Harinarayan C V, Ramalakshmi T, Prasad U V, Sudhakar D
Department of Endocrinology & Metabolism, Sri Venkateswara Institute of Medical Sciences Tirupati, India.
Indian J Med Res. 2008 Mar;127(3):211-8.
BACKGROUND & OBJECTIVE: Data on the vitamin D status of the population in a tropical country like India have seldom been documented. Vitamin D deficiency is presumed to be rare. We carried out this study to document the dietary habits, serum calcium, 25(OH)vitamin D [25(OH)D], and parathyroid hormone levels of urban and rural population in a State in south India.
A total of 943 healthy urban and 205 rural adult subjects and 76 urban and 70 rural healthy children were studied for their dietary pattern, serum calcium, phosphorus, alkaline phosphatase, 25(OH)D, and N-tact parathyroid hormone levels (N-tact PTH).
The daily dietary calcium intake of both the urban and rural population was low compared to that of recommended daily/dietary allowances (RDA) issued by Indian Council of Medical Research (ICMR). Dietary calcium and phosphorus were significantly lower(P<0.0001) in both the rural adult and children compared to that of the urban adult and children. The dietary phytate to calcium ratio was significantly (P<0.0001) higher in rural adult and children compared to that of urban adult and children. N-tact PTH levels negatively correlated with 25(OH)D in rural (r=-0.24; P<0.002), in urban adult subjects (r=-0.12; P<0.0001) and in rural and urban children (r=-0.2; P<0.05). The 25(OH)D levels of rural adult subjects were significantly higher (P<0.001) than that of urban adult subjects in both males and female groups. The 25(OH)D levels of both the urban and rural children were low.
INTERPRETATION & CONCLUSION: Low dietary calcium intake and 25(OH)D levels were associated with deleterious effect on bone mineral homeostasis. Prospective longitudinal studies are required to assess the effect on bone mineral density, a surrogate marker for fracture risk and fracture rates.
像印度这样的热带国家,有关人群维生素D状况的数据鲜有记录。一般认为维生素D缺乏症较为罕见。我们开展这项研究,以记录印度南部一个邦城乡人口的饮食习惯、血清钙、25(OH)维生素D [25(OH)D] 以及甲状旁腺激素水平。
共对943名城市健康成年受试者、205名农村健康成年受试者、76名城市健康儿童和70名农村健康儿童的饮食模式、血清钙、磷、碱性磷酸酶、25(OH)D以及N端甲状旁腺激素水平(N-tact PTH)进行了研究。
与印度医学研究理事会(ICMR)发布的每日推荐摄入量/膳食营养素参考摄入量(RDA)相比,城乡人口的每日膳食钙摄入量均较低。农村成年受试者和儿童的膳食钙和磷含量均显著低于城市成年受试者和儿童(P<0.0001)。农村成年受试者和儿童的膳食植酸与钙的比值显著高于城市成年受试者和儿童(P<0.0001)。农村人群(r=-0.24;P<0.002)、城市成年受试者(r=-0.12;P<0.0001)以及农村和城市儿童(r=-0.2;P<0.05)中,N-tact PTH水平与25(OH)D呈负相关。在男性和女性组中,农村成年受试者的25(OH)D水平均显著高于城市成年受试者(P<0.001)。城乡儿童的25(OH)D水平均较低。
膳食钙摄入量低和25(OH)D水平低与骨矿物质稳态的有害影响相关。需要进行前瞻性纵向研究,以评估其对骨密度(骨折风险和骨折率的替代指标)的影响。