Woo J, Swaminathan R, Pang C P, Mak Y T, MacDonald D
Department of Medicine, Chinese University of Hong Kong.
Bone Miner. 1990 Jan;8(1):31-8. doi: 10.1016/0169-6009(91)90138-p.
Plasma concentrations of calcium-phosphate, alkaline phosphatase, 25-hydroxyvitamin D (25(OH)D) and albumin, and fasting urinary sodium/creatinine (Na/Cr), calcium/creatinine (Ca/Cr) and hydroxyproline/creatinine (HPr/Cr) were measured in a survey of 208 Chinese elderly subjects living in chronic care institutions, and compared with values from free-living elderly subjects. Plasma parathyroid hormone estimations were also performed on a subpopulation of women living in an institution. Subjects in institutions had higher urinary HPr/Cr ratios in both men and women, as well as higher urinary Ca/Cr ratios in women, suggesting increased bone resorption. These values show significant variation depending on the degree of mobility. Factors which could contribute to the increased bone loss among institutionalized subjects are: reduced physical activity, reduced exposure to sunlight and hence reduced plasma 25(OH)D concentrations, low calcium intake, protein calorie malnutrition and possibly higher sodium intake. Correction of these factors may reduce the risk of fractures among the elderly living in chronic care institutions.
对208名居住在长期护理机构中的中国老年人进行了一项调查，测量了他们血浆中钙磷、碱性磷酸酶、25-羟基维生素D（25(OH)D）和白蛋白的浓度，以及空腹尿钠/肌酐（Na/Cr）、钙/肌酐（Ca/Cr）和羟脯氨酸/肌酐（HPr/Cr），并与自由生活的老年人的数值进行了比较。还对居住在机构中的一部分女性亚人群进行了血浆甲状旁腺激素测定。机构中的男性和女性受试者尿HPr/Cr比值均较高，女性尿Ca/Cr比值也较高，提示骨吸收增加。这些数值因活动程度不同而有显著差异。导致机构化受试者骨质流失增加的因素有：身体活动减少、阳光照射减少从而血浆25(OH)D浓度降低、钙摄入量低、蛋白质热量营养不良以及可能的钠摄入量较高。纠正这些因素可能会降低居住在长期护理机构中的老年人发生骨折的风险。
