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瑞典精神科门诊患者血清 25-羟维生素 D 水平较低:与季节、年龄、种族和精神科诊断的关系。

Low serum levels of 25-hydroxyvitamin D (25-OHD) among psychiatric out-patients in Sweden: relations with season, age, ethnic origin and psychiatric diagnosis.

机构信息

Department of Clinical Neuroscience, Division of Psychiatry, St. Göran, Karolinska Institutet, Stockholm, Sweden.

出版信息

J Steroid Biochem Mol Biol. 2010 Jul;121(1-2):467-70. doi: 10.1016/j.jsbmb.2010.03.013. Epub 2010 Mar 7.

Abstract

In a chart review at a psychiatric out-patient department, latitude 59.3 degrees N, a sample of patients with tests of serum 25-hydroxy-vitamin D (25-OHD) and plasma intact parathyroid hormone (iPTH) was collected, together with demographic data and psychiatric diagnoses. During 19 months, 117 patients were included. Their median 25-OHD was 45 nmol/l; considerably lower than published reports on Swedish healthy populations. Only 14.5% had recommended levels (over 75). In 56.4%, 25-OHD was under 50 nmol/l, which is related to several unfavourable health outcomes. Seasonal variation of 25-OHD was blunted. Patients with ADHD had unexpectedly low iPTH levels. Middle East, South-East Asian or African ethnic origin, being a young male and having a diagnosis of autism spectrum disorder or schizophrenia predicted low 25-OHD levels. Hence, the diagnoses that have been hypothetically linked to developmental (prenatal) vitamin D deficiency, schizophrenia and autism, had the lowest 25-OHD levels in this adult sample, supporting the notion that vitamin D deficiency may not only be a predisposing developmental factor but also relate to the adult patients' psychiatric state. This is further supported by the considerable psychiatric improvement that coincided with vitamin D treatment in some of the patients whose deficiency was treated.

摘要

在一家位于北纬 59.3 度的精神科门诊的病历回顾中,收集了一组接受血清 25-羟维生素 D(25-OHD)和血浆完整甲状旁腺激素(iPTH)检测的患者样本,同时还收集了人口统计学数据和精神科诊断信息。在 19 个月的时间里,共纳入了 117 名患者。他们的中位 25-OHD 水平为 45nmol/l,远低于瑞典健康人群的报道值。仅有 14.5%的患者达到了推荐水平(超过 75nmol/l)。56.4%的患者 25-OHD 水平低于 50nmol/l,这与多种不良健康结果相关。25-OHD 的季节性变化较为平缓。患有注意力缺陷多动障碍(ADHD)的患者 iPTH 水平异常低。中东、东南亚或非洲裔、年轻男性、被诊断为自闭症谱系障碍或精神分裂症的患者更可能出现低 25-OHD 水平。因此,这些被假设与发育(产前)维生素 D 缺乏、精神分裂症和自闭症相关的诊断,在这个成年患者样本中 25-OHD 水平最低,这支持了维生素 D 缺乏不仅可能是一种先天发育因素,而且还与成年患者的精神状态有关的观点。这一观点得到了进一步支持,因为一些患者的维生素 D 缺乏得到了治疗,他们的精神状态得到了显著改善。

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