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多民族人群中多个时间点测量的25-羟基维生素D浓度的预测因素

Predictors of 25-Hydroxyvitamin D Concentration Measured at Multiple Time Points in a Multiethnic Population.

作者信息

Knight Julia A, Wong Jody, Cole David E C, Lee Tim K, Parra Esteban J

出版信息

Am J Epidemiol. 2017 Nov 15;186(10):1180-1193. doi: 10.1093/aje/kwx180.

Abstract

The evidence for a relationship between serum vitamin D levels and nonskeletal health outcomes is inconsistent. The validity of single or predicted measurements of 25-hydroxyvitamin D (25(OH)D) concentration is unknown, as levels of this biomarker are highly seasonally variable. We compared models of 25(OH)D measured at baseline, at multiple time points throughout the year, and averaged over the year among 309 persons in Toronto, Ontario, Canada (43°N latitude) during 2009-2013. Information and blood samples were collected every 2 months. Baseline and average 25(OH)D concentrations were correlated (r = 0.88). Major factors associated with 25(OH)D level were similar across models and included race/ethnicity (concentrations in non-European groups were lower than those in Europeans), vitamin D supplement use of ≥1,000 IU/day (18.9 nmol/L (95% confidence interval (CI): 16.1, 21.8) vs. no supplement use in a full data set with all factors), and the presence of the group-specific component/vitamin D binding protein gene (GC/DBP) rs4588 functional polymorphism (AA vs. CC: -16.7 nmol/L (95% CI: -26.2, -7.1); CA vs. CC: -10.7 nmol/L (95% CI: -14.9, -6.5)). Most factors had similar associations in Europeans and non-Europeans. Genetic factors may play a greater role in average 25(OH)D concentrations. Prediction models for 25(OH)D are challenging and population-specific, but use of genetic factors along with a few common population-relevant, quantifiable nongenetic factors with strong associations may be the most feasible approach to vitamin D assessment over time.

摘要

血清维生素D水平与非骨骼健康结局之间关系的证据并不一致。25-羟维生素D(25(OH)D)浓度单次测量或预测测量的有效性尚不清楚,因为该生物标志物的水平具有高度季节性变化。我们比较了2009年至2013年期间在加拿大多伦多(北纬43°)的309人在基线、全年多个时间点测量的以及全年平均的25(OH)D模型。每2个月收集一次信息和血样。基线和平均25(OH)D浓度具有相关性(r = 0.88)。各模型中与25(OH)D水平相关的主要因素相似,包括种族/族裔(非欧洲群体中的浓度低于欧洲群体)、每天使用≥1000 IU的维生素D补充剂(在包含所有因素的完整数据集中,与未使用补充剂相比为18.9 nmol/L(95%置信区间(CI):16.1, 21.8))以及特定群体成分/维生素D结合蛋白基因(GC/DBP)rs4588功能多态性的存在(AA与CC相比:-16.7 nmol/L(95% CI:-26.2, -7.1);CA与CC相比:-10.7 nmol/L(95% CI:-14.9, -6.5))。大多数因素在欧洲人和非欧洲人中的关联相似。遗传因素可能在平均25(OH)D浓度中起更大作用。25(OH)D的预测模型具有挑战性且因人群而异,但将遗传因素与一些常见的、与人群相关的、可量化的非遗传因素(具有强关联)结合使用可能是随时间评估维生素D最可行的方法。

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