Department of Endocrinology and Metabolism, ZhongShan Hospital, Fudan University, Shanghai, China (mainland).
Department of Endocrinology and Metabolism, ZhongShan Hospital, Fudan University, , China (mainland).
Med Sci Monit. 2017 Dec 19;23:6001-6011. doi: 10.12659/msm.904495.
BACKGROUND The aim of this study was to investigate the optimal vitamin D status in the middle-aged and elderly population residing in Shanghai, China. MATERIAL AND METHODS A total of 1,829 males and postmenopausal females older than 45 years of age in the Changfeng community of Shanghai were included in this study. The optimal vitamin D level was determined according to the suppression of parathyroid hormone (PTH) and the highest bone mineral density (BMD). Locally weighted scatter plot smoothing (LOWESS) was performed to study the correlations of 25(OH)D with PTH and BMD in the lumbar spine and total hip, adjusting for gender, age, weight, use of calcium and vitamin D supplements, eGFR, smoking status, and alcohol consumption. RESULTS The mean serum 25(OH)D concentration was 48.0±19.2 nmol/L for the whole study population. The circulating PTH was maximally suppressed by the serum 25(OH)D of 55 nmol/L in the total population (60 nmol/L for males and 50 nmol/L for females). The 25(OH)D concentrations corresponding to the highest BMD at lumbar spine (L1-L4) and total hip were 53 nmol/L and 75 nmol/L, respectively, for the whole population. These values were also higher in males than females. CONCLUSIONS The optimal 25(OH)D concentration of 55 nmol/L is sufficient to maintain the bone health and metabolic status in middle-aged and elderly individuals living in Shanghai. Males probably need higher vitamin D concentration than females. There are differences between vitamin D status based on lumbar spine BMD and total hip BMD.
本研究旨在探讨中国上海中老年人群的最佳维生素 D 状态。
本研究纳入上海长风社区年龄大于 45 岁的 1829 名男性和绝经后女性。根据甲状旁腺激素（PTH）的抑制和最高骨密度（BMD）来确定最佳维生素 D 水平。通过局部加权散点平滑（LOWESS）来研究 25（OH）D 与腰椎和全髋部 PTH 和 BMD 的相关性，调整性别、年龄、体重、钙和维生素 D 补充剂的使用、eGFR、吸烟状况和饮酒情况。
全人群血清 25（OH）D 浓度的平均值为 48.0±19.2 nmol/L。全人群血清 25（OH）D 为 55 nmol/L 时，循环 PTH 抑制最大（男性 60 nmol/L，女性 50 nmol/L）。腰椎（L1-L4）和全髋部 BMD 最高时的 25（OH）D 浓度分别为全人群 53 nmol/L 和 75 nmol/L，男性高于女性。
55 nmol/L 的最佳 25（OH）D 浓度足以维持上海中老年人群的骨骼健康和代谢状态。男性可能比女性需要更高的维生素 D 浓度。基于腰椎 BMD 和全髋部 BMD 的维生素 D 状态存在差异。
