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步态控制的生物学:维生素 D 的作用。

Biology of gait control: vitamin D involvement.

机构信息

Department of Internal Medicine and Geriatrics, Angers University Hospitals, 49933 Angers cedex 9, France.

出版信息

Neurology. 2011 May 10;76(19):1617-22. doi: 10.1212/WNL.0b013e318219fb08. Epub 2011 Apr 6.

Abstract

BACKGROUND

Adverse neuromuscular events have been described in case of low serum 25-hydroxyvitamin D (25OHD) concentrations, suggesting that vitamin D may be involved in gait stability. The objective of this cross-sectional study was to examine the association between stride-to-stride variability of stride time (STV) and serum 25OHD concentration in adults aged 65 years and older.

METHODS

STV and 25OHD concentration were assessed in 411 community-dwelling older adults (mean age 70.4 ± 1.8 years, 57.9% women). The following established 25OHD thresholds were used: severe 25OHD insufficiency <10 ng/mL, moderate 10-30 ng/mL, and normal >30 ng/mL. Age, number of drugs used per day, use of psychoactive drugs, depressive symptoms, cognitive decline, history of falls, distance visual acuity, lower limb proprioception, center of mass (CoM) motion, and walking speed were considered as potential confounders.

RESULTS

A total of 16.6% (n = 68) of subjects had severe 25OHD insufficiency, 70.3% (n = 289) moderate insufficiency, and 13.1% (n = 54) normal concentrations. In the full adjusted and the stepwise backward linear regression models, high STV (worse performance) was associated with severe 25OHD insufficiency (p = 0.028 and p = 0.044, respectively), high CoM motion (p = 0.031 and p = 0.014, respectively), and low lower limb proprioception score (p = 0.017 and p = 0.008, respectively). The stepwise backward regression model also showed that high STV was associated with female gender (p = 0.041).

CONCLUSIONS

Low serum 25OHD concentrations were associated with high STV reflecting a disturbed gait control. This association could be explained by a possible action of vitamin D on different components involved in gait control.

摘要

背景

已有研究表明,血清 25-羟维生素 D(25OHD)浓度较低时会出现不良神经肌肉事件,这表明维生素 D 可能与步态稳定性有关。本横断面研究的目的是探讨 65 岁及以上成年人步长时间(ST)逐拍差异(STV)与血清 25OHD 浓度之间的关系。

方法

对 411 名居住在社区的老年人(平均年龄 70.4±1.8 岁,57.9%为女性)进行了 STV 和 25OHD 浓度评估。本研究使用了以下已建立的 25OHD 阈值:严重 25OHD 不足<10ng/ml、中度 10-30ng/ml 和正常>30ng/ml。年龄、每日使用药物的数量、使用精神药物、抑郁症状、认知能力下降、跌倒史、远距离视力、下肢本体感觉、质心(CoM)运动和步行速度被认为是潜在的混杂因素。

结果

共有 16.6%(n=68)的受试者存在严重 25OHD 不足,70.3%(n=289)为中度不足,13.1%(n=54)为正常浓度。在完全调整和逐步向后线性回归模型中,高 STV(表现较差)与严重 25OHD 不足(p=0.028 和 p=0.044)、高 CoM 运动(p=0.031 和 p=0.014)和下肢本体感觉评分低(p=0.017 和 p=0.008)相关。逐步向后回归模型还显示,女性(p=0.041)与高 STV 相关。

结论

低血清 25OHD 浓度与高 STV 相关,提示步态控制受损。这种关联可能是由于维生素 D 对参与步态控制的不同成分的可能作用。

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