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