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维生素D缺乏:医学生有风险吗?

Hypovitaminosis d: are medical students at risk?

作者信息

Zabihiyeganeh Mozhdeh, Jahed S Adel, Sarami Samira, Nojomi Marzieh

机构信息

Department of Internal Medicine and Rheumatology, Firouzgar General Hospital, Iran University of Medical Sciences, Tehran, Iran.

Department of Internal Medicine and Endocrinology, Booali General Hospital, Islamic Azad University, Tehran Medical Sciences Branch, Tehran, Iran.

出版信息

Int J Prev Med. 2014 Sep;5(9):1161-8.

Abstract

BACKGROUND

Vitamin D deficiency is a pandemic problem mostly diagnosed in elderly. Few studies are available exclusively done on the topic among young adults. Specific professions such as medical students may have higher risk for developing hypovitaminosis D. We aimed to assess the vitamin D status in medical students of Iran University of Medical Sciences; and to define a cut-off point for 25-hydroxyvitamin-D (25(OH)D) level based on secondary hyperparathyroidism.

METHODS

This was a cross-sectional study on 100 medical students conducted during October 2012. Serum 25(OH)D, intact parathyroid hormone (iPTH), and calcium were measured. Age, sex, body mass index, daily dietary fish and egg consumption, sun exposure, and sunscreen usage were recorded. The association between serum 25(OH)D and iPTH was assessed. Receiver operating characteristics curve analysis was performed.

RESULTS

25-hydroxyvitamin-D level was <30 ng/ml in 99% of all participants, and <20 ng/ml in 77%. Mean serum 25(OH)D level was 16.8 ± 4.7 ng/ml. iPTH level in the group with 25(OH)D level of <10 ng/ml was significantly higher than in those with serum 25(OH)D level of 10 to <20 ng/ml and 20 to <30 ng/ml (109 ± 47 pg/ml, 47 ± 27 pg/ml and 46 ± 19 pg/ml, respectively; P = 0.0001). There was a significant linear inverse correlation between serum iPTH and 25(OH)D (r = -0.36, P = 0.0001). 25(OH)D level of 15.4 ng/ml was determined as the optimal cut-off point in detecting possible secondary hyperparathyroidism.

CONCLUSIONS

To improve the community vitamin D status, in addition to population-based food fortification programs, educational programs seem essential; not only for general population, but also for the more educated groups.

摘要

背景

维生素D缺乏是一个普遍存在的问题,多见于老年人。专门针对年轻人进行该主题研究的较少。医学生等特定职业人群发生维生素D缺乏症的风险可能更高。我们旨在评估伊朗医科大学医学生的维生素D状况;并根据继发性甲状旁腺功能亢进确定25-羟维生素D(25(OH)D)水平的切点。

方法

这是一项于2012年10月对100名医学生开展的横断面研究。检测血清25(OH)D、全段甲状旁腺激素(iPTH)和钙水平。记录年龄、性别、体重指数、每日饮食中鱼和蛋的摄入量、日照情况以及防晒霜使用情况。评估血清25(OH)D与iPTH之间的关联。进行受试者操作特征曲线分析。

结果

所有参与者中99%的25-羟维生素D水平<30 ng/ml,77%的<20 ng/ml。血清25(OH)D平均水平为16.8±4.7 ng/ml。25(OH)D水平<10 ng/ml组的iPTH水平显著高于血清25(OH)D水平为10至<20 ng/ml组以及20至<30 ng/ml组(分别为109±47 pg/ml、47±27 pg/ml和46±19 pg/ml;P = 0.0001)。血清iPTH与25(OH)D之间存在显著的线性负相关(r = -0.36,P = 0.0001)。确定25(OH)D水平为15.4 ng/ml作为检测可能的继发性甲状旁腺功能亢进的最佳切点。

结论

为改善社区维生素D状况,除了基于人群的食品强化计划外,教育项目似乎至关重要;不仅对普通人群,对受教育程度较高的群体也同样如此。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f0b/4192779/d7feb8534155/IJPVM-5-1161-g003.jpg

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