Endocrine Unit, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts 02114, USA.
Endocr Pract. 2012 Nov-Dec;18(6):914-23. doi: 10.4158/EP12072.OR.
Vitamin D deficiency is highly prevalent in high-risk patient populations, but the prevalence among otherwise healthy adults is less well-defined. The goal of this study was to determine the prevalence and predictors of low 25-hydroxyvitamin D [25(OH)D] levels in healthy younger adults.
This was a cross-sectional study of 634 healthy volunteers aged 18-50 years performed between January, 2006 and May, 2008. We measured serum 25(OH)D and parathyroid hormone and recorded demographic variables including age, sex, race, and use of multivitamin supplements.
Thirty-nine percent of subjects had 25(OH)D ≤ 20 ng/mL and 64% had 25(OH)D ≤ 30 ng/mL. Predictors of lower 25(OH)D levels included male sex, black or Asian race, and lack of multivitamin use (P<0.001 for each predictor). Seasonal variation in 25(OH)D levels was present in the overall cohort but was not observed in multivitamin users. Lower 25(OH)D levels were associated with increased risk of elevated parathyroid hormone. Regression models predicted 25(OH)D levels ≤ 20 or ≤ 30 ng/mL with areas under the receiver operating characteristic curves of 0.76 and 0.80, respectively.
Low 25(OH)D levels are prevalent in healthy adults and may confer risk of skeletal disease. Black and Asian adults are at increased risk of deficiency and multivitamin use appears partially protective. Our models predicting low 25(OH)D levels may guide decision-making regarding whom to screen for vitamin D deficiency.
维生素 D 缺乏在高危人群中非常普遍,但在其他健康成年人中的患病率则不太明确。本研究旨在确定健康年轻成年人中低 25-羟维生素 D [25(OH)D]水平的患病率和预测因素。
这是一项横断面研究,共纳入 634 名年龄在 18-50 岁的健康志愿者,研究时间为 2006 年 1 月至 2008 年 5 月。我们测量了血清 25(OH)D 和甲状旁腺激素,并记录了人口统计学变量,包括年龄、性别、种族和使用多种维生素补充剂的情况。
39%的受试者 25(OH)D≤20ng/mL,64%的受试者 25(OH)D≤30ng/mL。较低 25(OH)D 水平的预测因素包括男性、黑种人或亚裔、未使用多种维生素(每个预测因素 P<0.001)。在整个队列中均观察到 25(OH)D 水平的季节性变化,但在使用多种维生素的人群中则未观察到这种变化。较低的 25(OH)D 水平与甲状旁腺激素升高的风险增加相关。回归模型预测 25(OH)D 水平≤20 或≤30ng/mL 的受试者时,受试者工作特征曲线下面积分别为 0.76 和 0.80。
低 25(OH)D 水平在健康成年人中较为普遍,可能增加骨骼疾病的风险。黑人和亚裔成年人发生缺乏的风险增加,而使用多种维生素可能具有部分保护作用。我们预测低 25(OH)D 水平的模型可能有助于决定对哪些人进行维生素 D 缺乏的筛查。