Samefors Maria, Östgren Carl Johan, Mölstad Sigvard, Lannering Christina, Midlöv Patrik, Tengblad Anders
Department of Medical and Health Sciences, Linköping University, SE-581 83 Linköping, Sweden.
Eur J Endocrinol. 2014 Apr 10;170(5):667-75. doi: 10.1530/EJE-13-0855. Print 2014 May.
Institutionalised elderly people at northern latitudes may be at elevated risk for vitamin D deficiency. In addition to osteoporosis-related disorders, vitamin D deficiency may influence several medical conditions conferring an increased mortality risk. The aim of this study was to explore the prevalence of vitamin D deficiency and its association with mortality.
The Study of Health and Drugs in the Elderly (SHADES) is a prospective cohort study among elderly people (>65 years) in 11 nursing homes in Sweden.
We analysed the levels of 25-hydroxyvitamin D₃ (25(OH)D₃) at baseline. Vital status of the subjects was ascertained and hazard ratios (HRs) for mortality according to 25(OH)D₃ quartiles were calculated.
We examined 333 study participants with a mean follow-up of 3 years. A total of 147 (44%) patients died within this period. Compared with the subjects in Q4 (25(OH)D₃ >48 nmol/l), HR (with 95% CI) for mortality was 2.02 (1.31-3.12) in Q1 (25(OH)D₃ <29 nmol/l) (P<0.05); 2.03 (1.32-3.14) in Q2 (25(OH)D₃ 30-37 nmol/l) (P<0.05) and 1.6 (1.03-2.48) in Q3 (25(OH)D₃ 38-47 nmol/l) (P<0.05). The mean 25(OH)D₃ concentration was 40.2 nmol/l (S.D. 16.0) and 80% had 25(OH)D₃ below 50 nmol/l. The vitamin D levels decreased from baseline to the second and third measurements.
Vitamin D deficiency was highly prevalent and associated with increased mortality among the elderly in Swedish nursing homes. Strategies are needed to prevent, and maybe treat, vitamin D deficiency in the elderly in nursing homes and the benefit of vitamin D supplementation should be evaluated in randomised clinical trials.
北纬地区的机构养老老年人维生素D缺乏风险可能更高。除了与骨质疏松症相关的疾病外，维生素D缺乏可能会影响多种疾病，增加死亡风险。本研究旨在探讨维生素D缺乏的患病率及其与死亡率的关联。
老年人健康与药物研究（SHADES）是一项针对瑞典11家养老院中65岁以上老年人的前瞻性队列研究。
我们分析了基线时25-羟维生素D₃（25(OH)D₃）的水平。确定了受试者的生命状态，并计算了根据25(OH)D₃四分位数划分的死亡率风险比（HR）。
我们对333名研究参与者进行了平均3年的随访。在此期间共有147名（44%）患者死亡。与四分位数4（25(OH)D₃>48 nmol/l）的受试者相比，四分位数1（25(OH)D₃<29 nmol/l）的死亡率HR（95%CI）为2.02（1.31 - 3.12）（P<0.05）；四分位数2（25(OH)D₃ 30-37 nmol/l）为2.03（1.32 - 3.14）（P<0.05），四分位数3（25(OH)D₃ 38-47 nmol/l）为1.6（1.03 - 2.48）（P<0.05）。25(OH)D₃的平均浓度为40.2 nmol/l（标准差16.0），80%的人25(OH)D₃低于50 nmol/l。维生素D水平从基线到第二次和第三次测量时下降。
维生素D缺乏在瑞典养老院老年人中非常普遍，且与死亡率增加相关。需要采取策略预防，甚至可能治疗养老院老年人的维生素D缺乏，并且应在随机临床试验中评估补充维生素D的益处。
