内科住院患者的维生素D状况。

Vitamin D status in inpatients admitted to an internal medicine department.

作者信息

Muscarella Silvana, Filabozzi Paola, D'Amico Grazia, Mascia Maria Lucia, Annese Maria Antonietta, Scillitani Alfredo, Carnevale Vincenzo

机构信息

Unit of Endocrinology, Casa Sollievo della Sofferenza Hospital, I.R.C.C.S., San Giovanni Rotondo (FG), Italy.

出版信息

Horm Res. 2006;66(5):216-20. doi: 10.1159/000094989. Epub 2006 Aug 11.

DOI:10.1159/000094989

PMID:16902309

Abstract

BACKGROUND/AIMS: A role of hypovitaminosis D has been advocated in several medical conditions. We investigated vitamin D status in medical inpatients, compared to a blood donors' group from the same area.

METHODS

Fifty-nine consecutive medical patients were recruited at hospital admission, concomitantly to 207 blood donors of both genders. Serum calcium, albumin, phosphate, creatinine, alkaline phosphatase total activity, 25-hydroxyvitamin D [25(OH)D] and parathyroid hormone (PTH) were assessed from April to May 2005.

RESULTS

In patients, 25(OH)D values were lower (13.1 +/- 9.2 vs. 16.3 +/- 8.5 ng/ml; p < 0.02) and PTH values higher (73.9 +/- 77.7 vs. 53.4 +/- 24.3 pg/ml; p < 0.01) than in controls, whose mean age was lower (62.5 +/- 14.5 vs. 45.8 +/- 15.6 years, p < 0.01). Such differences were not confirmed when comparing patients to a subgroup of age and sex-matched controls drawn from the whole sample of blood donors. In both patients and controls there was a trend towards a negative correlation between 25(OH)D and age and a positive correlation between PTH and age. The prevalence of 25(OH)D <12 ng/ml was higher in patients than in controls as a whole (58 vs. 34%; chi(2) = 9.95; p < 0.002), but not in respect to the subgroup of matched controls (58 vs. 44%; chi(2) = 2.09; p = 0.14). The prevalence of severe vitamin D deficiency, 25(OH)D <5 ng/ml, was significantly higher in patients than in matched controls (17 vs. 4%; chi(2) = 6.75; p < 0.01).

CONCLUSION

Hypovitaminosis D, defined as 25(OH)D <12 ng/ml, is frequent among inpatients, as in the general population of comparable age. A severe vitamin D deficiency is more common in hospitalized patients.

摘要

背景/目的：维生素D缺乏在多种疾病中被认为发挥了一定作用。我们对内科住院患者的维生素D状况进行了调查，并与同一地区的献血者群体进行了比较。

方法

在医院收治的59例连续内科患者中，同时纳入了207名不同性别的献血者。于2005年4月至5月评估血清钙、白蛋白、磷酸盐、肌酐、碱性磷酸酶总活性、25-羟维生素D [25(OH)D] 和甲状旁腺激素（PTH）。

结果

患者的25(OH)D值低于对照组（13.1±9.2对16.3±8.5 ng/ml；p<0.02），PTH值高于对照组（73.9±77.7对53.4±24.3 pg/ml；p<0.01），对照组的平均年龄更低（62.5±14.5对45.8±15.6岁，p<0.01）。当将患者与从献血者全样本中抽取的年龄和性别匹配的对照组亚组进行比较时，这些差异未得到证实。在患者和对照组中，25(OH)D与年龄之间均存在负相关趋势，PTH与年龄之间均存在正相关趋势。患者中25(OH)D<12 ng/ml的患病率高于总体对照组（58%对34%；χ²=9.95；p<0.002），但与匹配对照组亚组相比则不然（58%对44%；χ²=2.09；p=0.14）。严重维生素D缺乏（2(OH)D<5 ng/ml）的患病率在患者中显著高于匹配对照组（17%对4%；χ²=6.75；p<0.01）。