Center for Chronic Disease Outcomes Research, VA Medical Center, and Department of Medicine, University of Minnesota, M.P.H., One Veterans Drive (111-0), Minneapolis, Minnesota 55417, USA.
J Clin Endocrinol Metab. 2010 Dec;95(12):5266-73. doi: 10.1210/jc.2010-2317.
Vitamin D deficiency and frailty are common with aging, but the association between these conditions is uncertain.
To determine the association between 25-hydroxyvitamin D (25(OH)D) levels and prevalent and incident frailty status among older women.
Cross-sectional and longitudinal analyses of a prospective cohort study.
Four U.S. centers.
6307 women aged≥69 years.
Frailty status classified as robust, intermediate stage, or frail at baseline; and robust, intermediate stage, frail, or dead (all-cause mortality) at follow-up an average of 4.5 years later.
At baseline, there was a U-shaped association between 25(OH)D level and odds of frailty with the lowest risk among women with levels 20.0-29.9 ng/ml (referent group). Compared with this group, the odds of frailty were higher among those with levels<15.0 ng/ml [multivariable odds ratio (MOR) 1.47, 95% confidence interval (CI), 1.19-1.82], those with levels 15.0-19.9 ng/ml (MOR 1.24, 95% CI 0.99-1.54), and those with levels≥30 ng/ml (MOR 1.32, 95% CI 1.06-1.63). Among 4551 nonfrail women at baseline, the odds of frailty/death (vs. robust/intermediate) at follow-up appeared higher among those with levels 15.0-19.9 ng/ml (MOR 1.21, 95% CI 0.99-1.49), but the CI overlapped 1.0. The odds of death (vs. robust/intermediate/frail at follow-up) was higher among those with levels<15.0 ng/ml (MOR 1.40, 95% CI 1.04-1.88) and those with levels 15.0-19.9 ng/ml (MOR 1.30, 95% CI 0.97-1.75), although the latter association did not quite reach significance.
Lower (<20 ng/ml) and higher (≥30 ng/ml) levels of 25(OH)D among older women were moderately associated with a higher odds of frailty at baseline. Among nonfrail women at baseline, lower levels (<20 ng/ml) were modestly associated with an increased risk of incident frailty or death at follow-up.
维生素 D 缺乏和虚弱是衰老的常见现象，但这些情况之间的关联尚不确定。
确定 25-羟维生素 D（25(OH)D）水平与老年女性中普遍存在和新出现的虚弱状态之间的关系。
前瞻性队列研究的横断面和纵向分析。
美国 4 个中心。
年龄≥69 岁的 6307 名女性。
在基线时，将虚弱状态分类为强壮、中间阶段或虚弱；在平均 4.5 年后的随访中，将虚弱状态分类为强壮、中间阶段、虚弱或死亡（全因死亡率）。
在基线时，25(OH)D 水平与虚弱风险呈 U 形关联，水平在 20.0-29.9ng/ml 的女性风险最低（参照组）。与该组相比，25(OH)D 水平<15.0ng/ml 的女性（多变量比值比[MOR]1.47，95%置信区间[CI]1.19-1.82）、25(OH)D 水平在 15.0-19.9ng/ml 的女性（MOR 1.24，95%CI 0.99-1.54）和 25(OH)D 水平≥30ng/ml 的女性（MOR 1.32，95%CI 1.06-1.63）患虚弱症的几率更高。在基线时无虚弱的 4551 名女性中，25(OH)D 水平在 15.0-19.9ng/ml 的女性（MOR 1.21，95%CI 0.99-1.49）在随访中出现虚弱/死亡（与强壮/中间）的几率似乎更高，但 CI 与 1.0 重叠。25(OH)D 水平<15.0ng/ml 的女性（MOR 1.40，95%CI 1.04-1.88）和 25(OH)D 水平在 15.0-19.9ng/ml 的女性（MOR 1.30，95%CI 0.97-1.75）的死亡几率（与随访中的强壮/中间/虚弱相比）更高，尽管后一种关联尚未达到显著水平。
老年女性 25(OH)D 水平较低（<20ng/ml）和较高（≥30ng/ml）与基线时虚弱的几率增加中度相关。在基线时无虚弱的女性中，25(OH)D 水平较低（<20ng/ml）与随访中虚弱或死亡的风险增加适度相关。
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