Saraiva Gabriela Luporini, Cendoroglo Maysa Seabra, Ramos Luiz Roberto, Araújo Lara Miguel Quirino, Vieira José Gilberto H, Maeda Sérgio Setsuo, Borba Victória Z C, Kunii Ilda, Hayashi Lillian F, Lazaretti-Castro Marise
Departamento de Endocrinologia, Escola Paulista de Medicina, Universidade Federal de São Paulo.
Arq Bras Endocrinol Metabol. 2007 Apr;51(3):437-42. doi: 10.1590/s0004-27302007000300012.
The occurrence of osteoporotic fractures in the elderly is associated with reduced levels of vitamin D and resulting secondary hyperparathyroidism, and inpatients are the ones at a higher risk. In Brazil, given its high level of insolation, the populations large amount of vitamin D is inferred to be adequate. In this study we aimed to assess the serum levels of 25-hydroxivitamin D (25OHD), parathormone (PTH) and ionized calcium (Cai), as well as to analyze the prevalence of both hypovitaminosis D and secondary hyperparathyroidism in the elderly living in the city of São Paulo. We studied 177 inpatients (125 women and 52 men) with mean age (SD) 76.6 (9.0) years, and 243 outpatients (168 women and 75 men) aged 79.1 (5.9) years. In this assessment 71.2% in the inpatients group and 43.8% in the outpatients group had 25OHD levels below the minimum recommended (50 nmol/l), with the women presenting with levels considerably lower than the men. Secondary hyperparathyroidism occurred in 61.7% of the inpatients and in 54% of the outpatients. Considering the results achieved, we recommend vitamin D supplementation in effective doses for the Brazilian elderly population, in addition to suggesting a discussion for the implementation of vitamin D-enhanced food policies, particularly oriented to the ones at a greater risk.
老年人骨质疏松性骨折的发生与维生素D水平降低及由此导致的继发性甲状旁腺功能亢进有关,住院患者的风险更高。在巴西,鉴于其日照充足,推断大量人群的维生素D水平充足。在本研究中,我们旨在评估血清25-羟维生素D(25OHD)、甲状旁腺激素(PTH)和离子钙(Cai)水平,并分析圣保罗市老年人维生素D缺乏症和继发性甲状旁腺功能亢进的患病率。我们研究了177名住院患者(125名女性和52名男性),平均年龄(标准差)为76.6(9.0)岁,以及243名门诊患者(168名女性和75名男性),年龄为79.1(5.9)岁。在本次评估中,住院患者组71.2%和门诊患者组43.8%的25OHD水平低于最低推荐值(50 nmol/l),女性的水平明显低于男性。继发性甲状旁腺功能亢进在住院患者中发生率为61.7%,在门诊患者中为54%。考虑到所取得的结果,我们建议对巴西老年人群采用有效剂量补充维生素D,此外还建议讨论实施强化维生素D的食品政策,特别是针对风险较高人群的政策。