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在澳大利亚老年男性中,衰弱与血清 25-羟维生素 D 和 1,25-二羟维生素 D 浓度之间的关联:Concord 健康与男性老龄化研究。

Associations between frailty and serum 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D concentrations in older Australian men: the Concord Health and Ageing in Men Project.

机构信息

Centre for Education and Research on Ageing, Concord Hospital, University of Sydney, Sydney, NSW 2139, Australia.

出版信息

J Gerontol A Biol Sci Med Sci. 2013 Sep;68(9):1112-21. doi: 10.1093/gerona/glt059. Epub 2013 May 8.

Abstract

BACKGROUND

Poor vitamin D status and frailty are common in older people and associated with adverse health outcomes. The aim of this study was to examine the associations between serum 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D levels and frailty and components of frailty in older Australian men.

METHODS

Cross-sectional analysis of the Concord Health and Ageing in Men Project, a large epidemiological study conducted in Sydney, Australia, between January 2005 and May 2007. Participants included 1,659 community-dwelling men. Main outcome measurements were frailty (assessed using the Cardiovascular Health Study), frailty criteria comprising five core components: weight loss; reduced muscular strength/weakness; slow walking speed; exhaustion; and low activity level, and the separate components of frailty. Covariates included serum 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D levels measured by radioimmunoassay, age, country of birth, season of blood collection, sun exposure, body mass index, vitamin D supplement use, income, measures of health, parathyroid hormone, estimated glomerular function.

RESULTS

Frailty was present in 9.2% of the sample. Low serum 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D levels were independently associated with frailty and with four of the five components of frailty (except weight loss).

CONCLUSIONS

1,25-dihydroxyvitamin D and 25-hydroxyvitamin D levels were independently associated with frailty in older men. This suggests that there might be a number of different biological mechanisms for how low vitamin D status might contribute to the frailty syndrome. In addition, the possibility that improving vitamin D status may specifically influence the incidence and progression of frailty needs to be explored.

摘要

背景

维生素 D 状态不佳和虚弱在老年人中很常见,并且与不良健康结果相关。本研究旨在研究血清 25-羟维生素 D 和 1,25-二羟维生素 D 水平与虚弱以及澳大利亚老年男性虚弱各组成部分之间的关联。

方法

对澳大利亚悉尼进行的一项大型流行病学研究 Concord 健康与老龄化男性项目(2005 年 1 月至 2007 年 5 月)的横断面分析。参与者包括 1659 名居住在社区的男性。主要观察指标为虚弱(采用心血管健康研究评估),虚弱标准包括五个核心组成部分:体重减轻;肌肉力量/虚弱减少;步行速度慢;疲劳;活动水平低,以及虚弱的单独组成部分。协变量包括通过放射免疫测定法测量的血清 25-羟维生素 D 和 1,25-二羟维生素 D 水平、年龄、出生国家、采血季节、阳光照射、体重指数、维生素 D 补充剂使用、收入、健康状况、甲状旁腺激素、估计肾小球滤过率。

结果

9.2%的样本存在虚弱。低血清 25-羟维生素 D 和 1,25-二羟维生素 D 水平与虚弱以及虚弱的五个组成部分中的四个(除体重减轻外)独立相关。

结论

1,25-二羟维生素 D 和 25-羟维生素 D 水平与老年男性的虚弱独立相关。这表明,维生素 D 状态低下可能通过多种不同的生物学机制导致虚弱综合征。此外,需要探索改善维生素 D 状态是否可能特别影响虚弱的发生和进展。

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