Santiago Tânia, Rebelo Marta, Porto João, Silva Nuno, Vieira José, Nascimento Costa J M
Serviço de Medicina, Hospitais da Universidade de Coimbra, Coimbra, Portugal.
Acta Med Port. 2012 Mar-Apr;25(2):68-76. Epub 2012 Jun 25.
Hypovitaminosis D (hypoD) is a vitamin deficiency that has been rising in the developed countries, due not only to inappropriate eating habits, but also because of lower sun exposure and lack of exercise.
To determine the prevalence of vitamin D deficiency and to analyze associated factors, in patients admitted to an Internal medicine Ward.
Cross-sectional study which included 123 hospitalized patients admitted to an Internal Medicine Ward between April and May. Serum levels of vitamin D [25-hydroxyvitamin D, 25(OH)D] were determined and the sample divided into three groups based on 25(OH)D levels: severe hypoD (<10ng/mL), moderate deficiency of 25(OH)D (>10ng/mL and <20ng/mL) and third group with normal levels of 25(OH)D (>20ng/mL). Demographic variables were recorded as were factors potentially related to vitamin D deficiency.
In this sample (52.0% women) the average age was 71 ± 17 years, 67.5% of patients had severe hypoD, 25.2% moderate deficiency and 7.3% normal levels of vitamin D. The patients in the group with severe hypoD were older (p=0.027). In the same group there was a higher percentage of patients in the bedridden state (p=0.022), with higher impaired functional capacity (p=0.009) and with chronic renal insufficiency (p=0.011). In multivariate logistic regression analysis, factors associated with an increased likelihood of severe hypoD were: furosemide treatment [OR=3.673 (1.232-10.956) p=0.020] and albumin ≤3.25 [OR=5.617 (2.257-13.981) p<0.001].
The high prevalence of hypoD (67.5%) in this sample expresses the need for systematic evaluation of serum levels of 25(OH)D, in order to initiate early treatment in patients with inadequate levels. Furosemide treatment and hypoalbuminaemia present an increased likelihood of being associated with severe hypoD. Treatment of this hypovitaminosis is warranted not only because of the clinical consequences related to bone loss, but also because of its relationship with hypoalbuminemia which is associated with a poorer prognosis in hospitalized patients.
维生素D缺乏症在发达国家呈上升趋势，这不仅归因于不当的饮食习惯，还与日照减少和缺乏运动有关。
确定内科病房住院患者维生素D缺乏的患病率，并分析相关因素。
采用横断面研究，纳入4月至5月间内科病房收治的123例住院患者。测定血清维生素D水平[25-羟维生素D，25(OH)D]，并根据25(OH)D水平将样本分为三组：严重维生素D缺乏组(<10ng/mL)、25(OH)D中度缺乏组(>10ng/mL且<20ng/mL)和25(OH)D水平正常组(>20ng/mL)。记录人口统计学变量以及可能与维生素D缺乏相关的因素。
在该样本中（女性占52.0%），平均年龄为71±17岁，67.5%的患者存在严重维生素D缺乏，25.2%为中度缺乏，7.3%维生素D水平正常。严重维生素D缺乏组的患者年龄更大（p=0.027）。在同一组中，卧床患者的比例更高（p=0.
