维生素 D、骨密度和甲状旁腺激素在国家健康和营养检查调查中的种族差异。
Racial differences in the relationship between vitamin D, bone mineral density, and parathyroid hormone in the National Health and Nutrition Examination Survey.
机构信息
Division of Nephrology and Hypertension, Department of Medicine, University of Miami Miller School of Medicine, 1120 NW 14th street, CRB, C-221, Room 815, Miami, FL 33136, USA.
出版信息
Osteoporos Int. 2011 Jun;22(6):1745-53. doi: 10.1007/s00198-010-1383-2. Epub 2010 Sep 17.
UNLABELLED
It is unclear whether optimal levels of 25-hydroxyvitamin D (25(OH)D) in whites are the same as in minorities. In adult participants of NHANES, the relationships between 25(OH)D, bone mineral density (BMD), and parathyroid hormone (PTH) differed in blacks as compared to whites and Mexican-Americans, suggesting that optimal 25(OH)D levels for bone and mineral metabolism may differ by race.
INTRODUCTION
Blacks and Hispanics have lower 25-hydroxyvitamin D concentrations than whites. However, it is unclear whether 25(OH)D levels considered "optimal" for bone and mineral metabolism in whites are the same as those in minority populations.
METHODS
We examined the relationships between 25(OH)D and parathyroid hormone in 8,415 adult participants (25% black and 24% Mexican-American) in the National Health and Nutrition Examination Surveys 2003-2004 and 2005-2006; and between 25(OH)D and bone mineral density in 4,206 adult participants (24% black and 24% Mexican-American) in the 2003-2004 sample.
RESULTS
Blacks and Mexican-Americans had significantly lower 25(OH)D and higher PTH concentrations than whites (P < 0.01 for both). BMD significantly decreased (P < 0.01) as serum 25(OH)D and calcium intake declined among whites and Mexican-Americans, but not among blacks (P = 0.2). The impact of vitamin D deficiency (25(OH)D ≤ 20 ng/ml) on PTH levels was modified by race/ethnicity (P for interaction, 0.001). Whereas inverse relationships between 25(OH)D and PTH were observed above and below a 25(OH)D level of 20 ng/ml in whites and Mexican-Americans, an inverse association between 25(OH)D and PTH was only observed below this threshold in blacks, with the slope of the relationship being essentially flat (P = 0.7) above this cut-point, suggesting that PTH may be maximally suppressed at lower 25(OH)D levels in blacks than in whites or Mexican-Americans.
CONCLUSIONS
The relationships between 25(OH)D, BMD, and PTH may differ by race among US adults. Whether race-specific ranges of optimal vitamin D are needed to appropriately evaluate the adequacy of vitamin D stores in minorities requires further study.
目的
不清楚白人的最佳 25-羟维生素 D（25（OH）D）水平是否与少数族裔相同。在 NHANES 的成年参与者中，黑人的 25（OH）D、骨密度（BMD）和甲状旁腺激素（PTH）之间的关系与白人和墨西哥裔美国人不同，这表明骨和矿物质代谢的最佳 25（OH）D 水平可能因种族而异。
简介
黑人及西班牙裔美国人的 25-羟维生素 D 浓度低于白人。然而，目前尚不清楚白人的 25（OH）D 水平是否与少数族裔人群的“最佳”骨和矿物质代谢水平相同。
方法
我们检查了 2003-2004 年和 2005-2006 年全国健康与营养调查（NHANES）中 8415 名成年参与者（25%为黑人，24%为墨西哥裔美国人）中 25（OH）D 与甲状旁腺激素之间的关系；以及 2003-2004 年样本中 4206 名成年参与者（24%为黑人，24%为墨西哥裔美国人）中 25（OH）D 与骨矿物质密度之间的关系。
结果
黑人及墨西哥裔美国人的 25（OH）D 浓度明显低于白人，而甲状旁腺激素浓度则高于白人（均<0.01）。随着血清 25（OH）D 和钙摄入量的下降，白人及墨西哥裔美国人的骨密度明显降低（P<0.01），而黑人则不然（P=0.2）。维生素 D 缺乏（25（OH）D≤20ng/ml）对甲状旁腺激素水平的影响因种族/民族而异（P 值<0.001）。虽然白人及墨西哥裔美国人中，25（OH）D 与甲状旁腺激素之间呈负相关关系，但在黑人中，这种负相关关系仅在 25（OH）D 水平低于 20ng/ml 时观察到，在该阈值以上，两者之间的关系斜率基本呈平坦状（P=0.7），这表明黑人的甲状旁腺激素可能在较低的 25（OH）D 水平下得到最大抑制，而白人或墨西哥裔美国人则不是这样。
结论
美国成年人中，25（OH）D、BMD 和 PTH 之间的关系可能因种族而异。少数族裔人群是否需要特定种族的最佳维生素 D 范围来适当评估维生素 D 储存的充足性，还需要进一步研究。
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