Välimäki Ville-Valtteri, Alfthan Henrik, Lehmuskallio Eero, Löyttyniemi Eliisa, Sahi Timo, Stenman Ulf-Håkan, Suominen Harri, Välimäki Matti J
Division of Endocrinology, Department of Medicine, Helsinki University Central Hospital, FIN-00290 Helsinki, Finland.
J Clin Endocrinol Metab. 2004 Jan;89(1):76-80. doi: 10.1210/jc.2003-030817.
Severe vitamin D deficiency causes rickets, but scarce data are available about the extent to which vitamin D status determines the development of the peak bone mass in young adults. Our aim was to evaluate the prevalence of vitamin D deficiency [serum 25-hydroxyvitamin D (25-OHD) less than the lower limit of the reference range of 20-105 nmol/liter] and the relationship between vitamin D status and peak bone mass among young Finnish men. A cross-sectional study of determinants of peak bone mass with data on lifestyle factors collected retrospectively was performed in 220 young men, aged 18.3-20.6 yr. One hundred and seventy men were recruits of the Finnish Army, and 50 were men of similar age who had postponed their military service for reasons not related to health. Bone mineral content, bone mineral density, and scan area were measured in lumbar spine and upper femur by dual energy x-ray absorptiometry. Serum 25-OHD concentrations were followed prospectively for 1 yr. In July 2000, only 0.9% of the men had vitamin D deficiency, but 6 months later, in the winter, the respective percentage was 38.9%. After adjusting for age, height, weight, exercise, smoking, calcium, and alcohol intake, there existed a positive correlation between serum 25-OHD and bone mineral content at lumbar spine (P = 0.057), femoral neck (P = 0.041), trochanter (P = 0.010), and total hip (P = 0.025). The correlation coefficients for the bone mineral densities at the four measurement sites were 0.035, 0.061, 0.056, and 0.068, respectively. No correlation was found to scan area. We conclude that vitamin D deficiency is very common in Finnish young men in the winter, and it may have detrimental effects on the acquisition of maximal peak bone mass. As in Finland vitamin D supplementation to infants is now stopped at the age of 3 yr, it can be asked whether at our latitude it should be continued from that age onward, not for the prevention of rickets, but as prophylaxis for osteoporosis.
严重维生素D缺乏会导致佝偻病，但关于维生素D状态在多大程度上决定年轻成年人峰值骨量的发展，现有数据稀少。我们的目的是评估维生素D缺乏（血清25-羟维生素D（25-OHD）低于20 - 105 nmol/升参考范围下限）的患病率，以及芬兰年轻男性中维生素D状态与峰值骨量之间的关系。对220名年龄在18.3 - 20.6岁的年轻男性进行了一项关于峰值骨量决定因素的横断面研究，回顾性收集了生活方式因素的数据。170名男性是芬兰军队的新兵，50名是因与健康无关的原因推迟服兵役的同龄男性。通过双能X线吸收法测量腰椎和股骨上段的骨矿物质含量、骨矿物质密度和扫描面积。前瞻性地随访血清25-OHD浓度1年。2000年7月，只有0.9%的男性存在维生素D缺乏，但6个月后的冬季，相应比例为38.9%。在调整年龄、身高、体重、运动、吸烟、钙和酒精摄入量后，血清25-OHD与腰椎（P = 0.057）、股骨颈（P = 0.041）、大转子（P = 0.010）和全髋（P = 0.025）的骨矿物质含量之间存在正相关。四个测量部位的骨矿物质密度的相关系数分别为0.035、0.061、0.056和0.068。未发现与扫描面积相关。我们得出结论，芬兰年轻男性在冬季维生素D缺乏非常普遍，这可能对获得最大峰值骨量有不利影响。由于在芬兰，现在婴儿在3岁时就停止补充维生素D，因此可以探讨在我们这个纬度，是否应该从那个年龄起继续补充，不是为了预防佝偻病，而是作为骨质疏松症的预防措施。
