澳大利亚患者人群的维生素 D 状况：一项大型回顾性病例系列研究，重点关注与血清 25(OH)D 变化相关的因素。

Vitamin D status in an Australian patient population: a large retrospective case series focusing on factors associated with variations in serum 25(OH)D.

机构信息

Department of Physiology, University of Melbourne, Parkville, Victoria, Australia.

Department of Neuroscience, Monash Univeristy, Melbourne, Victoria, Australia.

出版信息

BMJ Open. 2020 Mar 4;10(3):e032567. doi: 10.1136/bmjopen-2019-032567.

DOI:10.1136/bmjopen-2019-032567

PMID:32139482

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7059428/

Abstract

OBJECTIVES

To investigate whether sex, age, medical specialty and seasonal variations in serum concentration of 25-hydroxy vitamin D (25(OH)D) are evident among an Australian patient population.

DESIGN

Retrospective study analysing the results of serum 25(OH)D lab tests and vitamin D supplementation from Royal Melbourne Hospital (RMH) between 2014 and 2017.

SETTING

Tertiary healthcare centre in Victoria, Australia.

PARTICIPANTS

30 023 patients (inpatient and outpatient) who had their serum 25(OH)D levels measured at RMH between 2014 and 2017.

MAIN OUTCOME MEASURES

Serum 25(OH)D levels stratified according to patients' sex, age and medical specialty admitted to, as well as the season and year (2014 to 2017) 25(OH)D level was measured.

RESULTS

Mean serum 25(OH)D level of study population was 69.9 nmol/L (95% CI 69.5 to 70.2). Only 40.2% patients in this cohort were sufficient in vitamin D (>75 nmol/L). On average, 25(OH)D levels in male patients were 6.1 units (95% CI 5.4 to 6.9) lower than in females. Linear regression analysis found that 25(OH)D levels increased by 0.16 unit (95% CI 0.14 to 0.18) for every year increase in age. One-way analysis of variance showed patients from neurology had the highest average 25(OH)D level, 76.8 nmol/L (95% CI 74.2 to 79.3) compared with other medical specialties. Mean 25(OH)D level during winter, 64.9 nmol/L (95% CI 64.2 to 65.6) was significantly lower compared with other seasons despite supplementation. Average 25(OH)D level measured in 2014, 71.5 nmol/L (95 CI% 70.8 to 72.2) was significantly higher than levels measured in 2016-2017.

CONCLUSIONS

There is a sex, age, medical specialty, seasonal and yearly variation in vitamin D status in an Australian patient population. The association between low vitamin D status and winter despite supplementation suggests other interventions are required to boost serum 25(OH)D levels.

摘要

目的

研究在澳大利亚患者人群中，血清 25-羟维生素 D（25（OH）D）浓度是否存在性别、年龄、医学专业和季节性变化。

设计

对 2014 年至 2017 年期间皇家墨尔本医院（RMH）的血清 25（OH）D 实验室检测和维生素 D 补充结果进行回顾性研究。

地点

澳大利亚维多利亚州的三级保健中心。

参与者

2014 年至 2017 年间在 RMH 测量血清 25（OH）D 水平的 30023 名（住院和门诊）患者。

主要观察指标

根据患者性别、年龄和所就诊的医学专业对血清 25（OH）D 水平进行分层，以及测量 25（OH）D 水平的季节和年份（2014 年至 2017 年）。

结果

研究人群的平均血清 25（OH）D 水平为 69.9 nmol/L（95%CI 69.5 至 70.2）。该队列中仅有 40.2%的患者维生素 D 充足（>75 nmol/L）。平均而言，男性患者的 25（OH）D 水平比女性低 6.1 个单位（95%CI 5.4 至 6.9）。线性回归分析发现，年龄每增加 1 岁，25（OH）D 水平增加 0.16 个单位（95%CI 0.14 至 0.18）。单因素方差分析显示，神经内科患者的平均 25（OH）D 水平最高，为 76.8 nmol/L（95%CI 74.2 至 79.3），高于其他医学专业。尽管进行了补充，但冬季 64.9 nmol/L（95%CI 64.2 至 65.6）的平均 25（OH）D 水平明显低于其他季节。2014 年测量的平均 25（OH）D 水平为 71.5 nmol/L（95%CI% 70.8 至 72.2），明显高于 2016-2017 年的水平。