Santos Alejandro, Amaral Teresa F, Guerra Rita S, Sousa Ana S, Álvares Luisa, Moreira Pedro, Padrão Patrícia, Afonso Cláudia, Borges Nuno
Faculdade de Ciências da Nutrição e Alimentação, Universidade do Porto, Porto, Portugal.
i3S-Instituto de Investigação e Inovação em Saúde, Porto, Portugal.
BMJ Open. 2017 Jun 22;7(6):e016123. doi: 10.1136/bmjopen-2017-016123.
To evaluate vitamin D status and its associated factors in Portuguese older adults from the Nutrition UP 65 study.
Cross-sectional observational study.
Nationwide cluster sample of 1500 Portuguese subjects ≥65 years old. Participants were classified, according to US Institute of Medicine cut-offs, as presenting normal 25-hydroxyvitamin D (25(OH)D) levels (≥50.0 nmol/L), at risk of inadequacy (30.0-49.9 nmol/L) or at risk of deficiency (<30 nmol/L). The association between individuals' characteristics and 25(OH)D levels was analysed through multinomial logistic regression analysis.
Median 25(OH)D serum value was 36.1 (interquartile range (IQR): 35.5) nmol/L. According to the used cut-offs, 39.6% of participants were at risk of 25(OH)D deficiency and 29.4% were at risk of 25(OH)D inadequacy. In the adjusted model, having higher skin pigmentation and waist circumference >88 cm for women and >102 cm for men were associated with higher odds of 25(OH)D deficiency. Otherwise, living in Lisbon Metropolitan Area and in Madeira, 1-12 years of schooling, being married or in a common-law marriage, monthly income ≥€1000, alcohol consumption, medication or supplements with vitamin D supplement use, and blood samples collected in spring or summer were associated with lower odds of being at risk of 25(OH)D deficiency. In this model, season of blood sample collection, medication or supplements use, and waist circumference were the factors more strongly associated with 25(OH)D levels.
Despite using the conservative Institute of Medicine cut-offs, over two-thirds of these study participants presented inadequate 25(OH)D levels, warranting the implementation of corrective measures. Potentially modifiable factors were strongly associated with 25(OH)D levels in this study. These findings may be particularly relevant to the development of public health policies in southern European countries.
在“营养提升65岁及以上人群”研究中评估葡萄牙老年人的维生素D状况及其相关因素。
横断面观察性研究。
对1500名年龄≥65岁的葡萄牙受试者进行全国性整群抽样。根据美国医学研究所的临界值，参与者被分类为25-羟维生素D（25(OH)D）水平正常（≥50.0 nmol/L）、有不足风险（30.0 - 49.9 nmol/L）或有缺乏风险（<30 nmol/L）。通过多项逻辑回归分析个体特征与25(OH)D水平之间的关联。
25(OH)D血清中位值为36.1（四分位间距（IQR）：35.5）nmol/L。根据所采用的临界值，39.6%的参与者有25(OH)D缺乏风险，29.4%有25(OH)D不足风险。在调整模型中，皮肤色素沉着程度较高以及女性腰围>88 cm、男性腰围>102 cm与25(OH)D缺乏几率较高相关。否则，居住在里斯本都会区和马德拉群岛、接受1 - 12年教育、已婚或处于事实婚姻关系、月收入≥1000欧元、饮酒、使用维生素D药物或补充剂以及在春季或夏季采集血样与25(OH)D缺乏风险几率较低相关。在该模型中，血样采集季节、药物或补充剂使用情况以及腰围是与25(OH)D水平关联更强的因素。
尽管采用了保守的医学研究所临界值，但超过三分之二的研究参与者25(OH)D水平不足，需要采取纠正措施。在本研究中，潜在可改变因素与25(OH)D水平密切相关。这些发现可能对南欧国家公共卫生政策的制定尤为重要。
