Section of Endocrinology, University of Illinois at Chicago, Chicago, Illinois 60612, USA.
Endocr Pract. 2012 Mar-Apr;18(2):219-26. doi: 10.4158/EP11269.OR.
To examine determinants of serum 25-hydroxyvitamin D [25(OH)D] and bone mineral density (BMD) in young physicians, a group not well studied previously.
We analyzed data from a questionnaire completed by young physicians as well as results of serum 25(OH)D, serum parathyroid hormone, and BMD measurements.
Among 104 study subjects, 42% were white, 46% were Asian, 12% were "other" (10 Hispanic and 2 African American subjects), and 75% were women. The mean age and body mass index (BMI) were 28.1 years and 23.0 kg/m², respectively. White subjects had a higher mean serum 25(OH)D level (27.3 ng/mL) than did Asian subjects (15.9 ng/mL) and other subjects (22.3 ng/mL) (P<.0001). White subjects tended to have higher Z-scores than Asian subjects and other subjects for the hip (P = .06), trochanter (P = .08), and lumbar spine (P = .08). The serum 25(OH)D level was negatively associated with serum parathyroid hormone (r = -0.44; P<.01) but not with BMD. The prevalence of vitamin D insufficiency [serum 25(OH)D <30 ng/mL, 77% for the entire group] was higher (P<.01) in Asian subjects (93%) than in white subjects (61%) and other subjects (73%). Significant determinants of serum 25(OH)D included age, ethnicity, exposure to sunlight, use of vitamin D supplements, and family history of osteoporosis (P<.05 for all), and together with sex, calcium supplements, exercise, and BMI, these factors explained 49% of serum 25(OH)D level variability. Significant determinants of low BMD (osteopenia plus osteoporosis, prevalence 37.5%) included sex (P = .002) and BMI (P<.0001) but not serum 25(OH)D; Asian ethnicity reached borderline significance (P = .088). Age, sex, ethnicity, smoking, and BMI explained 20% to 30% of the Z-score variations.
In young physicians with a healthful lifestyle, determinants of low serum 25(OH)D and BMD included modifiable risk factors. Vitamin D insufficiency and low BMD could be important contributors to future osteoporotic fractures in this population.
研究年轻医生血清 25-羟维生素 D [25(OH)D]和骨密度 (BMD) 的决定因素，该人群此前研究较少。
我们分析了年轻医生完成的问卷数据以及血清 25(OH)D、血清甲状旁腺激素和 BMD 测量结果。
在 104 名研究对象中，42%为白人，46%为亚洲人，12%为“其他”（10 名西班牙裔和 2 名非裔美国人），75%为女性。平均年龄和体重指数（BMI）分别为 28.1 岁和 23.0kg/m²。白人的平均血清 25(OH)D 水平（27.3ng/mL）高于亚洲人（15.9ng/mL）和其他人（22.3ng/mL）（P<.0001）。白人的髋部（P=.06）、转子（P=.08）和腰椎（P=.08）的 Z 评分高于亚洲人和其他人。血清 25(OH)D 水平与血清甲状旁腺激素呈负相关（r = -0.44；P<.01），但与 BMD 无关。维生素 D 不足[血清 25(OH)D <30ng/mL，整个组的 77%]在亚洲人（93%）中比白人（61%）和其他人（73%）更高（P<.01）。血清 25(OH)D 的显著决定因素包括年龄、种族、阳光暴露、维生素 D 补充剂的使用以及骨质疏松症家族史（所有因素 P<.05），与性别、钙补充剂、运动和 BMI 一起，这些因素解释了 49%的血清 25(OH)D 水平变异性。低 BMD（骨质疏松症和骨质疏松症，患病率 37.5%）的显著决定因素包括性别（P=.002）和 BMI（P<.0001），但与血清 25(OH)D 无关；亚洲种族达到边缘显著（P=.088）。年龄、性别、种族、吸烟和 BMI 解释了 Z 评分变化的 20%至 30%。
在生活方式健康的年轻医生中，低血清 25(OH)D 和 BMD 的决定因素包括可改变的危险因素。维生素 D 不足和低 BMD 可能是该人群未来发生骨质疏松性骨折的重要因素。
