L in the fall (p = 0.008). The anticipated inverse relation between 25(OH)D and parathyroid hormone was not consistently observed: after adjustment for age, sex, body mass index and serum calcium, serum levels of parathyroid hormone did decrease significantly, from 39.5 (SD 18.8) ng/L in winter to 36.3 (SD 17.8) ng/L in summer (p = 0.001), but they continued to decline to 34.5 (SD 17.3) ng/L in the fall (p < 0.001). There was no association between 25(OH)D and parathyroid hormone (p = 0.21).
INTERPRETATION
We documented a high prevalence of vitamin D insufficiency, which warrants consideration of dietary vitamin D supplementation.
背景
维生素D及其代谢产物水平较低的人群发生骨质疏松性骨折的风险增加。我们希望确定加拿大西部成年人群代表性样本中的维生素D水平，以帮助评估风险程度。我们评估了维生素D不足（定义为25-羟维生素D[25(OH)D]低于40 nmol/L）的患病率，以及居住在卡尔加里（北纬51度07分）的健康加拿大社区居民中25(OH)D、甲状旁腺激素及相关生化指标的季节性变化。
方法
在1999年全年，我们每3个月从60名男性和128名女性（年龄范围27至89岁）中采集空腹过夜血样，这些人自愿参与另一项研究。我们使用商业放射免疫分析试剂盒测量钙调节激素和其他生化指标。使用纵向数据的回归模型评估季节和其他潜在预测因素对个体参数的影响。
结果
在4次采样中，共有64名参与者（34%）至少有一次记录到维生素D不足（定义为25(OH)D低于40 nmol/L）。在调整年龄、体重指数和节假日旅行因素后，我们观察到血清25(OH)D如预期那样升高，从冬季的平均57.3（标准差[SD]21.3）nmol/L升至春季的62.9（SD 28.8）nmol/L（p = 0.001）和夏季的71.6（SD 23.6）nmol/L（p < 0.001），随后在秋季降至52.9（SD 17.2）nmol/L（p = 0.008）。未始终观察到25(OH)D与甲状旁腺激素之间预期的负相关关系：在调整年龄、性别、体重指数和血清钙后，甲状旁腺激素的血清水平确实显著下降，从冬季的39.5（SD 18.8）ng/L降至夏季的36.3（SD 17.8）ng/L（p = 0.001），但在秋季继续降至34.5（SD 17.3）ng/L（p < 0.001）。25(OH)D与甲状旁腺激素之间无关联（p = 0.21）。
解读
我们记录了维生素D不足的高患病率，这值得考虑膳食补充维生素D。
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