Herranz Antolín Sandra, García Martínez María del Carmen, Alvarez De Frutos Visitación
Sección de Endocrinología y Nutrición, Hospital Universitario de Guadalajara, Guadalajara, España.
Endocrinol Nutr. 2010 Jun-Jul;57(6):256-61. doi: 10.1016/j.endonu.2010.04.003. Epub 2010 May 24.
Recent studies show a high prevalence of vitamin D deficiency in the general population, especially in the elderly. There are also studies reporting the same observations in the morbidly obese, although few of these studies have compared morbidly obese individuals with non-obese persons. The objectives of this study were to estimate the prevalence of vitamin D deficiency and secondary hyperparathyroidism in both groups and to assess whether there is a relationship between obesity and vitamin D deficiency.
This study was carried out in 138 patients in the Guadalajara University Hospital (Spain) between December 2008 and December 2009. Of these, 50.7% were morbidly obese and 49.3% were not obese. Fasting blood samples were taken from both groups for determination of 25-hydroxyvitamin D, intact parathyroid hormone, calcium, albumin and phosphorus, among other biochemical parameters.
The mean concentration of 25-hydroxyvitamin D was 16.6+/-8.12 ng/ml in the morbidly obese group and 21.9+/-7.34 ng/ml in the non-obese group (p<0.0001). The prevalence of vitamin D deficiency was 80% in morbidly obese patients and 41% in non-obese patients (p<0.0001). There were no statistically significant differences in concentrations of parathyroid hormone, calcium or phosphorus between the two groups.
A high prevalence of vitamin D deficiency was found in both groups studied, although the concentration of 25-hydroxyvitamin D was significantly lower in the morbidly obese. Morbid obesity is closely linked to vitamin D deficiency. To prevent this deficiency, determination of 25-hydroxyvitamin D should be included in clinical practice guidelines for the treatment of obesity.
近期研究表明，普通人群中维生素D缺乏症的患病率很高，尤其是老年人。也有研究报告称病态肥胖者中也存在同样的情况，不过这些研究中很少有将病态肥胖个体与非肥胖者进行比较的。本研究的目的是估计两组人群中维生素D缺乏症和继发性甲状旁腺功能亢进的患病率，并评估肥胖与维生素D缺乏之间是否存在关联。
本研究于2008年12月至2009年12月在西班牙瓜达拉哈拉大学医院的138名患者中进行。其中，50.7%为病态肥胖者，49.3%为非肥胖者。两组均采集空腹血样，以测定25-羟维生素D、完整甲状旁腺激素、钙、白蛋白和磷等生化参数。
病态肥胖组25-羟维生素D的平均浓度为16.6±8.12 ng/ml，非肥胖组为21.9±7.34 ng/ml（p<0.0001）。病态肥胖患者中维生素D缺乏症的患病率为80%，非肥胖患者中为41%（p<0.0001）。两组之间甲状旁腺激素、钙或磷的浓度无统计学显著差异。
在所研究的两组人群中均发现维生素D缺乏症的患病率很高，不过病态肥胖者中25-羟维生素D的浓度明显较低。病态肥胖与维生素D缺乏密切相关。为预防这种缺乏症，肥胖治疗的临床实践指南应纳入25-羟维生素D的测定。
