维生素D与甲状旁腺激素：来自赤道地区人群横断面研究的数据。

Vitamin D and PTH: data from a cross-sectional study in an equatorial population.

作者信息

Neves Marques de Queiroz Natércia, Trindade Cunha de Melo Franciane, de Souza Resende Fabrício, Corrêa Janaú Luísa, Jorge Kzan de Souza Neto Norberto, Nascimento de Lemos Manuela, Lobato Virgolino Ana Carolina, Neres Iunes de Oliveira Maria Clara, Leite de Alcântara Angélica, Vilhena de Moraes Lorena, Franco David Tiago, Maia da Silva Wanderson, Souza Reis Scarlatt, Costa Dos Santos Márcia, Contente Braga de Souza Ana Carolina, Freire Piani Pedro Paulo, Arroyo Lara Mourão Neyla, Mileo Felício Karem, Felício Abrahão Neto João, Felício João Soares

出版信息

Endocr Connect. 2020 Jul;9(7):667-675. doi: 10.1530/EC-20-0206.

DOI:10.1530/EC-20-0206

PMID:32567548

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7424356/

Abstract

OBJECTIVE

Investigate the prevalence of vitamin D deficiency in an equatorial population through a large-sample study.

METHODS

Cross-sectional study with 30,224 healthy individuals from the North Region, in Brazil (Amazônia - state of Pará), who had 25-hydroxy-vitamin D (25(OH)D) and intact parathyroid hormone (PTH) serum levels measured by immunoassay method. Those with history of acute or chronic diseases were excluded. Abnormal levels of calcium, creatinine, glycemia and albumin were also exclusion criteria.

RESULTS

25(OH)D levels were 29.1 ± 8.2 ng/mL and values <12.7 ng/mL were equal to < -2 s.d. below average. Hypovitaminosis D was present in 10% of subjects according to the Institute of Medicine (values <20 ng/mL) and in 59%, in consonance with Endocrine Society (values 20-30 ng/mL as insufficiency and <20 ng/mL as deficiency) criteria. Individuals were divided according to four age brackets: children, adolescents, adults and elderly, and their 25(OH)D levels were: 33 ± 9; 28.5 ± 7.4; 28.3 ± 7.7; 29.3 ± 8.5 ng/mL, respectively. All groups differed in 25(OH)D, except adolescents vs adults. Regression model showed BMI, sex, living zone (urban or rural) and age as independent variables to 25(OH)D levels. Comparing subjects with vitamin D deficiency (<20 ng/mL) to those with vitamin D insufficiency (20-30 ng/mL), a difference between PTH levels in these two groups was observed (95.9 ± 24.7 pg/mL vs 44.2 ± 64.5 pg/mL; P < 0.01). Additionally, the most accurate predictive vitamin D level for subclinical hyperparathyroidism in ROC curve was 26 ng/mL.

CONCLUSION

Our equatorial population showed low prevalence of vitamin D hypovitaminosis ranging with age bracket. The insufficient category by Endocrine Society was corroborated by our PTH data.

摘要

目的

通过一项大样本研究调查赤道地区人群维生素D缺乏症的患病率。

方法

对来自巴西北部地区（亚马孙州帕拉州）的30224名健康个体进行横断面研究，通过免疫分析法测量其血清25-羟维生素D（25(OH)D）和完整甲状旁腺激素（PTH）水平。排除有急慢性疾病史的个体。钙、肌酐、血糖和白蛋白水平异常也作为排除标准。

结果

25(OH)D水平为29.1±8.2 ng/mL，<12.7 ng/mL的值相当于低于平均值2个标准差。根据医学研究所的标准（值<20 ng/mL），10%的受试者存在维生素D缺乏症；根据内分泌学会的标准（值20 - 30 ng/mL为不足，<20 ng/mL为缺乏），59%的受试者存在维生素D缺乏症。个体按四个年龄组划分：儿童、青少年、成年人和老年人，他们的25(OH)D水平分别为：33±9；28.5±7.4；28.3±7.7；29.3±8.5 ng/mL。除青少年与成年人外，所有组的25(OH)D水平均有差异。回归模型显示体重指数、性别、居住区域（城市或农村）和年龄是25(OH)D水平的独立变量。将维生素D缺乏（<20 ng/mL）的受试者与维生素D不足（20 - 30 ng/mL）的受试者进行比较，观察到这两组的PTH水平存在差异（95.9±24.7 pg/mL对44.2±64.5 pg/mL；P<0.01）。此外，ROC曲线中预测亚临床甲状旁腺功能亢进最准确的维生素D水平为26 ng/mL。