Kwon Jinhee, Suzuki Takao, Yoshida Hideyo, Kim Hunkyung, Yoshida Yuko, Iwasa Hajime
Research Team for Promoting Independence of the Elderly, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.
Gerontology. 2007;53(5):322-8. doi: 10.1159/000103257. Epub 2007 May 29.
Previous studies have shown that serum albumin or vitamin D is associated with physical performance. We hypothesized that older adults with concomitant lower serum albumin and vitamin D (25-hydroxyvitamin D, 25OHD) levels are associated with decreased physical performance compared to those with 1 or none of the 2 risk factors.
To investigate the association of combined serum albumin and 25OHD levels with physical performance (muscle strength and balance capability) in community-dwelling elderly.
A cross-sectional study in a community-based population in the province of Tokyo, Japan, was performed. For the study, 1,094 community-dwelling people aged 70 and older underwent an interview, anthropometric measurements, blood analysis and physical performance testing. The subjects were classified into 4 types by combining serum albumin and 25OHD levels: lower albumin only, lower vitamin D only, lower albumin and lower vitamin D, higher albumin and higher vitamin D.
Men with concomitant lower albumin and lower 25OHD levels had significantly decreased knee extension power, usual timed Up & Go and maximal timed Up & Go, even after adjusting for age and body mass index (BMI). In women, concomitant lower albumin and lower vitamin D was associated with significantly decreased handgrip strength and functional reach, even after adjusting for age and BMI. Subjects with combined lower albumin and lower vitamin D levels showed a significant decline in muscle strength and balance capability compared to higher albumin and higher vitamin D, even after adjusting for age, current drinking or smoking status, physical activity, history of chronic disease, basic activities of daily living, instrumental activities of daily living, BMI and bone mineral density.
Concomitant lower serum albumin and lower vitamin D levels are associated with decreased muscle strength and balance capability in both men and women. These results suggest that serum albumin and 25OHD together may be an important target for strategies aiming to achieve a healthy life and prevent loss of independence in community-dwelling elderly.
既往研究表明，血清白蛋白或维生素D与身体机能相关。我们推测，与仅有1种或无这2种危险因素的老年人相比，血清白蛋白和维生素D（25-羟基维生素D，25OHD）水平均较低的老年人身体机能会下降。
探讨血清白蛋白与25OHD联合水平与社区居住老年人身体机能（肌肉力量和平衡能力）之间的关联。
在日本东京都的一个社区人群中开展了一项横断面研究。本研究纳入了1094名70岁及以上的社区居住者，对其进行访谈、人体测量、血液分析和身体机能测试。根据血清白蛋白和25OHD水平将受试者分为4类：仅白蛋白水平较低、仅维生素D水平较低、白蛋白和维生素D水平均较低、白蛋白和维生素D水平均较高。
即使在调整年龄和体重指数（BMI）后，白蛋白和25OHD水平均较低的男性，其膝关节伸展力量、常规计时起立行走时间和最大计时起立行走时间仍显著下降。在女性中，即使在调整年龄和BMI后，白蛋白和维生素D水平均较低与握力和功能性伸展显著下降相关。与白蛋白和维生素D水平均较高的受试者相比，白蛋白和维生素D水平均较低的受试者，即使在调整年龄、当前饮酒或吸烟状况、身体活动、慢性病病史、日常生活基本活动能力、日常生活工具性活动能力、BMI和骨密度后，其肌肉力量和平衡能力仍显著下降。
血清白蛋白和维生素D水平均较低与男性和女性的肌肉力量及平衡能力下降有关。这些结果表明，血清白蛋白和25OHD共同作用，可能是旨在实现健康生活并预防社区居住老年人丧失独立生活能力的策略的重要目标。
