Pasco Julie A, Henry Margaret J, Nicholson Geoffrey C, Brennan Sharon L, Kotowicz Mark A
Department of Clinical and Biomedical Sciences: Barwon Health, The University of Melbourne, Australia.
Bone. 2009 Jun;44(6):1085-91. doi: 10.1016/j.bone.2009.02.020. Epub 2009 Mar 2.
For most people in Australia, the primary source of vitamin D is casual exposure to sunlight. Hypovitaminosis D has been reported for high-risk populations, but little has been documented for women of all ages living in the community. Using cross-sectional data, we aimed to describe physical and behavioural characteristics associated with serum 25-hydroxyvitamin D (25OHD) for such women and to determine the association of serum 25OHD with hypertension and bone health. Serum 25OHD, parathyroid hormone (PTH), blood pressure, bone mineral density (BMD) and anthropometry were measured in a random sample of 861 women aged 20-92 years enrolled in the Geelong Osteoporosis Study, set in a temperate region at latitude 38-39 degrees S. Lifestyle factors (including diet, smoking, medication use, socio-economic status, residence, education, occupation, and physical activity) were documented by questionnaire. In season-adjusted models for women aged 20-54 years, physical activity and living with a partner were independently and positively associated with serum 25OHD; associations with weight and waist-hip ratio were negative. Among older women, physical activity, vitamin D intake and urban dwelling were positively associated with serum 25OHD; age, weight and smoking were negative. Compared with the lowest tertile, those in the highest serum 25OHD tertile were less likely to have elevated serum PTH (adjusted OR=0.25, 95% CI 0.16-0.41) and high blood pressure (adjusted OR=0.40, 95% CI 0.22-0.72), and more likely to have normal hip and spine BMD (adjusted OR=1.65, 95% CI 1.08-2.52). In multivariable models adjusting for season, age, weight (and height), BMD was associated with serum 25OHD at the spine, hip and whole body; no associations were detected at the forearm and no other characteristics were identified as confounders. Factors associated with high vitamin D status generally reflected healthy body habitus and active lifestyles. In contrast, excessive weight and smoking were associated with poorer vitamin D status. Women with high vitamin D were less likely to have elevated PTH, hypertension or bone deficits than women with poor levels.
对于澳大利亚的大多数人来说，维生素D的主要来源是偶尔晒太阳。已有报道称高危人群存在维生素D缺乏症，但关于社区中所有年龄段女性的相关记录却很少。利用横断面数据，我们旨在描述这类女性血清25-羟基维生素D（25OHD）相关的身体和行为特征，并确定血清25OHD与高血压和骨骼健康之间的关联。在吉朗骨质疏松症研究中，对861名年龄在20 - 92岁的女性进行随机抽样，测量其血清25OHD、甲状旁腺激素（PTH）、血压、骨密度（BMD）和人体测量数据。该研究位于南纬38 - 39度的温带地区。通过问卷调查记录生活方式因素（包括饮食、吸烟、用药情况、社会经济地位、居住情况、教育程度、职业和身体活动）。在对20 - 54岁女性的季节调整模型中，身体活动和与伴侣同住与血清25OHD独立且呈正相关；与体重和腰臀比的关联为负相关。在老年女性中，身体活动、维生素D摄入量和居住在城市与血清25OHD呈正相关；年龄、体重和吸烟与之呈负相关。与最低三分位数相比，血清25OHD最高三分位数的女性血清PTH升高的可能性较小（调整后OR = 0.25，95% CI 0.16 - 0.41），患高血压的可能性也较小（调整后OR = 0.40，95% CI 0.22 - 0.72），而髋部和脊柱骨密度正常的可能性更大（调整后OR =
1.65，95% CI 1.08 - 2.52）。在调整季节、年龄、体重（和身高）的多变量模型中，骨密度与脊柱、髋部和全身的血清25OHD相关；在前臂未检测到关联，也未发现其他特征为混杂因素。与高维生素D状态相关的因素通常反映了健康的身体状况和积极的生活方式。相比之下，超重和吸烟与较差的维生素D状态相关。维生素D水平高的女性比水平低的女性患PTH升高、高血压或骨骼缺陷的可能性更小。
