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新加坡维生素D缺乏症的患病率:及其对心血管危险因素的影响。

Prevalence of Vitamin D Deficiency in Singapore: Its Implications to Cardiovascular Risk Factors.

作者信息

Bi Xinyan, Tey Siew Ling, Leong Claudia, Quek Rina, Henry Christiani Jeyakumar

机构信息

Clinical Nutrition Research Centre, Centre for Translational Medicine, 14 Medical Drive #07-02, MD 6 Building, Singapore 117599, Singapore.

Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Brenner Centre for Molecular Medicine, 30 Medical Drive, Singapore 117609, Singapore.

出版信息

PLoS One. 2016 Jan 22;11(1):e0147616. doi: 10.1371/journal.pone.0147616. eCollection 2016.

Abstract

OBJECTIVE

Vitamin D deficiency is a global health challenge and has been linked to type 2 diabetes and other chronic diseases. However, the relationship between vitamin D status, body composition, and cardiovascular risks has not been well characterized in Asian populations. The objectives of this study were to examine the factors associated with the low vitamin D levels in a sunny tropical region and to assess the role of vitamin D status in cardiovascular risk factors.

DESIGN AND METHODS

This was a cross-sectional study. One hundred and fourteen healthy participants (59 males and 55 females) residing in Singapore took part in this study. Plasma 25OH-D3 concentration was measured by using LC-MS/MS. Body fat (%) was measured by using three different techniques including bioelectrical impedance analysis (BIA), BOD POD, and dual-energy X-ray absorptiometry (DEXA). Basic anthropometric measurements, fasting blood glucose (FBG), fasting serum insulin (FSI), and lipid profiles were obtained using standard protocols.

RESULTS

Approximately 42% of the participants were vitamin D deficient (< 20 ng/mL). Vitamin D status was inversely associated with body fat (%), homeostasis model assessment of insulin resistance (HOMA-IR), and total cholesterol/high density lipoprotein (TC/HDL) ratio, while positively associated with lean body mass (LBM) and hand grip strength (HGS).

CONCLUSIONS

The high prevalence of vitamin D deficiency in a sunny tropical region reinforces the need to recognize that sunlight alone is not the precursor for optimal vitamin D status. This raises the need to investigate public health measures that will encourage exposure to sunlight without overexposure that is harmful to skin. More importantly, vitamin D deficiency is associated with increased cardiovascular risks, i.e. HOMA-IR, TC/HDL, and LDL/HDL. Future studies should attempt to elucidate the potential mechanisms.

摘要

目的

维生素D缺乏是一项全球性的健康挑战,且与2型糖尿病及其他慢性疾病相关。然而,在亚洲人群中,维生素D状态、身体组成与心血管风险之间的关系尚未得到充分描述。本研究的目的是探究阳光充足的热带地区维生素D水平低的相关因素,并评估维生素D状态在心血管危险因素中的作用。

设计与方法

这是一项横断面研究。居住在新加坡的114名健康参与者(59名男性和55名女性)参与了本研究。采用液相色谱-串联质谱法测定血浆25-羟基维生素D3浓度。使用生物电阻抗分析(BIA)、人体成分分析仪(BOD POD)和双能X线吸收法(DEXA)三种不同技术测量体脂(%)。采用标准方案获取基本人体测量数据、空腹血糖(FBG)、空腹血清胰岛素(FSI)和血脂谱。

结果

约42%的参与者维生素D缺乏(<20 ng/mL)。维生素D状态与体脂(%)、胰岛素抵抗稳态模型评估(HOMA-IR)以及总胆固醇/高密度脂蛋白(TC/HDL)比值呈负相关,而与瘦体重(LBM)和握力(HGS)呈正相关。

结论

阳光充足的热带地区维生素D缺乏的高患病率凸显了认识到仅靠阳光并非最佳维生素D状态的前体的必要性。这就需要研究公共卫生措施,鼓励适度晒太阳,避免过度暴露对皮肤造成伤害。更重要的是,维生素D缺乏与心血管风险增加相关,即HOMA-IR、TC/HDL和LDL/HDL。未来的研究应试图阐明潜在机制。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ec2b/4723156/f3ed6e93cd3a/pone.0147616.g001.jpg

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