Hintzpeter B, Mensink G B M, Thierfelder W, Müller M J, Scheidt-Nave C
Department of Epidemiology and Health Reporting, Robert Koch-Institute, Berlin, Germany.
Eur J Clin Nutr. 2008 Sep;62(9):1079-89. doi: 10.1038/sj.ejcn.1602825. Epub 2007 May 30.
To analyze vitamin D status based on serum 25-hydroxyvitamin D (25OHD) measurements, its determinants and health correlates in a representative sample of German adults.
A total of 1763 men and 2267 women, 18- to 79-year old, who participated in the representative German National Health Interview and Examination Survey 1998 and the integrated German Nutrition Survey.
The median vitamin D intake from both diet and supplements did not meet the recommended level of 5 microg/day, in either men (2.8 microg/day) or women (2.3 microg/day). Altogether 80.9% of men and 88.5% of women had vitamin D intakes below this level. Moderate (12.5-25 nmol/l serum 25OHD levels) and mild (25-50 nmol/l) vitamin D deficiency was prevalent in the adult population in Germany, even in younger age groups. Overall, 57% of men and 58% of women had vitamin D levels below 50 nmol/l. Among 65- to 79-year-old women, the proportion amounted to 75%, even during the sunnier half of the year. In sex-specific multiple linear regression models, independent determinants of serum 25OHD levels consistently included season, vitamin D intake from both diet and supplements, physical activity and living in a partnership. In addition, age and current menopausal hormone use contributed to the model among women, as opposed to time of day of blood sampling and body mass index (marginally) among men. Significantly lower serum 25OHD levels were observed in women with hypertension, cardiovascular diseases and noninsulin-treated diabetes mellitus as well as in men with insulin-treated diabetes mellitus compared with nonaffected participants.
Vitamin D deficiency is a public health issue in Germany. We identified a number of determinants with potential for primary prevention of vitamin D deficiency. Risk and benefits of preventive actions need to be examined in further studies.
基于血清25-羟维生素D（25OHD）测量值分析德国成年人代表性样本中的维生素D状况、其决定因素及与健康的相关性。
共有1763名男性和2267名女性，年龄在18至79岁之间，他们参与了1998年具有代表性的德国国民健康访谈与检查调查以及综合德国营养调查。
男性（2.8微克/天）和女性（2.3微克/天）通过饮食和补充剂摄入的维生素D中位数均未达到建议的5微克/天水平。总计80.9%的男性和88.5%的女性维生素D摄入量低于该水平。中度（血清25OHD水平为12.5 - 25纳摩尔/升）和轻度（25 - 50纳摩尔/升）维生素D缺乏在德国成年人群中普遍存在，甚至在较年轻年龄组中也是如此。总体而言，57%的男性和58%的女性维生素D水平低于50纳摩尔/升。在65至79岁的女性中，这一比例高达75%，即使在一年中阳光更充足的半年期间也是如此。在性别特异性多元线性回归模型中，血清25OHD水平的独立决定因素始终包括季节、饮食和补充剂中的维生素D摄入量、身体活动以及处于伴侣关系。此外，年龄和当前的绝经激素使用对女性模型有影响，而男性模型中则是采血时间和体重指数（微弱影响）。与未受影响的参与者相比，患有高血压、心血管疾病和非胰岛素治疗糖尿病的女性以及接受胰岛素治疗糖尿病的男性血清25OHD水平显著更低。
维生素D缺乏是德国的一个公共卫生问题。我们确定了一些具有初级预防维生素D缺乏潜力的决定因素。预防措施的风险和益处需要在进一步研究中进行考察。
