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维生素 D 缺乏的老年人更容易患代谢综合征,但代谢综合征的参数并不多。

Vitamin D Deficient Older Adults Are More Prone to Have Metabolic Syndrome, but Not to a Greater Number of Metabolic Syndrome Parameters.

机构信息

Department of Medicine, Federal University of São Carlos (UFSCar), São Carlos 13565-905, Brazil.

Department of Gerontology, Federal University of São Carlos (UFSCar), São Carlos 13565-905, Brazil.

出版信息

Nutrients. 2020 Mar 12;12(3):748. doi: 10.3390/nu12030748.

Abstract

This study investigated the relationship between metabolic parameters and low serum 25-hydroxyvitamin D (25(OH)D) levels in older adults (n = 265). They were assessed for anthropometrics and metabolic measurements, including 25(OH)D, insulin, glucose, total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglycerides (TG) and other inflammatory markers. Vitamin D deficiency was defined as a 25(OH)D level below 50 nmol/L. Comparisons between groups were performed using Wilcoxon-Mann-Whitney or Pearson's Chi-squared test. A multivariate adjusted Poisson regression was used to model the number of metabolic parameters as a function of a set of explanatory variables. Subjects with 25(OH)D deficiency were predominantly females and presented higher body weight, body mass index, waist circumference, triglycerides and Tumor Necrosis Factor-α (TNF-α), and higher insulin resistance. Metabolic syndrome was also more prevalent among 25(OH)D-deficient subjects. In those without metabolic syndrome, 25(OH)D deficiency was related only to obesity and higher insulin resistance. Female sex, hypertension, higher waist circumference and higher levels of hemoglobin A1C (%), HDL-C, and TG were significantly associated with an increased number of metabolic syndrome parameters after adjusting for covariates, but 25(OH)D was not. The fact that serum 25(OH)D concentration was inversely associated with metabolic syndrome and insulin resistance not only reaffirms the relevance to consider serum 25(OH)D concentration as an influencing factor for insulin resistance, but also the need to actively screen for hypovitaminosis D in all patients with this condition.

摘要

本研究调查了代谢参数与老年人(n=265)低血清 25-羟维生素 D(25(OH)D)水平之间的关系。他们接受了人体测量学和代谢测量,包括 25(OH)D、胰岛素、葡萄糖、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、甘油三酯(TG)和其他炎症标志物。维生素 D 缺乏症定义为 25(OH)D 水平低于 50nmol/L。使用 Wilcoxon-Mann-Whitney 或 Pearson's Chi-squared 检验比较组间差异。使用多变量调整泊松回归模型将代谢参数数量作为一组解释变量的函数进行建模。25(OH)D 缺乏的受试者主要为女性,体重、体重指数、腰围、甘油三酯和肿瘤坏死因子-α(TNF-α)较高,胰岛素抵抗也较高。代谢综合征在 25(OH)D 缺乏的受试者中也更为普遍。在没有代谢综合征的受试者中,25(OH)D 缺乏仅与肥胖和更高的胰岛素抵抗有关。在调整协变量后,女性、高血压、较高的腰围和较高的血红蛋白 A1C(%)、HDL-C 和 TG 水平与代谢综合征参数的数量增加显著相关,但 25(OH)D 与代谢综合征参数的数量增加无关。血清 25(OH)D 浓度与代谢综合征和胰岛素抵抗呈负相关,这不仅再次证实了考虑血清 25(OH)D 浓度作为胰岛素抵抗的影响因素的相关性,而且还需要积极筛查所有患有这种疾病的患者的维生素 D 缺乏症。

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