Wicherts Ilse S, van Schoor Natasja M, Boeke A Joan P, Visser Marjolein, Deeg Dorly J H, Smit Jan, Knol Dirk L, Lips Paul
Department of Endocrinology, VU University Medical Center, Amsterdam, The Netherlands.
J Clin Endocrinol Metab. 2007 Jun;92(6):2058-65. doi: 10.1210/jc.2006-1525. Epub 2007 Mar 6.
Vitamin D deficiency is common among older people and can cause mineralization defects, bone loss, and muscle weakness.
The aim of this study was to investigate the association of serum 25-hydroxyvitamin D (25-OHD) concentration with current physical performance and its decline over 3 yr among elderly.
The study consisted of a cross-sectional and longitudinal design (3-yr follow-up) within the Longitudinal Aging Study Amsterdam.
An age- and sex-stratified random sample of the Dutch older population was used.
Subjects included 1234 men and women (aged 65 yr and older) for cross-sectional analysis and 979 (79%) persons for longitudinal analysis.
MAIN OUTCOME MEASURE(S): Physical performance (sum score of the walking test, chair stands, and tandem stand) and decline in physical performance were measured.
Serum 25-OHD was associated with physical performance after adjustment for age, gender, chronic diseases, degree of urbanization, body mass index, and alcohol consumption. Compared with individuals with serum 25-OHD levels above 30 ng/ml, physical performance was poorer in participants with serum 25-OHD less than 10 ng/ml [regression coefficient (B) = -1.69; 95% confidence interval (CI) = -2.28; -1.10], and with serum 25-OHD of 10-20 ng/ml (B = -0.46; 95% CI = -0.90; -0.03). After adjustment for confounding variables, participants with 25-OHD less than 10 ng/ml and 25-OHD between 10 and 20 ng/ml had significantly higher odds ratios (OR) for 3-yr decline in physical performance (OR = 2.21; 95% CI = 1.00-4.87; and OR = 2.01; 95% CI = 1.06-3.81), compared with participants with 25-OHD of at least 30 ng/ml. The results were consistent for each individual performance test.
Serum 25-OHD concentrations below 20 ng/ml are associated with poorer physical performance and a greater decline in physical performance in older men and women. Because almost 50% of the population had serum 25-OHD below 20 ng/ml, public health strategies should be aimed at this group.
维生素D缺乏在老年人中很常见，可导致矿化缺陷、骨质流失和肌肉无力。
本研究旨在调查老年人血清25-羟维生素D（25-OHD）浓度与当前身体机能及其3年下降情况之间的关联。
该研究包括阿姆斯特丹纵向衰老研究中的横断面和纵向设计（3年随访）。
使用了荷兰老年人群按年龄和性别分层的随机样本。
横断面分析的受试者包括1234名男性和女性（年龄65岁及以上），纵向分析的有979人（79%）。
测量身体机能（步行测试、从椅子上站起和单脚站立的总分）和身体机能下降情况。
在调整年龄、性别、慢性病、城市化程度、体重指数和饮酒量后，血清25-OHD与身体机能相关。与血清25-OHD水平高于30 ng/ml的个体相比，血清25-OHD低于10 ng/ml的参与者身体机能较差[回归系数（B）=-1.69；95%置信区间（CI）=-2.28；-1.10]，血清25-OHD为10-20 ng/ml的参与者也是如此（B=-0.46；95%CI=-0.90；-0.03）。在调整混杂变量后，血清25-OHD低于10 ng/ml和25-OHD在10至20 ng/ml之间的参与者身体机能3年下降的优势比（OR）显著更高（OR=2.21；95%CI=1.00-4.87；OR=2.01；95%CI=1.06-3.81），与血清25-OHD至少为30 ng/ml的参与者相比。每个个体性能测试的结果都是一致的。
血清25-OHD浓度低于20 ng/ml与老年男性和女性较差的身体机能以及身体机能更大程度的下降相关。由于近50%的人群血清25-OHD低于20 ng/ml，公共卫生策略应针对这一群体。
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