马来西亚吉隆坡多民族成年人的维生素D水平及其与肥胖的关联：一项横断面研究。
Vitamin D level and its association with adiposity among multi-ethnic adults in Kuala Lumpur, Malaysia: a cross sectional study.
作者信息
Shafinaz I S, Moy F M
机构信息
Julius Centre University of Malaya, Department of Social & Preventive Medicine, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia.
出版信息
BMC Public Health. 2016 Mar 7;16:232. doi: 10.1186/s12889-016-2924-1.
BACKGROUND
Vitamin D deficiency is highly prevalent in both temperate as well as tropical countries. Obesity is one of the factors contributing to vitamin D deficiency. As our country has a high prevalence of overweight and obesity, we aimed to study serum 25-hydroxyvitamin D (25(OH)D) level and its association with adiposity using various adiposity indicators; and to study other risk factors that affect serum 25(OH)D level among multi-ethnic adults in Kuala Lumpur, Malaysia.
METHODS
This was a cross sectional study conducted with a multistage sampling. All permanent teachers working in government secondary schools in Kuala Lumpur were invited for the study. The data collection included serum 25(OH)D, Parathyroid Hormone (PTH), body fat percentage, waist circumference, body mass index (BMI) and blood pressure. Demographic characteristics, sun avoidance, sun exposure and physical activity were enquired from the participants using a self-administered questionnaire. The data was analyzed using a complex sample analysis.
RESULTS
A total of 858 participants were recruited. Majority of them were Malays, females and had tertiary education. The overall prevalence of vitamin D deficiency (<20 ng/ml) was 67.4 %. Indian participants (80.9 %) had the highest proportion of vitamin D deficiency, followed by Malays (75.6 %), others (44.9 %) and Chinese (25.1 %). There was a significant negative association between serum 25(OH)D level with BMI (β = -0.23) and body fat percentage (β = -0.14). In the multivariate linear regression analysis, Malays, Indians and females (p < 0.001); higher BMI and larger waist circumference (p < 0.05) were significantly associated with lower serum 25(OH)D level. The full model explained 32.8 % of the variation between participants in the serum 25(OH)D level. The two most influential factors affecting serum 25(OH)D level were ethnicity and gender.
CONCLUSIONS
The prevalence of vitamin D deficiency among our participants was high. Adiposity was associated with serum 25(OH)D level. Skin pigmentation and gender based behaviours were more dominant in contributing to serum 25(OH)D level. Health education should be targeted in weight management, gender based behaviours on sun exposure, as skin pigmentation is non-modifiable.
背景
维生素D缺乏在温带国家和热带国家都极为普遍。肥胖是导致维生素D缺乏的因素之一。由于我国超重和肥胖的患病率较高，我们旨在使用各种肥胖指标研究血清25-羟基维生素D（25(OH)D）水平及其与肥胖的关联；并研究影响马来西亚吉隆坡多民族成年人血清25(OH)D水平的其他风险因素。
方法
这是一项采用多阶段抽样进行的横断面研究。邀请了所有在吉隆坡政府中学工作的常任教师参与该研究。数据收集包括血清25(OH)D、甲状旁腺激素（PTH）、体脂百分比、腰围、体重指数（BMI）和血压。使用自填问卷向参与者询问人口统计学特征、避免日晒、日晒暴露和身体活动情况。数据采用复杂样本分析进行分析。
结果
共招募了858名参与者。他们大多数是马来人、女性且接受过高等教育。维生素D缺乏（<20 ng/ml）的总体患病率为67.4%。印度参与者中维生素D缺乏的比例最高（80.9%），其次是马来人（75.6%）、其他族裔（44.9%）和华人（25.1%）。血清25(OH)D水平与BMI（β = -0.23）和体脂百分比（β = -0.14）之间存在显著的负相关。在多变量线性回归分析中，马来人、印度人和女性（p < 0.001）；较高的BMI和较大的腰围（p < 0.05）与较低的血清25(OH)D水平显著相关。完整模型解释了参与者血清25(OH)D水平差异的32.8%。影响血清25(OH)D水平的两个最具影响力的因素是种族和性别。
结论
我们的参与者中维生素D缺乏的患病率很高。肥胖与血清25(OH)D水平相关。皮肤色素沉着和基于性别的行为在影响血清25(OH)D水平方面更为突出。鉴于皮肤色素沉着不可改变，健康教育应针对体重管理以及基于性别的日晒行为。
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