Yoshimura N, Muraki S, Oka H, Nakamura K, Kawaguchi H, Tanaka S, Akune T
Department of Joint Disease Research, 22nd Century Medical and Research Center, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan,
Osteoporos Int. 2015 Jan;26(1):151-61. doi: 10.1007/s00198-014-2844-9. Epub 2014 Aug 20.
Assessment of serum 25-hydroxyvitamin D levels in association with the occurrence of musculoskeletal diseases using a population-based cohort study design revealed that serum 25-hydroxyvitamin D levels could predict the occurrence of osteoporosis at the femoral neck within 3 years, but not the occurrence of knee osteoarthritis or lumbar spondylosis.
The aim of this study is to clarify the association between serum 25-hydroxyvitamin D (25D) levels and occurrence of osteoporosis and osteoarthritis in the general population.
The Research on Osteoarthritis/Osteoporosis Against Disability study, a large-scale population-based cohort study, was performed during 2005-2007. Serum 25D levels were measured in 1,683 participants. Of these, 1,384 individuals (81.9%) completed a second follow-up survey 3 years later. Osteoporosis was defined according to World Health Organization criteria, in which osteoporosis is diagnosed by T-scores of bone mineral density (BMD) that are 2.5 standard deviations (SD) less than normal BMD. Knee osteoarthritis and lumbar spondylosis were defined as Kellgren-Lawrence grade ≥2, using paired X-ray films. Cumulative incidences were determined according to changes in measurements using World Health Organization criteria for osteoporosis or Kellgren-Lawrence grades for osteoarthritis between the baseline and second survey.
The mean (SD) serum 25D level of the 1,384 participants in both surveys was 23.4 ng/mL (6.5). The annual cumulative incidences of osteoporosis at L2-4 and the femoral neck were 0.76 and 1.83%/year, respectively. The incidences of knee osteoarthritis and lumbar spondylosis were 3.3 and 11.4%/year, respectively. After adjusting for potential associated factors, logistic regression analyses revealed that the odds ratio for the occurrence of femoral neck osteoporosis significantly decreased as serum 25D levels increased (+1 SD; odds ratio 0.67; 95% confidence interval 0.49-0.92; p = 0.014).
Higher serum 25D levels may prevent the occurrence of osteoporosis at the femoral neck, but not knee osteoarthritis, lumbar spondylosis, or osteoporosis at L2-4.
采用基于人群的队列研究设计评估血清25-羟维生素D水平与肌肉骨骼疾病发生之间的关联,结果显示血清25-羟维生素D水平可预测3年内股骨颈骨质疏松症的发生,但不能预测膝关节骨关节炎或腰椎间盘突出症的发生。
本研究的目的是阐明一般人群中血清25-羟维生素D(25D)水平与骨质疏松症和骨关节炎发生之间的关联。
2005年至2007年期间进行了一项针对骨关节炎/骨质疏松症预防残疾的大规模基于人群的队列研究。对1683名参与者测量了血清25D水平。其中,1384人(81.9%)在3年后完成了第二次随访调查。骨质疏松症根据世界卫生组织标准定义,即通过骨密度(BMD)的T值诊断骨质疏松症,该T值比正常BMD低2.5个标准差(SD)。膝关节骨关节炎和腰椎间盘突出症根据配对X线片定义为Kellgren-Lawrence分级≥2级。根据基线和第二次调查之间使用世界卫生组织骨质疏松症标准或骨关节炎Kellgren-Lawrence分级的测量变化确定累积发病率。
两次调查中1384名参与者的平均(SD)血清25D水平为23.4 ng/mL(6.5)。L2-4和股骨颈骨质疏松症的年累积发病率分别为0.76%和1.83%/年。膝关节骨关节炎和腰椎间盘突出症的发病率分别为3.3%和11.4%/年。在调整潜在相关因素后,逻辑回归分析显示,随着血清25D水平升高(+1 SD),股骨颈骨质疏松症发生的优势比显著降低(优势比0.67;95%置信区间0.49-0.92;p = 0.014)。
较高的血清25D水平可能预防股骨颈骨质疏松症的发生,但不能预防膝关节骨关节炎、腰椎间盘突出症或L2-4处的骨质疏松症。