Liu Ling, Cao Zhaojin, Lu Feng, Liu Yingchun, Lv Yuebin, Qu Yingli, Gu Heng, Li Chengcheng, Cai Jiayi, Ji Saisai, Li Yawei, Zhao Feng, Shi Xiaoming
National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, #29 Nanwei Road, Xicheng, Beijing, 100050 China.
Beijing Municipal Health Commission Information Center, (Beijing Municipal Health Commission Policy Research Center), Beijing, 100034 China.
Nutr Metab (Lond). 2020 Jul 29;17:58. doi: 10.1186/s12986-020-00479-3. eCollection 2020.
Both low vitamin D status and metabolic syndrome (MetS) are worldwide concerns, and low 25-hydroxyvitamin D [25(OH)D] levels are associated with MetS; however, related epidemiological evidence based on elderly Chinese individuals, especially those over 80 years of age, is limited. In the present study, we aimed to evaluate the association between serum 25(OH)D and MetS in elderly Chinese individuals.
Serum 25(OH)D was measured in a cross-sectional sample of 2493 elderly people aged 65-112 years from eight areas of China in which the density of centenarians is exceptionally high. MetS was diagnosed according to blood pressure, lipid, and blood sugar levels; waist circumference; and body mass index (BMI). Adjusted multivariable logistic regression was used to analyze the associations between vitamin D and MetS based on different diagnostic criterias.
A total of 890 (35.7%) of the recruited elderly individuals had insufficient levels of vitamin D, and 1029 participants (41.3%) were vitamin D deficient. High serum vitamin D concentrations were associated with a low prevalence of MetS according to the modified Adult Treatment Panel III (ATP III) criteria for adequate versus deficient vitamin D levels (OR: 0.63, 95% CI: 0.45, 0.88) and inadequate versus deficient vitamin D levels (OR: 0.70, 95% CI: 0.52, 0.92). Each 10 ng/ml increase in serum vitamin D was significantly associated with a decreased prevalence of MetS according to the modified ATP III criteria for people with normal waist circumference (WC) (OR: 0.55, 95% CI: 0.43,0.71). However, no significant statistical correlation was found among elderly people with a high WC. Additionally, in the analysis of the individual components, the ORs of adequate versus deficient vitamin D levels were 0.46 (95% CI: 0.30, 0.71) for elevated triglycerides and 0.64 (95% CI: 0.42, 0.97) for reduced high-density lipoprotein cholesterol (HDL-C) after adjustment for other components.
Vitamin D deficiency is very common among elderly Chinese individuals. Vitamin D deficiency may be a risk factor for MetS; however, the association was only statistically significant among elderly people with noncentral obesity. Further studies are needed to examine the causal direction of the association.
维生素D水平低下和代谢综合征(MetS)都是全球关注的问题,25-羟基维生素D[25(OH)D]水平低下与MetS相关;然而,基于中国老年人,尤其是80岁以上老年人的相关流行病学证据有限。在本研究中,我们旨在评估中国老年人群血清25(OH)D与MetS之间的关联。
对来自中国八个百岁老人密度异常高的地区的2493名65-112岁老年人的横断面样本进行血清25(OH)D检测。根据血压、血脂、血糖水平、腰围和体重指数(BMI)诊断MetS。采用校正后的多变量逻辑回归分析基于不同诊断标准的维生素D与MetS之间的关联。
在招募的老年人中,共有890人(35.7%)维生素D水平不足,1029名参与者(41.3%)维生素D缺乏。根据成人治疗小组第三次修订版(ATP III)中维生素D水平充足与缺乏的标准(OR:0.63,95%CI:0.45,0.88)以及维生素D水平不足与缺乏的标准(OR:0.70,95%CI:0.52,0.92),血清维生素D浓度高与MetS患病率低相关。根据修订后的ATP III标准,对于腰围(WC)正常的人群,血清维生素D每增加10 ng/ml,与MetS患病率显著降低相关(OR:0.55,95%CI:0.43,0.71)。然而,在WC高的老年人中未发现显著的统计学相关性。此外,在个体成分分析中,校正其他成分后,维生素D水平充足与缺乏相比,甘油三酯升高的OR为0.46(95%CI:0.30,0.71),高密度脂蛋白胆固醇(HDL-C)降低的OR为0.64(95%CI:0.42,0.97)。
维生素D缺乏在中国老年人中非常普遍。维生素D缺乏可能是MetS的一个危险因素;然而,这种关联仅在非中心性肥胖的老年人中具有统计学意义。需要进一步研究来检验这种关联的因果方向。