Department of Internal Medicine and Geriatrics, Angers University Hospital, Angers, France.
J Bone Miner Res. 2010 Aug;25(8):1858-66. doi: 10.1002/jbmr.80.
The purpose of this study was to determine whether there was an association between serum 25-hydroxyvitamin D [25(OH)D] concentration and walking speed measured at usual and fast pace among older women. Usual- and fast-pace walking speeds and 25(OH)D concentrations were assessed in 739 randomized older women (mean age 80.2 +/- 3.5 years) from the EPIDOS study. The following 25(OH)D thresholds were used: 10, 20, and 30 ng/mL. Walking speed was dichotomized on being in the worst quintile or not. Age, body mass index, number of chronic diseases, physical activity, quadriceps strength, cognition, use of psychoactive drugs, and serum parathyroid hormone were used as potential confounders. The results show that 90% of subjects had 25(OH)D insufficiency. Only fast-pace walking speed was significantly different between groups (p = .021) and decreased from normal serum 25(OH)D concentrations to severe insufficiency (trend p = .007). Serum 25(OH)D concentration was associated with walking speed at both usual and fast pace in the unadjusted linear regression (beta = 0.16, p = .027 and beta = 0.23, p = .009, respectively). This association remained significant only for fast-pace walking after adjustment (adjusted beta = 0.18, p = .033) and was strengthened from a lower 25(OH)D value compared with usual pace [25(OH)D = 27.15 ng/mL for fast pace and 38.65 ng/mL for usual pace). Lastly, logistic regression showed a stronger association of serum 25(OH)D insufficiency with fast-pace walking speed whatever the 25(OH)D thresholds used [30 to 20 ng/mL: adjusted odds ratio (adjOR) = 6.01, p = .003; 20 to 10 ng/mL: adjOR = 4.10, p = .014; <10 ng/mL: adjOR = 6.95, p = .001) compared with usual pace (30 to 20 ng/mL: adjOR = 3.79, p = .022; 20 to 10 ng/mL: adjOR = 3.76, p = .016; <10 ng/mL: adjOR = 5.44, p = .003). The findings show a stronger positive association between 25(OH)D concentrations and fast-pace walking speed that is a more sensitive marker of neuromuscular functioning compared with usual-pace walking.
本研究旨在确定血清 25-羟维生素 D [25(OH)D]浓度与老年女性常速和快速行走速度之间是否存在关联。在 EPIDOS 研究中，对 739 名随机老年女性（平均年龄 80.2 +/- 3.5 岁）进行了常速和快速行走速度以及 25(OH)D 浓度评估。使用了以下 25(OH)D 阈值：10、20 和 30ng/mL。行走速度根据最差五分位数或未达到最差五分位数进行二分。年龄、体重指数、慢性疾病数量、体力活动、股四头肌力量、认知、精神活性药物使用和甲状旁腺激素被用作潜在的混杂因素。结果表明，90%的受试者 25(OH)D 不足。只有快速行走速度在组间存在显著差异（p=0.021），并且随着血清 25(OH)D 浓度从正常降至严重不足，行走速度逐渐下降（趋势 p=0.007）。在未调整的线性回归中，血清 25(OH)D 浓度与常速和快速行走速度均相关（β=0.16，p=0.027 和β=0.23，p=0.009，分别）。调整后，这种关联仅在快速行走时仍然显著（调整后β=0.18，p=0.033），与常速相比，从较低的 25(OH)D 值开始[25(OH)D=27.15ng/mL 用于快速步伐，38.65ng/mL 用于常速步伐）。最后，逻辑回归显示，血清 25(OH)D 不足与快速行走速度之间的关联更强，无论使用何种 25(OH)D 阈值[30 至 20ng/mL：调整后的优势比（adjOR）=6.01，p=0.003；20 至 10ng/mL：adjOR=4.10，p=0.014；<10ng/mL：adjOR=6.95，p=0.001）与常速（30 至 20ng/mL：adjOR=3.79，p=0.022；20 至 10ng/mL：adjOR=3.76，p=0.016；<10ng/mL：adjOR=5.44，p=0.003）。研究结果表明，血清 25(OH)D 浓度与快速行走速度之间存在更强的正相关关系，与常速行走相比，快速行走速度是一种更敏感的神经肌肉功能标志物。
