Snijder Marieke B, van Schoor Natasja M, Pluijm Saskia M F, van Dam Rob M, Visser Marjolein, Lips Paul
Institute of Health Sciences, Faculty of Earth and Life Sciences, Vrije Universiteit Amsterdam, De Boelelaan 1085, 1081 HV Amsterdam, The Netherlands.
J Clin Endocrinol Metab. 2006 Aug;91(8):2980-5. doi: 10.1210/jc.2006-0510. Epub 2006 May 9.
Falls frequently occur in the elderly and are a major cause of morbidity and mortality.
The objective of the study was to prospectively investigate the association between serum 25-hydroxyvitamin D [25(OH)D] levels and risk of recurrent falling in older men and women.
This was a prospective cohort study.
An age- and sex-stratified random sample of the Dutch older population was determined.
Subjects included 1231 men and women (aged 65 yr and older) participating in the Longitudinal Aging Study Amsterdam.
Baseline serum 25(OH)D was determined by a competitive protein binding assay. During 1 yr, falls were prospectively recorded by means of a fall calendar.
Low 25(OH)D (<10 ng/ml) was associated with an increased risk of falling. After adjustment for age, sex, education level, region, season, physical activity, smoking, and alcohol intake, the odds ratios (95% confidence interval) were 1.78 (1.06-2.99) for subjects who experienced two falls or more as compared with those who did not fall or fell once and 2.23 (1.17-4.25) for subjects who fell three or more times as compared with those who fell two times or less. There was a statistically significant effect modification by age, and stratified analyses (<75 and > or = 75 yr) showed that the associations were particularly strong in the younger age group; the odds ratios (95% confidence interval) were 5.21 (2.03-13.40) for two falls or more and 4.96 (1.52-16.23) for three falls or more.
Poor vitamin D status is independently associated with an increased risk of falling in the elderly, particularly in those aged 65-75 yr.
跌倒在老年人中频繁发生，是发病和死亡的主要原因。
本研究的目的是前瞻性调查老年男性和女性血清25-羟基维生素D [25(OH)D]水平与再次跌倒风险之间的关联。
这是一项前瞻性队列研究。
确定了荷兰老年人群按年龄和性别分层的随机样本。
对象包括1231名年龄在65岁及以上的男性和女性，他们参与了阿姆斯特丹纵向衰老研究。
通过竞争性蛋白结合测定法测定基线血清25(OH)D。在1年期间，通过跌倒日历前瞻性记录跌倒情况。
低25(OH)D水平（<10 ng/ml）与跌倒风险增加相关。在调整年龄、性别、教育水平、地区、季节、身体活动、吸烟和饮酒量后，与未跌倒或仅跌倒一次的受试者相比，经历两次或更多次跌倒的受试者的比值比（95%置信区间）为1.78（1.06 - 2.99），与跌倒两次或更少次的受试者相比，跌倒三次或更多次的受试者的比值比为2.23（1.17 - 4.25）。年龄存在统计学上显著的效应修饰，分层分析（<75岁和≥75岁）表明，这种关联在较年轻年龄组中尤为强烈；两次或更多次跌倒的比值比（95%置信区间）为5.21（2.03 - 13.40），三次或更多次跌倒的比值比为4.96（1.52 - 16.23）。
维生素D水平低下与老年人跌倒风险增加独立相关，尤其是在65 - 75岁的人群中。
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