Rejnmark L, Jørgensen M E, Pedersen M B, Hansen J C, Heickendorff L, Lauridsen A L, Mulvad G, Siggaard C, Skjoldborg H, Sørensen T B, Pedersen E B, Mosekilde L
Department of Endocrinology and Metabolism C, Aarhus Amtssygehus, Aarhus University Hospital, Aarhus, Denmark.
Calcif Tissue Int. 2004 Mar;74(3):255-63. doi: 10.1007/s00223-003-0110-9. Epub 2003 Dec 23.
We studied the influence of age, gender, latitude, season, diet and ethnicity on plasma 25-hydroxyvitamin D 25 OHD, PTH, 1,25-dihydroxyvitamin D, vitamin D-binding protein, bone-specific alkaline phosphatase, and osteocalcin levels in 46 Greenlanders living in Nuuk (64 degrees N) on a traditional fare (group A), 45 Greenlanders living in Nuuk on a westernized fare (group B), 54 Greenlanders (group C), and 43 Danes (Group D) living in Denmark (55 degrees N) on a westernized fare. Blood specimens were drawn both summer and winter. Vitamin D insufficiency (plasma 25 OHD <40 nmol/l) was common in all four study groups during summer (23-74%) and winter (42-81%). Compared to groups A and D, vitamin D insufficiency was significantly more frequent in groups B and C. In all groups, summer levels of 25 OHD were above winter levels. Multiple regression analysis revealed a significant effect of ethnicity. Compared to Danes, Greenlanders had higher 1,25-dihydroxyvitamin D levels, but lower 25 OHD and PTH levels despite relatively low plasma calcium concentrations. In addition to ethnicity, 25(OH)D levels were influenced by age, season (summer > winter), and diet (a traditional Inuit diet>westernized diet). Ethnic differences exist between Greenlanders and Danes. Our results suggest that Greenlanders may have an inherent lower "set-point" for calcium-regulated PTH release or an enhanced renal 1,25(OH)(2)D production. In addition to ethnicity, age, season, and diet were important determinants of vitamin D status. Changes from a traditional to a westernized fare are associated with a reduced vitamin D status in Greenlanders. Vitamin D supplementation should be considered.
我们研究了年龄、性别、纬度、季节、饮食和种族对46名居住在努克(北纬64度)、以传统食物为生的格陵兰人(A组)、45名居住在努克、以西化食物为生的格陵兰人(B组)、54名格陵兰人(C组)以及43名居住在丹麦(北纬55度)、以西化食物为生的丹麦人(D组)血浆25-羟基维生素D[25(OH)D]、甲状旁腺激素(PTH)、1,25-二羟基维生素D、维生素D结合蛋白、骨特异性碱性磷酸酶和骨钙素水平的影响。在夏季和冬季均采集了血样。在所有四个研究组中,夏季(23%-74%)和冬季(42%-81%)维生素D不足(血浆25(OH)D<40nmol/L)的情况都很常见。与A组和D组相比,B组和C组维生素D不足的情况明显更频繁。在所有组中,25(OH)D的夏季水平高于冬季水平。多元回归分析显示种族有显著影响。与丹麦人相比,格陵兰人的1,25-二羟基维生素D水平较高,但尽管血浆钙浓度相对较低,其25(OH)D和PTH水平却较低。除种族外,25(OH)D水平还受年龄、季节(夏季>冬季)和饮食(传统因纽特饮食>西化饮食)的影响。格陵兰人和丹麦人之间存在种族差异。我们的结果表明,格陵兰人可能对钙调节的PTH释放有内在较低的“设定点”,或者肾1,25(OH)₂D的产生增强。除种族外,年龄、季节和饮食是维生素D状态的重要决定因素。从传统饮食转变为西化饮食与格陵兰人维生素D状态降低有关。应考虑补充维生素D。