Neuprez Audrey, Bruyère Olivier, Collette Julien, Reginster Jean-Yves
Department of Epidemiology, Public Health and Health Economics, University of Liege, 4020 Liege, Belgium.
BMC Public Health. 2007 Apr 26;7:64. doi: 10.1186/1471-2458-7-64.
Inadequate serum vitamin D [25(OH)D] concentrations are associated with secondary hyperparathyroidism, increased bone turnover and bone loss, which increase fracture risk. The objective of this study is to assess the prevalence of inadequate serum 25(OH)D concentrations in postmenopausal Belgian women. Opinions with regard to the definition of vitamin D deficiency and adequate vitamin D status vary widely and there are no clear international agreements on what constitute adequate concentrations of vitamin D.
Assessment of 25-hydroxyvitamin D [25(OH)D] and parathyroid hormone was performed in 1195 Belgian postmenopausal women aged over 50 years. Main analysis has been performed in the whole study population and according to the previous use of vitamin D and calcium supplements. Four cut-offs of 25(OH)D inadequacy were fixed : < 80 nmol/L, <75 nmol/L, < 50 nmol/L and < 30 nmol/L.
Mean (SD) age of the patients was 76.9 (7.5) years, body mass index was 25.7 (4.5) kg/m2. Concentrations of 25(OH)D were 52.5 (21.4) nmol/L. In the whole study population, the prevalence of 25(OH)D inadequacy was 91.3 %, 87.5 %, 43.1 % and 15.9% when considering cut-offs of 80, 75, 50 and 30 nmol/L, respectively. Women who used vitamin D supplements, alone or combined with calcium supplements, had higher concentrations of 25(OH)D than non-users. Significant inverse correlations were found between age/serum PTH and serum 25(OH)D (r = -0.23/r = -0.31) and also between age/serum PTH and femoral neck BMD (r = -0.29/r = -0.15). There is a significant positive relation between age and PTH (r = 0.16), serum 25(OH)D and femoral neck BMD (r = 0.07). (P < 0.05)Vitamin D concentrations varied with the season of sampling but did not reach statistical significance (P = 0.09).
This study points out a high prevalence of vitamin D inadequacy in Belgian postmenopausal osteoporotic women, even among subjects receiving vitamin D supplements.
血清维生素D[25(OH)D]浓度不足与继发性甲状旁腺功能亢进、骨转换增加和骨质流失有关,这会增加骨折风险。本研究的目的是评估比利时绝经后女性血清25(OH)D浓度不足的患病率。关于维生素D缺乏的定义和充足的维生素D状态的观点差异很大,对于什么构成充足的维生素D浓度尚无明确的国际共识。
对1195名年龄超过50岁的比利时绝经后女性进行了25-羟基维生素D[25(OH)D]和甲状旁腺激素评估。主要分析在整个研究人群中进行,并根据之前维生素D和钙补充剂的使用情况进行。确定了四个25(OH)D不足的临界值:<80 nmol/L、<75 nmol/L、<50 nmol/L和<30 nmol/L。
患者的平均(标准差)年龄为76.9(7.5)岁,体重指数为25.7(4.5)kg/m²。25(OH)D浓度为52.5(21.4)nmol/L。在整个研究人群中,当考虑80、75、50和30 nmol/L的临界值时,25(OH)D不足的患病率分别为91.3%、87.5%、43.1%和15.9%。单独或联合使用钙补充剂的维生素D补充剂使用者的25(OH)D浓度高于非使用者。年龄/血清甲状旁腺激素与血清25(OH)D之间(r=-0.23/r=-0.31)以及年龄/血清甲状旁腺激素与股骨颈骨密度之间(r=-0.29/r=-0.15)存在显著的负相关。年龄与甲状旁腺激素之间(r=0.16)、血清25(OH)D与股骨颈骨密度之间(r=0.07)存在显著的正相关。(P<0.05)维生素D浓度随采样季节而变化,但未达到统计学显著性(P=0.09)。
本研究指出,比利时绝经后骨质疏松女性中维生素D不足的患病率很高,即使在接受维生素D补充剂的人群中也是如此。