Orces Carlos, Lorenzo Carlos, Guarneros Juan E
Rheumatology, Laredo Medical Center, Laredo, USA.
Rheumatology, University of Texas, San Antonio, USA.
Cureus. 2019 Aug 1;11(8):e5300. doi: 10.7759/cureus.5300.
Background Older adults (i.e., adults aged ≥ 60 years) are at higher risk of vitamin D deficiency compared to younger adults as a result of inadequate dietary vitamin D intake and limited exposure to sunlight. Thus, the present study aimed to describe the prevalence of vitamin deficiency and inadequacy among U.S. adults aged ≥ 60 years and the effect of vitamin D supplementation on 25, hydroxyvitamin D (25(OH)D) and its metabolites concentrations. Methods The present analysis was based on data from 6,261 participants in the National Health and Nutrition Examination Survey cycles 2007/2008 through 2013/2014. The prevalence of vitamin D deficiency and inadequacy was described according to demographic, behavioral, and health characteristics. Vitamin D deficiency was defined as 25(OH)D < 30 nmol/L; and vitamin D inadequacy was defined as < 50 nmol/L. Logistic regression models were assembled to examine the independent association of participants characteristics and the odds of having 25(OH)D inadequacy. Similarly, general linear models were used to assess the effect of vitamin D supplementation doses on 25(OH)D and its metabolites concentrations. Results The prevalence of 25(OH)D deficiency and inadequacy was 4.0% (standard error (SE), 0.4) and 17.4% (SE, 0.8), respectively. In general, the prevalence of 25(OH)D deficiency and inadequacy increased significantly among participants examined during the fall and winter months, women, non-Hispanic black patients, obese subjects, smokers, those physically inactive, and older adults with a daily vitamin D intake < 400 IU. After adjustment for potential confounders, subjects examined during the fall and winter months, females, non-Hispanic blacks, obesity, having a sedentary lifestyle, smokers, and a total vitamin D intake < 400 IU/day were variables significantly associated with increased odds of having vitamin D inadequacy. Notably, vitamin D supplement doses between 400 and 800 IU or > 800 IU/day were significantly correlated with higher 25(OH)D concentrations considered as sufficient. Conclusion 25(OH)D inadequacy remains prevalent among U.S. older adults. Notably, optimal 25(OH)D concentrations were consistently seen among vitamin D supplement users. Despite this finding, nearly half of the participants did not take vitamin D supplements. Thus, vitamin D supplementation should be considered an effective strategy to maintain adequate 25(OH)D status among older adults.
背景 与年轻人相比，老年人（即年龄≥60岁的成年人）由于饮食中维生素D摄入不足和阳光照射有限，维生素D缺乏风险更高。因此，本研究旨在描述美国年龄≥60岁成年人中维生素缺乏和不足的患病率，以及维生素D补充剂对25-羟基维生素D（25(OH)D）及其代谢物浓度的影响。方法 本分析基于2007/2008年至2013/2014年国家健康与营养检查调查中6261名参与者的数据。根据人口统计学、行为和健康特征描述维生素D缺乏和不足的患病率。维生素D缺乏定义为25(OH)D<30nmol/L；维生素D不足定义为<50nmol/L。构建逻辑回归模型以检验参与者特征与25(OH)D不足几率之间的独立关联。同样，使用一般线性模型评估维生素D补充剂剂量对25(OH)D及其代谢物浓度的影响。结果 25(OH)D缺乏和不足的患病率分别为4.0%（标准误（SE），0.4）和17.4%（SE，0.8）。总体而言，在秋季和冬季接受检查的参与者、女性、非西班牙裔黑人患者、肥胖受试者、吸烟者、缺乏运动的人以及每日维生素D摄入量<400IU的老年人中，25(OH)D缺乏和不足的患病率显著增加。在对潜在混杂因素进行调整后，秋季和冬季接受检查的受试者、女性、非西班牙裔黑人、肥胖、久坐不动的生活方式、吸烟者以及每日总维生素D摄入量<400IU是与维生素D不足几率增加显著相关的变量。值得注意的是，400至800IU或>800IU/天的维生素D补充剂剂量与被认为充足的较高25(OH)D浓度显著相关。结论 25(OH)D不足在美国老年人中仍然普遍存在。值得注意的是，在维生素D补充剂使用者中始终能看到最佳的25(OH)D浓度。尽管有这一发现，但近一半的参与者未服用维生素D补充剂。因此，维生素D补充应被视为维持老年人25(OH)D充足状态的有效策略。
