5年以上维生素D不足与骨折风险增加相关——一项老年女性的观察性队列研究
Vitamin D insufficiency over 5 years is associated with increased fracture risk-an observational cohort study of elderly women.
作者信息
Buchebner D, McGuigan F, Gerdhem P, Malm J, Ridderstråle M, Akesson K
机构信息
Clinical and Molecular Osteoporosis Research Unit, Department of Clinical Science Malmö, Lund University, Lund, Sweden,
出版信息
Osteoporos Int. 2014 Dec;25(12):2767-75. doi: 10.1007/s00198-014-2823-1. Epub 2014 Aug 13.
UNLABELLED
This study of elderly Swedish women investigated the association between chronic vitamin D insufficiency and osteoporotic fractures occurring between ages 80-90. The incidence and risk of hip and major osteoporotic fractures was significantly higher in elderly women with low vitamin D levels maintained over 5 years.
INTRODUCTION
Vitamin D insufficiency among the elderly is common; however, relatively little is known about the effects of long-term hypovitaminosis D on fracture. We investigated sequential assessment of serum 25(OH)D at age 75 and 80 to determine if continuously low 25(OH)D levels are associated with increased 10-year fracture incidence.
METHODS
One thousand forty-four Swedish women from the population-based OPRA cohort, all 75 years old, attended at baseline (BL); 715 attended at 5 years. S-25(OH)D was available in 987 and 640, respectively and categorized as: <50 (Low), 50-75 (Intermediate), and >75 nmol/L (High). Incident fracture data was collected with maximum follow-up to 90 years of age.
RESULTS
Hip fracture incidence between age 80-85 was higher in women who had low 25(OH)D at both baseline and 5 years (22.2 % (Low) vs. 6.6 % (High); p = 0.003). Between age 80-90, hip fracture incidence was more than double that of women in the high category (27.9 vs. 12.3 %; p = 0.006). Within 5-years, 50 % of women in the continuously low group compared to 34 % in the continuously high 25(OH)D group had an osteoporotic fracture (p = 0.004) while 10-year incidence was higher compared to the intermediate (p = 0.020) but not the high category (p = 0.053). The 10-year relative risk of hip fracture was almost three times higher and osteoporotic fracture risk almost doubled for women in the lowest 25(OH)D category compared to the high category (HR 2.7 and 1.7; p = 0.003 and 0.023, respectively).
CONCLUSION
In these elderly women, 25(OH)D insufficiency over 5-years was associated with increased 10-year risk of hip and major osteoporotic fractures.
未标注
本项针对瑞典老年女性的研究调查了慢性维生素D不足与80至90岁之间发生的骨质疏松性骨折之间的关联。维生素D水平持续5年偏低的老年女性髋部骨折和主要骨质疏松性骨折的发生率及风险显著更高。
引言
老年人维生素D不足很常见；然而，关于长期维生素D缺乏对骨折的影响，人们了解相对较少。我们对75岁和80岁时血清25(OH)D进行了连续评估，以确定25(OH)D水平持续偏低是否与10年骨折发生率增加有关。
方法
来自基于人群的OPRA队列的1044名瑞典女性，均为75岁，参加了基线检查（BL）；715人在5年后参加检查。分别有987人和640人可获得S-25(OH)D数据，并分为：<50（低）、50 - 75（中）和>75 nmol/L（高）。收集了至90岁的最大随访期内的新发骨折数据。
结果
在基线和5年时25(OH)D水平均低的女性中，80至85岁之间的髋部骨折发生率更高（22.2%（低）对6.6%（高）；p = 0.003）。在80至90岁之间，髋部骨折发生率是高类别女性的两倍多（27.9%对12.3%；p = 0.006）。在5年内，持续低水平组中50%的女性发生了骨质疏松性骨折，而持续高水平25(OH)D组中这一比例为34%（p = 0.004），同时10年发生率高于中等水平组（p = 0.020）但不高于高水平组（p = 0.053）。与高水平组相比，25(OH)D类别最低的女性髋部骨折的10年相对风险几乎高出三倍，骨质疏松性骨折风险几乎翻倍（HR分别为2.7和1.7；p分别为0.003和0.023）。
结论
在这些老年女性中，5年期间的25(OH)D不足与髋部和主要骨质疏松性骨折的10年风险增加有关。
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