意大利北部工人横断面队列中25(OH)D水平与性别、超重、胰岛素抵抗及炎症的关系：对预防性医疗保健计划的支持证据

25(OH)D Levels in Relation to Gender, Overweight, Insulin Resistance, and Inflammation in a Cross-Sectional Cohort of Northern Italian Workers: Evidence in Support of Preventive Health Care Programs.

作者信息

Vigna Luisella, Cassinelli Letizia, Tirelli Amedea Silvia, Felicetta Irene, Napolitano Filomena, Tomaino Laura, Mutti Michela, Barberi Claudia Eleonora, Riboldi Luciano

机构信息

a Department of Preventive Medicine, Workers Health Protection and Promotion Unit , Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico , Milan , ITALY.

d Department of Clinical Science and Community Health DISCCO , University of Milan , Milano , ITALY.

出版信息

J Am Coll Nutr. 2017 May-Jun;36(4):253-260. doi: 10.1080/07315724.2016.1264280. Epub 2017 Apr 26.

DOI:10.1080/07315724.2016.1264280

PMID:28443804

Abstract

OBJECTIVE

In recent years, the welfare of workers and the prevention of chronic disabling diseases has become a topic of great interest. This study investigates serum levels of total 25-hydroxyvitamin D (25(OH)D) in a cohort of overweight-obese and insulin-resistant northern Italian indoor workers in apparent good health followed a nutritional education program.

METHODS

An observational cross-sectional study on 385 patients (females = 291, males = 94), age range 18-69 years and body mass index (BMI) > 25 kg/m, was performed at the Department of Occupational Medicine Milan, Italy, latitude 45.465454 N. We evaluated nutritional intakes, occupational and leisure physical activity, anthropometric measurements, impedance evaluation, blood pressure, the presence of metabolic syndrome (MetS) and nonalcoholic fatty liver diseases (NAFLD) by fatty liver index (FLI). Hematologic and biochemical parameters and (25(OH)D) levels were evaluated from fasting blood samples.

RESULTS

Only 10.91% of subjects had optimal values of 25(OH)D; 17.40% of the remaining 89.09% subjects were severely deficient, with no gender difference and insufficient intake of vitamin D. Only 28% declared leisure physical activity; 39.48% had metabolic syndrome and 62.60% had an FLI > 30. An inverse relationship between 25(OH)D levels and BMI was found, with a significant reduction of total 25(OH)D serum concentrations in winter. The homeostasis model assessment-insulin resistance (HOMA-IR) is positively related to BMI and inversely related to 25(OH)D concentrations. A positive correlation between vitamin D and leisure physical activity was found. At univariate analysis adjusted for age, gender and BMI, an inverse relationship between vitamin D and FLI was observed in both genders. The correlation between 25(OH)D levels, inflammation markers, BMI, and FLI showed an increased risk of cardiovascular disease in this cohort of workers.

CONCLUSION

Our results suggest the rationale for a large-scale screening program for vitamin D by means of easily implementable low-cost preventive supplementation.

摘要

目的

近年来，工人福利及慢性致残性疾病的预防已成为备受关注的话题。本研究调查了一群表面健康的意大利北部室内超重肥胖且胰岛素抵抗的工人在接受营养教育项目后血清总25-羟基维生素D（25(OH)D）水平。

方法

在意大利米兰职业医学部（北纬45.465454）对385名患者（女性 = 291名，男性 = 94名）进行了一项观察性横断面研究，年龄范围为18 - 69岁，体重指数（BMI）> 25 kg/m²。我们评估了营养摄入、职业和休闲体力活动、人体测量、阻抗评估、血压、代谢综合征（MetS）的存在情况以及通过脂肪肝指数（FLI）评估的非酒精性脂肪性肝病（NAFLD）。从空腹血样中评估血液学和生化参数以及（25(OH)D）水平。

结果

只有10.91%的受试者25(OH)D值处于最佳水平；其余89.09%的受试者中有17.40%严重缺乏，且无性别差异，维生素D摄入量不足。只有28%的人宣称有休闲体力活动；39.48%的人患有代谢综合征，62.60%的人FLI > 30。发现25(OH)D水平与BMI呈负相关，冬季血清总25(OH)D浓度显著降低。稳态模型评估 - 胰岛素抵抗（HOMA - IR）与BMI呈正相关，与25(OH)D浓度呈负相关。发现维生素D与休闲体力活动呈正相关。在对年龄、性别和BMI进行调整的单因素分析中，观察到维生素D与FLI在两性中均呈负相关。25(OH)D水平、炎症标志物、BMI和FLI之间的相关性表明该工人群体患心血管疾病的风险增加。