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爱尔兰社区居住的老年人血清维生素 D 的季节性变化和维生素 D 补充的效果。

Seasonal variation of serum vitamin D and the effect of vitamin D supplementation in Irish community-dwelling older people.

机构信息

Trinity College Dublin-TRIL Clinic, Hospital, St James's Hospital, Dublin 8, Co. Dublin, Ireland.

出版信息

Age Ageing. 2011 Mar;40(2):168-74. doi: 10.1093/ageing/afq138. Epub 2010 Nov 3.


DOI:10.1093/ageing/afq138
PMID:21051444
Abstract

BACKGROUND: Ireland is at 53°N, and its population risk of vitamin D deficiency is high. Previous Irish studies suggested a significant seasonality of serum 25-hydroxyvitamin D [25(OH)D] and a beneficial effect of supplementation in raising 25(OH)D levels. However, in Irish older people, little is known about the magnitude of the supplementation effect and whether supplementation affects 25(OH)D seasonality. DESIGN: cross-sectional observational. SETTING: outpatient clinic. SUBJECTS: five hundred and forty-six community-dwelling subjects (mean age 73.0, SD 7.4; 68.5% females) were assessed between September 2007 and May 2009. METHODS: for supplemented and non-supplemented: 'cosinor' analysis (Pulse_XP®) of monthly 25(OH)D. Period global solar radiation (GSR) and solar elevation angle (SEA) data were collected as proxy markers of ultraviolet-B radiation exposure. Multivariate linear regression was conducted to investigate the independent effect of GSR and SEA on 25(OH)D, controlling for confounders. RESULTS: supplemented group (N = 183): 89.1% were on cholecalciferol 800 IU/day. Mean 25(OH)D = 64.1 (95% confidence interval: 52.2-75.8) nmol/l, with no significant seasonality; regression: neither GSR nor SEA predicted 25(OH)D. Non-supplemented group (N = 363): mean 25(OH)D = 40.3 (35.5-45.0) nmol/l, with significant seasonality (55.5% variance remaining), peak in August, amplitude = 6.0 (3.1-8.8) nmol/l; regression: both GSR (P = 0.002) and the interaction GSR * SEA (P = 0.018) predicted 25(OH)D. CONCLUSIONS: vitamin D supplementation was associated with a mean serum 25(OH)D increase of 23.8 nmol/l. Interestingly, supplementation seemed to blunt seasonality. In the supplemented group, 72.1% had individual 25(OH)D levels below the recommended 75 nmol/l. There is a case for universal supplementation in Irish older people, probably at a higher dose. Further research is needed to establish the optimum dose.

摘要

背景:爱尔兰位于北纬 53 度,其人口维生素 D 缺乏的风险很高。此前爱尔兰的研究表明,血清 25-羟维生素 D [25(OH)D]存在显著的季节性,补充剂对提高 25(OH)D 水平有有益的影响。然而,在爱尔兰的老年人中,对于补充剂的影响程度以及补充剂是否会影响 25(OH)D 的季节性知之甚少。

设计:横断面观察性研究。

地点:门诊诊所。

研究对象:2007 年 9 月至 2009 年 5 月期间评估了 546 名居住在社区的受试者(平均年龄 73.0,标准差 7.4;68.5%为女性)。

方法:对于补充和未补充的受试者:使用“Pulse_XP®”(Pulse_XP®)对每月 25(OH)D 进行“余弦分析”。收集月总太阳辐射(GSR)和太阳仰角(SEA)数据作为紫外线-B 辐射暴露的替代标志物。进行多元线性回归,以在控制混杂因素的情况下,研究 GSR 和 SEA 对 25(OH)D 的独立影响。

结果:补充组(N=183):89.1%服用胆钙化醇 800IU/天。平均 25(OH)D=64.1(95%置信区间:52.2-75.8)nmol/L,无明显季节性;回归:GSR 和 SEA 均不能预测 25(OH)D。未补充组(N=363):平均 25(OH)D=40.3(35.5-45.0)nmol/L,季节性明显(55.5%的方差),峰值在 8 月,振幅=6.0(3.1-8.8)nmol/L;回归:GSR(P=0.002)和 GSR*SEA 交互作用(P=0.018)均能预测 25(OH)D。

结论:维生素 D 补充剂可使血清 25(OH)D 平均增加 23.8 nmol/L。有趣的是,补充剂似乎削弱了季节性。在补充组中,72.1%的个体 25(OH)D 水平低于推荐的 75 nmol/L。爱尔兰老年人普遍需要补充维生素 D,可能需要更高的剂量。需要进一步研究来确定最佳剂量。

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