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血清总25-羟维生素D和游离25-羟维生素D以及甲状旁腺激素值在确定冬季末维生素D状态中的作用:一项代表性调查。

The role of serum total and free 25-hydroxyvitamin D and PTH values in defining vitamin D status at the end of winter: a representative survey.

作者信息

Szabó Boglárka, Tabák Ádám G, Toldy Erzsébet, Szekeres László, Szili Balázs, Bakos Bence, Balla Bernadett, Kósa János Pál, Lakatos Péter, Takács István

机构信息

1st Department of Medicine, Semmelweis University Faculty of Medicine, Budapest, Korányi Sándor u. 2/a, Budapest, 1083, Hungary.

Department of Epidemiology and Public Health, University College London, London, UK.

出版信息

J Bone Miner Metab. 2017 Jan;35(1):83-90. doi: 10.1007/s00774-015-0729-4. Epub 2015 Dec 10.

Abstract

We sought the lowest serum total 25-hydroxyvitamin D (t-25OHD) values in geographic areas with four seasons and investigated whether the calculation of serum free 25-hydroxyvitamin D (f-25OHD) could provide additional information on vitamin D status. This is a representative, cross-sectional study restricted to a sampling period at the end of winter, using a non-probability, stratified sample of the adult community-dwelling Hungarian population (n = 882). We measured t-25OHD, vitamin D binding protein (DBP), parathyroid hormone (PTH), and albumin levels. f-25OHD concentrations were calculated. We assessed environmental factors that could affect vitamin D levels and diseases possibly related to vitamin D deficiency. Mean t-25OHD values of the total population were 41.3 ± 20.6 nmol/L. t-25OHD levels were below 75, 50, and 30 nmol/L in 97, 77, and 34 % of participants not receiving vitamin D supplementation, respectively. t-25OHD values weakly positively correlated with DBP (r = 0.174; p = 0.000), strongly with f-25OHD (r = 0.70; p = 0.000). The association between t-25OHD and f-25OHD and between t-25OHD and PTH were non-linear (p  = 0.0004 and 0.004, respectively). t-25OHD levels were not affected by gender, age, place of residence; however, they were related to body mass index, sunbed sessions, and tropical travel. In contrast, f-25OHD levels were different in males and females but were not related to obesity. t- and f-25OHD were lower among people with cardiovascular diseases (p = 0.012). Nearly the entire Hungarian population is vitamin D insufficient at the end of winter. The use of t-25OHD could show a spurious association with obesity; however, it does not reflect the obvious sex difference.

摘要

我们在有四季的地理区域中寻找血清总25-羟基维生素D(t-25OHD)的最低值,并研究血清游离25-羟基维生素D(f-25OHD)的计算是否能提供有关维生素D状态的额外信息。这是一项代表性的横断面研究,仅限于冬季末的采样期,采用非概率分层抽样的匈牙利成年社区居民(n = 882)。我们测量了t-25OHD、维生素D结合蛋白(DBP)、甲状旁腺激素(PTH)和白蛋白水平。计算了f-25OHD浓度。我们评估了可能影响维生素D水平的环境因素以及可能与维生素D缺乏相关的疾病。总体人群的平均t-25OHD值为41.3±20.6 nmol/L。在未补充维生素D的参与者中,分别有97%、77%和34%的人的t-25OHD水平低于75、50和30 nmol/L。t-25OHD值与DBP呈弱正相关(r = 0.174;p = 0.000),与f-25OHD呈强正相关(r = 0.70;p = 0.000)。t-25OHD与f-25OHD之间以及t-25OHD与PTH之间的关联是非线性的(分别为p = 0.0004和0.004)。t-25OHD水平不受性别、年龄、居住地点的影响;然而,它们与体重指数、日光浴次数和热带旅行有关。相比之下,f-25OHD水平在男性和女性中有所不同,但与肥胖无关。心血管疾病患者的t-和f-25OHD较低(p = 0.012)。几乎整个匈牙利人群在冬季末维生素D都不足。使用t-25OHD可能显示出与肥胖的虚假关联;然而,它并未反映出明显的性别差异。

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