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分析患有维生素 D 缺乏症的老年社区居民:分类树分析。

Profiling older community-dwellers with hypovitaminosis D: A classification tree analysis.

机构信息

Department of Geriatric Medicine and Memory Clinic, Research Center of Autonomy and Longevity, UPRES EA 4638, Angers University Hospital, Angers, France.

School of Medicine, University of Angers, France.

出版信息

Int J Vitam Nutr Res. 2020 Jun;90(3-4):195-199. doi: 10.1024/0300-9831/a000591. Epub 2019 May 6.

Abstract

Despite the high prevalence of hypovitaminosis D in older adults, universal vitamin D supplementation is not recommended due to potential risk of intoxication. Our aim here was to determine the clinical profiles of older community-dwellers with hypovitaminosis D. The perspective is to build novel strategies to screen for and supplement those with hypovitaminosis D. A classification tree (CHAID analysis) was performed on multiple datasets standardizedly collected from 1991 older French community-dwelling volunteers ≥ 65 years in 2009-2012. Hypovitaminosis D was defined as serum 25-hydroxyvitamin D ≤ 50 nmol/L. CHAID analysis retained 5 clinical profiles of older community-dwellers with different risks of hypovitaminosis D up to 87.3%, based on various combinations of the following characteristics: polymorbidity, obesity, sadness and gait disorders. For instance, the probability of hypovitaminosis D was 1.42-fold higher [95CI: 1.27-1.59] for those with polymorbidity and gait disorders compared to those with no polymorbidity, no obesity and no sadness. In conclusion, these easily-recordable measures may be used in clinical routine to identify older community-dwellers for whom vitamin D supplementation should be initiated.

摘要

尽管老年人普遍存在维生素 D 缺乏症,但由于潜在的中毒风险,不建议普遍补充维生素 D。我们的目的是确定患有维生素 D 缺乏症的老年社区居民的临床特征。目的是制定新的策略,对维生素 D 缺乏症患者进行筛查和补充。对 1991 名年龄在 65 岁及以上的法国社区居住志愿者在 2009-2012 年期间标准化收集的多个数据集进行分类树(CHAID 分析)。维生素 D 缺乏症定义为血清 25-羟维生素 D 水平≤50nmol/L。CHAID 分析保留了 5 种不同维生素 D 缺乏风险的老年社区居民的临床特征,最高可达 87.3%,这是基于以下特征的各种组合:多种合并症、肥胖、悲伤和步态障碍。例如,与没有多种合并症、肥胖和悲伤的人相比,有多种合并症和步态障碍的人患维生素 D 缺乏症的概率高 1.42 倍[95%CI:1.27-1.59]。总之,这些易于记录的措施可用于临床常规,以确定应开始补充维生素 D 的老年社区居民。

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