Bacon C J, Woo J, Lau E M C, Lam C W K, Gamble G D, Reid I R
Department of Medicine, University of Auckland, Auckland, New Zealand.
Osteoporos Int. 2010 Nov;21(11):1935-41. doi: 10.1007/s00198-009-1163-z. Epub 2010 Feb 13.
Optimal levels of 25-hydroxyvitamin D [25(OH)D] were investigated in premenopausal Chinese women. Parathyroid hormone (PTH) change at 3 months was associated with change in 25(OH)D but not with baseline levels, and PTH fell even when starting levels of 25(OH)D were >40 nmol/L, consistent with optimal values for 25(OH)D of ≥40 nmol/l.
The upper level of 25-hydroxyvitamin D [25(OH)D] which constitutes a long-term bone health risk by causing elevated PTH levels is uncertain. Although many studies have addressed this question using cross-sectional data, the present study is one of few employing a prospective approach to determine 25(OH)D levels required to minimize PTH.
Relationships among baseline values and 3-month changes (Δ) in PTH and 25(OH)D were assessed in 221 Chinese women, aged 28.0±4.4 years (mean±SD), taking part in a placebo-controlled dairy product intervention delivering 200 IU vitamin D(3)/day.
Baseline 25(OH)D was 34±11 nmol/L and was inversely related to baseline PTH (r=-0.18, P=0.007), with a plateau in PTH levels when 25(OH)D was >40 nmol/L. After 3 months intervention, PTH fell 11% and neither Δ25(OH)D nor ΔPTH differed between treatment and control groups. ΔPTH was inversely related to Δ25(OH)D (P<0.001) but not to baseline 25(OH)D. Similarly, ΔPTH differed between quartiles of Δ25(OH)D (P<0.001), but not between quartiles of baseline 25(OH)D and no interaction was observed between quartiles of baseline 25(OH)D and Δ25(OH)D. Even in the highest quartile of baseline 25(OH)D (>40 nmol/L), PTH fell 0.4±0.1 pmol/L (mean±SEM; P=0.008).
We conclude that vitamin D deficiency is common in young women in Hong Kong. The cross-sectional analysis indicates that optimal 25(OH)D is >40 nmol/L, and the longitudinal data is consistent with a higher optimal value which is not defined in this study's results.
对绝经前中国女性的25-羟维生素D[25(OH)D]最佳水平进行了研究。3个月时甲状旁腺激素(PTH)的变化与25(OH)D的变化相关,但与基线水平无关,并且即使25(OH)D起始水平>40 nmol/L时PTH也会下降,这与25(OH)D的最佳值≥40 nmol/l一致。
通过导致PTH水平升高而构成长期骨骼健康风险的25-羟维生素D[25(OH)D]的上限尚不确定。尽管许多研究已使用横断面数据解决了这个问题,但本研究是少数采用前瞻性方法来确定使PTH最小化所需的25(OH)D水平的研究之一。
在221名年龄为28.0±4.4岁(均值±标准差)的中国女性中评估了PTH和25(OH)D的基线值与3个月变化(Δ)之间的关系,这些女性参与了一项每天提供200 IU维生素D(3)的安慰剂对照乳制品干预研究。
基线25(OH)D为34±11 nmol/L,与基线PTH呈负相关(r=-0.18,P=0.007),当25(OH)D>40 nmol/L时PTH水平出现平台期。3个月干预后,PTH下降了11%,治疗组和对照组之间的Δ25(OH)D和ΔPTH均无差异。ΔPTH与Δ25(OH)D呈负相关(P<0.001),但与基线25(OH)D无关。同样,ΔPTH在Δ25(OH)D的四分位数之间存在差异(P<0.001),但在基线25(OH)D的四分位数之间无差异,并且未观察到基线25(OH)D的四分位数与Δ25(OH)D之间存在相互作用。即使在基线25(OH)D的最高四分位数(>40 nmol/L)中,PTH也下降了0.4±0.1 pmol/L(均值±标准误;P=0.008)。
我们得出结论,维生素D缺乏在香港年轻女性中很常见。横断面分析表明,25(OH)D的最佳值>40 nmol/L,纵向数据与更高的最佳值一致,该最佳值在本研究结果中未明确界定。