Bischoff-Ferrari Heike A, Dietrich Thomas, Orav E John, Hu Frank B, Zhang Yuqing, Karlson Elisabeth W, Dawson-Hughes Bess
Division of Aging, The Robert B Brigham Arthritis and Musculoskeletal Diseases Clinical Research Center, Brigham and Women's Hospital, 1620 Tremont Street, Boston, MA 02120, USA.
Am J Clin Nutr. 2004 Sep;80(3):752-8. doi: 10.1093/ajcn/80.3.752.
BACKGROUND: Vitamin D may improve muscle strength through a highly specific nuclear receptor in muscle tissue. OBJECTIVES: We investigated whether there is an association between 25-hydroxyvitamin D [25(OH)D] concentrations and lower-extremity function in ambulatory older persons, whether that association differs by activity level, and, if so, whether there is an identifiable threshold in the association. DESIGN: The study was a population-based survey of the ambulatory US population aged 60 to > or =90 y (n = 4100). Lower-extremity function according to serum 25(OH)D concentrations was assessed by linear regression analyses and regression plots after control for activity level (inactive or active) and several other potential confounders. Separate analyses were performed for the timed 8-foot (ie, 2.4 m) walk test and a repeated sit-to-stand test. RESULTS: The 8-foot walk test compared subjects in the lowest and highest quintiles of 25(OH)D; the latter group had an average decrease of 0.27 s [95% CI: -0.44, -0.09 s (or 5.6%); P for trend < 0.001]. The sit-to-stand test compared subjects in the lowest and highest quintiles of 25(OH)D; the latter group had an average decrease of 0.67 s [95% CI: -1.11, -0.23 s (or 3.9%); P for trend = 0.017]. In the 25(OH)D reference range of 22.5-94 nmol/L, most of the improvement occurred in subjects with 25(OH)D concentrations between 22.5 and approximately 40 nmol/L, and further improvement was seen in the range of 40-94 nmol/L. Stratification by activity level showed no significant effect modification. CONCLUSION: In both active and inactive ambulatory persons aged > or =60 y, 25(OH)D concentrations between 40 and 94 nmol/L are associated with better musculoskeletal function in the lower extremities than are concentrations < 40 nmol/L.
背景:维生素D可能通过肌肉组织中一种高度特异性的核受体来增强肌肉力量。 目的:我们调查了在能走动的老年人中,25-羟维生素D[25(OH)D]浓度与下肢功能之间是否存在关联,这种关联是否因活动水平而异,如果存在差异,该关联中是否存在一个可识别的阈值。 设计:该研究是一项基于人群的对60至≥90岁能走动的美国人群(n = 4100)的调查。在控制活动水平(不活动或活动)及其他几个潜在混杂因素后,通过线性回归分析和回归图评估根据血清25(OH)D浓度得出的下肢功能。对定时8英尺(即2.4米)步行测试和重复坐立测试分别进行分析。 结果:在8英尺步行测试中,比较了25(OH)D最低和最高五分位数的受试者;后一组平均减少了0.27秒[95%可信区间:-0.44,-0.09秒(或5.6%)];趋势P<0.001。在坐立测试中,比较了25(OH)D最低和最高五分位数的受试者;后一组平均减少了0.67秒[95%可信区间:-1.11,-0.23秒(或3.9%)];趋势P = 0.017。在25(OH)D参考范围22.5 - 94 nmol/L内,大部分改善发生在25(OH)D浓度在22.5至约40 nmol/L之间的受试者中,在40 - 94 nmol/L范围内也观察到了进一步改善。按活动水平分层未显示出显著的效应修饰。 结论:在年龄≥60岁的活动和不活动的能走动人群中,25(OH)D浓度在40至94 nmol/L之间与下肢更好的肌肉骨骼功能相关,而低于40 nmol/L的浓度则不然。
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