Department of Osteology and Biomechanics; University Medical Center Hamburg-Eppendorf, Germany.
Gait Posture. 2014 Jan;39(1):166-71. doi: 10.1016/j.gaitpost.2013.06.017. Epub 2013 Jul 15.
Due to inconsistent findings, the influence of vitamin D on postural body sway (PBS) is currently under debate. This study evaluated the impact of vitamin D on PBS with regards to different foot positions and eye opening states in community-dwelling older individuals.
In a cross-sectional study, we assessed PBS in 342 older individuals (264 females [average age (± SD): 68.3 ± 9.0 years], 78 males [65.7 ± 9.6 years]). A detailed medical history and vitamin D level were obtained for each individual. Fall risk was evaluated using the New York-Presbyterian Fall Risk Assessment Tool (NY PFRA). PBS parameters (area, distance, velocity, frequency) were evaluated on a pressure plate with feet in closed stance (CS) or hip-width stance (HWS), open eyes and closed eyes. Statistical analysis included logarithmic mixed models for repeated measures with the MIXED model procedure to test the influence of vitamin D (categorized in <10 μg/l, 10-20 μg/l, 21-30 μg/l, >30 μg/l), foot position, eye opening state, age, sex and frequency of physical activity on PBS.
Vitamin D was not an independent risk factor for falls experienced in the last 12 months. Nonetheless, PBS was higher in patients with vitamin D deficiency (<10 μg/l) in HWS (A/P p=0.028 and area p=0.037). Additionally, vitamin D deficiency intensified the deleterious effects of male sex (distance p=0.002) and absence of vision (area p<0.001) on PBS.
Independent risk factors for increased PBS like male sex and absence of vision are additionally compromised by vitamin D deficiency.
由于研究结果不一致,目前维生素 D 对姿势性身体摆动(PBS)的影响仍存在争议。本研究评估了社区居住的老年人不同足部位置和睁眼状态下维生素 D 对 PBS 的影响。
在一项横断面研究中,我们评估了 342 名老年人(264 名女性[平均年龄(±标准差):68.3±9.0 岁],78 名男性[65.7±9.6 岁])的 PBS。为每位个体获取详细的病史和维生素 D 水平。使用纽约长老会医院跌倒风险评估工具(NY PFRA)评估跌倒风险。使用压力板评估 PBS 参数(面积、距离、速度、频率),足部位置为闭足位(CS)或髋宽位(HWS),睁眼和闭眼状态。统计分析采用对数混合模型进行重复测量,使用 MIXED 模型程序测试维生素 D(分类为<10μg/l、10-20μg/l、21-30μg/l、>30μg/l)、足部位置、睁眼状态、年龄、性别和身体活动频率对 PBS 的影响。
维生素 D 不是过去 12 个月内发生跌倒的独立危险因素。然而,在 HWS 中,维生素 D 缺乏(<10μg/l)患者的 PBS 更高(A/P p=0.028 和面积 p=0.037)。此外,维生素 D 缺乏加剧了男性(距离 p=0.002)和视力缺失(面积 p<0.001)对 PBS 的不利影响。
像男性和视力缺失这样导致 PBS 增加的独立危险因素,会因维生素 D 缺乏而进一步恶化。