维生素D与老年人身体虚弱状况及全因死亡率的前瞻性关联：KORA-Age研究结果
Prospective association of vitamin D with frailty status and all-cause mortality in older adults: Results from the KORA-Age Study.
作者信息
Vogt Susanne, Decke Siona, de Las Heras Gala Tonia, Linkohr Birgit, Koenig Wolfgang, Ladwig Karl-Heinz, Peters Annette, Thorand Barbara
机构信息
Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Ingolstädter Landstraße 1, 85764 Neuherberg, Germany.
Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Ingolstädter Landstraße 1, 85764 Neuherberg, Germany; Institute of Medical Informatics, Biometry and Epidemiology, Ludwig-Maximilians-Universität, Marchioninistr. 15, 81377 Munich, Germany.
出版信息
Prev Med. 2015 Apr;73:40-6. doi: 10.1016/j.ypmed.2015.01.010. Epub 2015 Jan 19.
OBJECTIVE
To assess the prospective association of serum 25-hydroxyvitamin D [25(OH)D] levels with frailty status and all-cause mortality in a cohort of community-dwelling participants of the population-based KORA [Cooperative Health Research in the Region of Augsburg]-Age Study.
METHODS
727 non-frail participants, aged ≥65years, with 25(OH)D measurement at baseline in 2009, were followed for 2.9±0.1years. Participants were classified as pre-frail or frail if they met 1-2 or ≥3, respectively, of the following five criteria: weight loss, exhaustion, physical inactivity, low walking speed, weakness. The association between 25(OH)D and mortality was assessed in 954 participants. Multivariable adjusted logistic regression models were calculated for each outcome.
RESULTS
The incidence of pre-frailty and frailty was 21.2% and 3.9% respectively. After multivariable adjustment, participants with very low 25(OH)D levels (<15ng/ml vs. ≥30ng/ml) had a significantly higher odds for pre-frailty (OR=2.43 [95% CI: 1.17-5.03]) and pre-frailty/frailty combined (OR=2.53 [95% CI: 1.23-5.22]), but not for frailty alone (OR=2.63 [95% CI: 0.39-17.67]). The association between 25(OH)D and mortality (OR=3.39 [95% CI: 1.08-10.65]) was partly mediated by frailty status.
CONCLUSION
Very low 25(OH)D levels were independently associated with incident pre-frailty, pre-frailty/frailty combined and all-cause mortality.
目的
在基于人群的奥格斯堡地区合作健康研究（KORA）-年龄研究的社区居住参与者队列中，评估血清25-羟维生素D[25(OH)D]水平与虚弱状态及全因死亡率之间的前瞻性关联。
方法
727名年龄≥65岁的非虚弱参与者于2009年进行了基线25(OH)D测量，并随访了2.9±0.1年。如果参与者分别符合以下五项标准中的1-2项或≥3项，则被分类为虚弱前期或虚弱：体重减轻、疲惫、身体活动不足、步行速度慢、虚弱。在954名参与者中评估了25(OH)D与死亡率之间的关联。针对每个结局计算多变量调整逻辑回归模型。
结果
虚弱前期和虚弱的发生率分别为21.2%和3.9%。多变量调整后，25(OH)D水平极低的参与者（<15ng/ml与≥30ng/ml相比）发生虚弱前期的几率显著更高（比值比[OR]=2.43[95%置信区间：1.17-5.03]），以及虚弱前期/虚弱合并的几率也显著更高（OR=2.53[95%置信区间：1.23-5.22]），但单独虚弱的几率不高（OR=2.63[95%置信区间：0.39-17.67]）。25(OH)D与死亡率之间的关联（OR=3.39[95%置信区间：1.08-10.65]）部分由虚弱状态介导。
结论
25(OH)D水平极低与虚弱前期、虚弱前期/虚弱合并及全因死亡率独立相关。
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