Visser Marjolein, Deeg Dorly J H, Puts Martine T E, Seidell Jaap C, Lips Paul
Institute of Health Sciences, Faculty of Earth and Life Sciences, Vrije University, Amsterdam, Netherlands.
Am J Clin Nutr. 2006 Sep;84(3):616-22; quiz 671-2. doi: 10.1093/ajcn/84.3.616.
The prevalence of vitamin D deficiency in nursing home patients is high.
We aimed to ascertain whether lower serum 25-hydroxyvitamin D [25(OH)D] concentrations increase the risk of future nursing home admission and early death.
We included 1260 independent, community-dwelling persons aged > or =65 y who were participating in the Longitudinal Aging Study Amsterdam (1995-1996). Study outcomes were time to nursing home admission during 6 y of follow-up and time to death until 1 April 2003.
Vitamin D deficiency [25(OH)D < 25 nmol/L] and insufficiency [25(OH)D = 25-49.9 nmol/L] were present in 127 (10.1%) and 462 (36.7%) subjects, respectively. During follow-up, 138 subjects (11.0%) were admitted to nursing homes, and 380 subjects (30.2%) died. The risk of nursing home admission for participants with 25(OH)D deficiency was 53 cases per 1000 person-years higher than that for those with high 25(OH)D (> or =75 nmol/L) concentrations (58 compared with 5 cases). After adjustment for potential confounders, the hazard ratio (95% CI) of nursing home admission was 3.48 (1.39, 8.75) for vitamin D-deficient, 2.77 (1.17, 6.55) for vitamin D-insufficient, and 1.92 (0.79, 4.66) for vitamin D-borderline persons as compared with persons with high 25(OH)D (P for trend = 0.002). The results remained after additional adjustment for frailty indicators. Lower 25(OH)D was associated with higher mortality risk, but this association was not significant after adjustment for frailty indicators.
Lower serum 25(OH)D concentrations in older persons are associated with a greater risk of future nursing home admission and may be associated with mortality.
疗养院患者中维生素D缺乏的患病率很高。
我们旨在确定较低的血清25-羟基维生素D [25(OH)D]浓度是否会增加未来入住疗养院和过早死亡的风险。
我们纳入了1260名年龄≥65岁的独立社区居民，他们参与了阿姆斯特丹纵向衰老研究（1995 - 1996年）。研究结局为随访6年期间入住疗养院的时间以及至2003年4月1日的死亡时间。
维生素D缺乏[25(OH)D < 25 nmol/L]和不足[25(OH)D = 25 - 49.9 nmol/L]分别出现在127名（10.1%）和462名（36.7%）受试者中。在随访期间，138名受试者（11.0%）入住了疗养院，380名受试者（30.2%）死亡。25(OH)D缺乏的参与者入住疗养院的风险比25(OH)D浓度高（≥75 nmol/L）的参与者每1000人年高53例（分别为58例和5例）。在对潜在混杂因素进行调整后，与25(OH)D浓度高的人相比，维生素D缺乏者入住疗养院的风险比（95% CI）为3.48（1.39，8.75），维生素D不足者为2.77（1.17，6.55），维生素D临界者为1.92（0.79，4.66）（趋势P值 = 0.002）。在对衰弱指标进行额外调整后，结果仍然成立。较低的25(OH)D与较高的死亡风险相关，但在对衰弱指标进行调整后，这种关联并不显著。
老年人较低的血清25(OH)D浓度与未来入住疗养院的风险增加相关，并且可能与死亡率相关。
