维生素 D 缺乏与绝经后妇女的代谢综合征有关。

Vitamin D deficiency is associated with metabolic syndrome in postmenopausal women.

机构信息

Department of Gynecology and Obstetrics, Botucatu Medical School, Sao Paulo State University - UNESP, Sao Paulo, Brazil.

出版信息

Maturitas. 2018 Jan;107:97-102. doi: 10.1016/j.maturitas.2017.10.011. Epub 2017 Oct 18.

DOI:10.1016/j.maturitas.2017.10.011

PMID:29169589

Abstract

OBJECTIVE

To evaluate the association between vitamin D (VD) deficiency and risk factors for metabolic syndrome (MetS) in postmenopausal women.

STUDY DESIGN

Observational, cross-sectional cohort study.

MAIN OUTCOME MEASURES

In this study, 463 women, aged 45-75 years, with amenorrhea >12months, without VD supplementation or established cardiovascular disease were included. Clinical and anthropometric data were collected. Biochemical parameters, including total cholesterol (TC), HDL, LDL, triglycerides, glucose, insulin and 25-hydroxyvitamin-D [25(OH)D] were measured. Women meeting three or more of the following criteria were diagnosed with MetS: waist circumference >88cm, triglycerides ≥150mg/dL, HDL <50mg/dL, blood pressure ≥130/85mmHg and glucose ≥100mg/dL. Serum 25(OH)D levels were classified as sufficient (≥30ng/mL), insufficient (20-29ng/mL) or deficient (<20ng/mL). ANOVA, chi-square test and logistic regression (odds ratio, OR) were used for statistical analysis.

RESULTS

Serum 25(OH)D levels were sufficient in 148 women (32.0%), insufficient in 151 (32.6%) and deficient in 164 (35.4%). Women with low 25(OH)D levels had higher TC, triglycerides, insulin and HOMA-IR levels (p<0.05). MetS was detected in 57.8% (182/315) of women with hypovitaminosis D (insufficient and deficient) and in 39.8% (59/148) of those with sufficient VD (p=0.003). In a multivariate logistic regression analysis, a low 25(OH)D level (<30ng/mL) was significantly associated with MetS (OR1.90, 95%CI=1.26-2.85), high triglyceride levels (OR1.55, 95%CI=1.13-2.35), and low HDL levels (OR1.60, 95%CI=1.19-2.40) (p<0.05) compared with women with sufficient 25(OH)D levels, after adjusting for age, time since menopause, body mass index, smoking and physical exercise. The mean concentration of 25(OH)D decreased with increasing numbers of MetS components (p=0.016).

CONCLUSIONS

VD deficiency in postmenopausal women was associated with a higher prevalence of MetS. Women with VD deficiency had a higher risk of MetS, hypertriglyceridemia and low HDL than those with adequate levels.

摘要

目的

评估维生素 D（VD）缺乏与绝经后妇女代谢综合征（MetS）相关危险因素之间的关系。

研究设计

观察性、横断面队列研究。

主要观察指标

本研究纳入了 463 名年龄在 45-75 岁、闭经>12 个月、无维生素 D 补充或已确诊心血管疾病的女性。收集了临床和人体测量数据。测量了总胆固醇（TC）、高密度脂蛋白（HDL）、低密度脂蛋白（LDL）、甘油三酯、葡萄糖、胰岛素和 25-羟维生素 D [25（OH）D]等生化参数。符合以下三个或更多标准的女性被诊断为代谢综合征：腰围>88cm、甘油三酯≥150mg/dL、HDL<50mg/dL、血压≥130/85mmHg 和血糖≥100mg/dL。血清 25（OH）D 水平分为充足（≥30ng/mL）、不足（20-29ng/mL）和缺乏（<20ng/mL）。采用方差分析、卡方检验和逻辑回归（比值比，OR）进行统计分析。

结果

148 名女性（32.0%）血清 25（OH）D 水平充足，151 名（32.6%）不足，164 名（35.4%）缺乏。25（OH）D 水平较低的女性 TC、甘油三酯、胰岛素和 HOMA-IR 水平更高（p<0.05）。在 315 名维生素 D 缺乏症（不足和缺乏）女性中，有 57.8%（182/315）患有代谢综合征，在 148 名维生素 D 充足的女性中，有 39.8%（59/148）患有代谢综合征（p=0.003）。在多变量逻辑回归分析中，25（OH）D 水平较低（<30ng/mL）与代谢综合征（OR1.90，95%CI=1.26-2.85）、高甘油三酯水平（OR1.55，95%CI=1.13-2.35）和低 HDL 水平（OR1.60，95%CI=1.19-2.40）显著相关（p<0.05），与 25（OH）D 水平充足的女性相比，调整年龄、绝经后时间、体重指数、吸烟和体育锻炼后。25（OH）D 的平均浓度随着 MetS 成分数量的增加而降低（p=0.016）。