Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, Room A517, 1081 BT Amsterdam, The Netherlands.
Eur J Endocrinol. 2012 Mar;166(3):477-85. doi: 10.1530/EJE-11-0917. Epub 2011 Dec 14.
Vitamin D deficiency and polypharmacy are common in the elderly. However, knowledge on the associations between the use of specific medicines and serum 25-hydroxyvitamin D (25(OH)D) is limited. The aim of this study was to (better) define the associations between the use of specific medicines and serum 25(OH)D.
Two different cohorts (1995/1996 and 2002/2003) from the Longitudinal Aging Study Amsterdam (LASA) were used for cross-sectional analyses. LASA is based on an age and sex-stratified random sample of the Dutch older population. Study participants were aged 65-88 years in the first cohort (n = 1301) and 55-65 years in the second cohort (n = 736). Serum 25(OH)D of users of several groups of medicines were compared with levels of non-users using multiple linear regression analysis.
Of all participants, 75.4% (first cohort) and 61.1% (second cohort) were using at least one medicine. In both cohorts, the number of medicines was associated with lower serum 25(OH)D. In the first cohort, after adjustment for confounding, users of any kind of medicine, loop diuretics and inhaled corticosteroids (only men) had respectively 4.4 nmol/l (P<0.01), 4.7 nmol/l (P = 0.04) and 7.3 nmol/l (P = 0.02) lower serum 25(OH)D than non-users. In the second cohort, the use of oral antidiabetics, calcium-channel blockers and angiotensin-converting enzyme inhibitors was associated with respectively 7.4 nmol/l (P = 0.04), 7.7 nmol/l (P = 0.01) and 7.6 nmol/l (P<0.01) lower serum 25(OH)D.
These data show that users of several medicines have lower serum 25(OH)D than non-users. Vitamin D supplementation may be considered in patients with chronic use of medicines.
维生素 D 缺乏和多种药物治疗在老年人中很常见。然而，关于特定药物使用与血清 25-羟维生素 D（25（OH）D）之间的关联的知识有限。本研究的目的是更好地定义特定药物使用与血清 25（OH）D 之间的关系。
使用来自阿姆斯特丹纵向老龄化研究（LASA）的两个不同队列（1995/1996 年和 2002/2003 年）进行横断面分析。LASA 是基于荷兰老年人群的年龄和性别分层随机样本。第一队列中研究参与者的年龄为 65-88 岁（n=1301），第二队列中为 55-65 岁（n=736）。使用多元线性回归分析比较了几种药物使用者与非使用者的血清 25（OH）D 水平。
在所有参与者中，75.4%（第一队列）和 61.1%（第二队列）至少使用一种药物。在两个队列中，药物数量与血清 25（OH）D 水平降低相关。在第一队列中，调整混杂因素后，任何类型药物、噻嗪类利尿剂和吸入皮质激素（仅男性）使用者的血清 25（OH）D 分别低 4.4 nmol/L（P<0.01）、4.7 nmol/L（P=0.04）和 7.3 nmol/L（P=0.02）。在第二队列中，口服降糖药、钙通道阻滞剂和血管紧张素转换酶抑制剂的使用分别与血清 25（OH）D 低 7.4 nmol/L（P=0.04）、7.7 nmol/L（P=0.01）和 7.6 nmol/L（P<0.01）相关。
这些数据表明，与非使用者相比，多种药物使用者的血清 25（OH）D 水平较低。对于长期使用药物的患者，可能需要考虑补充维生素 D。
