Bruyère O, Malaise O, Neuprez A, Collette J, Reginster J-Y
WHO Collaborating Center for Public Health Aspect of Osteoarticular Disorders and Department of Public Health, Epidemiology and Health Economics, University of Liège, Belgium.
Curr Med Res Opin. 2007 Aug;23(8):1939-44. doi: 10.1185/030079907X219562.
Inadequate vitamin D level is associated with secondary hyperparathyroidism and increased bone turnover and bone loss, which in turn increases fracture risk. The objective of this study is to assess the prevalence of inadequate serum vitamin D levels in postmenopausal European women. There are no clear international agreements on what constitutes a level of vitamin D inadequacy, but recent publications suggest that the circulating level of vitamin D should be over 80 nmol/L or at least between 50 and 80 nmol/L.
Assessment of 25-hydroxyvitamin D [25(OH)D] was performed in 8532 European postmenopausal women with osteoporosis or osteopenia. European countries included France, Belgium, Denmark, Italy, Poland, Hungary, United Kingdom, Spain and Germany. Two cut-offs of 25(OH)D inadequacy were fixed : < 80 nmol/L and < 50 nmol/L.
Mean (SD) age of the patients was 74.2 (7.1) years, body mass index was 25.7 (4.1) kg/m(2). Level of 25(OH)D was 61.0 (27.2) nmol/L. There was a highly significant difference of 25(OH)D level across European countries (p < 0.0001). The lowest level of 25(OH)D was found in France [51.5 (26.1) nmol/L] and the highest in Spain [85.2 (33.3) nmol/L]. In the whole study population, the prevalence of 25(OH)D inadequacy was 79.6% and 32.1% when considering cut-offs of 80 and 50 nmol/L, respectively and when considering patients aged less than 65 years, the prevalence reached 86% (cut-off of 80 nmol/L) and 45% (cut-off of 50 nmol/L).
This study indicates a high prevalence of vitamin D [25(OH)D] inadequacy in European postmenopausal women. The prevalence could be even higher in some particular countries. A greater awareness of the importance of vitamin D inadequacy is needed to address this public health problem.
维生素D水平不足与继发性甲状旁腺功能亢进、骨转换增加及骨质流失相关，进而增加骨折风险。本研究的目的是评估绝经后欧洲女性血清维生素D水平不足的患病率。目前对于维生素D不足的定义尚无明确的国际共识，但近期的出版物表明，维生素D的循环水平应超过80 nmol/L或至少在50至80 nmol/L之间。
对8532名患有骨质疏松症或骨质减少症的欧洲绝经后女性进行了25-羟维生素D [25(OH)D]评估。涉及的欧洲国家包括法国、比利时、丹麦、意大利、波兰、匈牙利、英国、西班牙和德国。设定了两个25(OH)D不足的临界值：<80 nmol/L和<50 nmol/L。
患者的平均（标准差）年龄为74.2（7.1）岁，体重指数为25.7（4.1）kg/m²。25(OH)D水平为61.0（27.2）nmol/L。欧洲各国之间25(OH)D水平存在高度显著差异（p<0.0001）。25(OH)D水平最低的是法国[51.5（26.1）nmol/L]，最高的是西班牙[85.2（33.3）nmol/L]。在整个研究人群中，当临界值为80 nmol/L和50 nmol/L时，25(OH)D不足的患病率分别为79.6%和32.1%；当考虑年龄小于65岁的患者时，患病率分别达到86%（临界值为80 nmol/L）和45%（临界值为50 nmol/L）。
本研究表明欧洲绝经后女性维生素D [25(OH)D]不足的患病率很高。在某些特定国家，患病率可能更高。需要提高对维生素D不足重要性的认识，以解决这一公共卫生问题。
