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绝经和绝经后女性中维生素D水平低、骨矿物质密度与抑郁症状负担的关系

Low vitamin D, and bone mineral density with depressive symptoms burden in menopausal and postmenopausal women.

作者信息

Bener Abdulbari, Saleh Najah M

机构信息

Department of Biostatistics and Medical Informatics, Cerrahpaşa Faculty of Medicine, Istanbul University, Istanbul, Turkey ; Department of Evidence for Population Health Unit, School of Epidemiology and Health Sciences, University of Manchester, Manchester, United Kingdom.

Department of Obstetrics and Gynecology, Women's Hospital, Hamad Medical Corporation, Doha, Qatar.

出版信息

J Midlife Health. 2015 Jul-Sep;6(3):108-14. doi: 10.4103/0976-7800.165590.

Abstract

BACKGROUND

The reported association between vitamin D level and loss of Bone mineral densitometry measurements (BMD) has been controversial.

OBJECTIVE

The objectıve of the current study was to determine whether low vitamin D level and BMD are associated with depresive symptoms as burden in Arab women during the menopausal and postmenopausal period.

DESIGN AND SETTING

A cross-sectional descriptive study design was used at the Primary Health Care (PHC) Centers in Qatar.

SUBJECTS

A multi-stage sampling design was used and a representative sample of 1436 women aged 45-65 years were included during July 2012 and November 2013 and 1106 women agreed to participate (77.2%) and responded to the study.

MATERIALS AND METHODS

BMD (g/m(2)) was assessed at the BMD unit using a Lunar Prodigy DXA system (Lunar Corp., Madison, WI). The antero-posterior lumbar spine (L2-L4) and the mean of the proximal right and left femur were be measured by two technician and then reviewed by one radiologist. Data on body mass index (BMI), clinical biochemistry variables including serum 25-hydroxyvitamin D were collected. The Beck Depression Inventory (BDI) was administered for depression purposes.

RESULTS

Of the 1436 women living in urban and rural areas, 1106 women agreed to participate (77.0%) and responded to the study. The mean age and standard deviation of the subjects was 53.8 ± 3.2. The median age of natural menopausal in the present study was 49 years (mean and standard deviation 49.5 ± 3.1 and postmenopausal was 58.1 ± 3.3). There were statistically significant differences between menopausal stages with regards to ethnicity, education level, systolic and dialostic blood pressure, parity, sheesha smoking and depressive symptoms. Overall 30.4% of women were affected with osteopenia/osteoporosis in premenopausal and postmenopausal (24.4% vs 35.7%; P = 0.0442). Osteopenia in premenopausal and postmenopausal (18.7% vs 29.3%; P = 0.030) and Osteoporosis (9.9% vs 15.9%; P = 0.049) were significantly higher in post-menopausal women than in premenopausal women (P = 0.046). Similarly, vitamin D deficiency was more prevalent among postmenopausal women than menopausal women. Overall, only 15.1% of women had optimum vitamin D level and 15.5% had severe, 33.2% had moderate vitamin D insufficiency and 36.3% had mild vitamin D insufficiency in menopausal and post menopausal women (P = 0.021). The study revealed that vitamin D level, hemoglobin level, serum iron fasting plasma glucose, calcium, triglycerides, high density lipid (HDL) cholesterol, low density lipid (LDL) Cholesterol, alkaline phosphate and magnesium were considerably lower in postmenopausal compared to menopausal women (P < 0.001).

CONCLUSION

The current study revealed that there was a strong association between vitamin D level and BMD in Arab women during the menopausal and post-menopausal period.

摘要

背景

维生素D水平与骨密度测量值降低之间的关联报道存在争议。

目的

本研究的目的是确定低维生素D水平和骨密度是否与阿拉伯女性绝经和绝经后期的抑郁症状负担相关。

设计与地点

在卡塔尔的初级卫生保健中心采用横断面描述性研究设计。

研究对象

采用多阶段抽样设计,2012年7月至2013年11月纳入1436名45-65岁的女性作为代表性样本,1106名女性同意参与(77.2%)并对研究做出回应。

材料与方法

使用Lunar Prodigy DXA系统(Lunar Corp.,麦迪逊,威斯康星州)在骨密度检测单位评估骨密度(g/m²)。两名技术人员测量腰椎前后位(L2-L4)以及左右股骨近端的平均值,然后由一名放射科医生进行复查。收集体重指数(BMI)、包括血清25-羟基维生素D在内的临床生化变量数据。采用贝克抑郁量表(BDI)进行抑郁情况评估。

结果

在1436名城乡女性中,1106名女性同意参与(77.0%)并对研究做出回应。研究对象的平均年龄和标准差为53.8±3.2。本研究中自然绝经的中位年龄为49岁(平均和标准差49.5±3.1),绝经后期为58.1±3.3。绝经阶段在种族、教育水平、收缩压和舒张压、产次、水烟吸食和抑郁症状方面存在统计学显著差异。总体而言,30.4%的女性在绝经前和绝经后患有骨质减少/骨质疏松(24.4%对35.7%;P = 0.0442)。绝经后女性的绝经前和绝经后骨质减少(18.7%对29.3%;P = 0.030)和骨质疏松(9.9%对15.9%;P = 0.049)显著高于绝经前女性(P = 0.046)。同样,绝经后女性维生素D缺乏比绝经女性更普遍。总体而言,只有15.1%的女性维生素D水平适宜,15.5%严重缺乏,33.2%中度维生素D不足以及36.3%轻度维生素D不足,绝经和绝经后女性存在差异(P = 0.021)。研究显示,与绝经女性相比,绝经后女性的维生素D水平、血红蛋白水平、血清铁、空腹血糖、钙、甘油三酯、高密度脂蛋白(HDL)胆固醇、低密度脂蛋白(LDL)胆固醇、碱性磷酸酶和镁显著降低(P < 0.001)。

结论

本研究显示,绝经和绝经后期阿拉伯女性的维生素D水平与骨密度之间存在强关联。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f4be/4604669/14b8f6cf16b7/JMH-6-108-g001.jpg

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