Drinka Paul J, Krause Peggy F, Nest Lori J, Goodman Brian M
Wisconsin Veterans Home, King, WI 54946, USA.
J Am Med Dir Assoc. 2007 Feb;8(2):76-9. doi: 10.1016/j.jamda.2006.09.015. Epub 2006 Dec 14.
To determine the effect of various doses of vitamin D(2) and D(3), as well as ambulatory status (a surrogate for sun exposure), on 25-OH-D levels.
Cross-sectional study with multiple regression analysis.
A state veterans home for veterans and their spouses.
Three hundred two of 609 eligible residents.
Serum 25-OH-D and parathyroid hormone (PTH) level, supplemental dose of vitamins D(2) and D(3) per kilogram of body weight, and 3 levels of ambulatory status.
The mean 25-OH-D level was 28.6 + 9.2 ng/mL; 6.6% of subjects had values of 16 ng/mL or below. Thirty-two percent of participants had 25-OH-D levels below 30 ng/mL and PTH elevation based on stage of kidney disease, evidence that the suboptimal 25-OH-D level had physiologic consequences. Residents unable to transfer independently had 25-OH-D levels 1.6 ng/mL lower than those able to transfer independently. A regression analysis performed in residents unable to transfer independently (less likely to be exposed to the sun) demonstrated that the average increase in 25-OH-D level per 100 IU of D(3) in a 70-kg resident was 2.1 ng/mL versus 1.8 ng/mL for vitamin D(2).
Nursing home residents should receive at least 800-1000 IU of D(3) per day in an effort to maintain optimal vitamin D levels.
确定不同剂量的维生素D2和D3以及活动状态（阳光照射的替代指标）对25-羟基维生素D水平的影响。
采用多元回归分析的横断面研究。
一家为退伍军人及其配偶设立的州立退伍军人之家。
609名符合条件的居民中的302名。
血清25-羟基维生素D和甲状旁腺激素（PTH）水平、每千克体重维生素D2和D3的补充剂量以及3个活动状态水平。
25-羟基维生素D的平均水平为28.6±9.2 ng/mL；6.6%的受试者该值为16 ng/mL或更低。32%的参与者25-羟基维生素D水平低于30 ng/mL且基于肾病分期出现PTH升高，这表明25-羟基维生素D水平未达最佳具有生理后果。无法独立转移的居民的25-羟基维生素D水平比能够独立转移的居民低1.6 ng/mL。在无法独立转移（较少可能暴露于阳光下）的居民中进行的回归分析表明，对于一名70千克的居民，每100 IU的维生素D3使25-羟基维生素D水平平均升高2.1 ng/mL，而维生素D2为1.8 ng/mL。
疗养院居民应每天至少摄入800 - 1000 IU的维生素D3，以维持最佳维生素D水平。
