中国北方农村基于人群的病例对照研究：社会经济地位与育龄妇女维生素 D 缺乏症。
Socioeconomic status and vitamin D deficiency among women of childbearing age: a population-based, case-control study in rural northern China.
机构信息
Institute of Population Research/China Center on Population Health and Development, Peking University, Beijing, China.
National Health Commission Key Laboratory of Birth Defects Prevention, Henan Key Laboratory of Population Defects Prevention, Zhengzhou, Henan, China.
出版信息
BMJ Open. 2021 Mar 22;11(3):e042227. doi: 10.1136/bmjopen-2020-042227.
OBJECTIVE
To explore the association between socioeconomic status (SES) and vitamin D deficiency/insufficiency of women of childbearing age in rural northern China.
DESIGN
A population-based, case-control study was conducted.
SETTING
Four counties of Henan Province, China from 2009 to 2010.
PARTICIPANTS
1151 non-pregnant healthy women between 18 and 40 years old.
PRIMARY AND SECONDARY OUTCOME MEASURES
Serum 25-hydroxyvitamin D (25(OH)D) levels were measured using high-performance liquid chromatography-tandem mass spectrometry. Vitamin D insufficiency was defined as serum 25(OH)D ≥20 ng/mL and <30 ng/mL, deficiency as ≥10 ng/mL and <20 ng/mL, and severe deficiency as <10 ng/mL. SES was measured separately by women's and their husbands' education level and occupation, household income and expenditure, as well as aggregately by SES index constructed with principal component analysis.
RESULTS
The median serum 25(OH)D level was 20.90 (13.60-34.60) ng/mL, and the prevalence of vitamin D insufficiency, deficiency and severe deficiency was 20.16%, 31.80% and 15.99%, respectively. After adjustment, household annual income <¥10 000 was associated with increased risk of vitamin D insufficiency (adjusted OR (aOR): 2.10, 95% CI 1.41 to 3.14), deficiency (aOR: 1.58, 95% CI 1.09 to 2.29) and severe deficiency (aOR: 2.79, 95% CI 1.78 to 4.38); inadequate household income for expenditure was associated with elevated risk of vitamin D insufficiency (aOR: 1.66, 95% CI 1.08 to 2.54) and deficiency (aOR: 1.81, 95% CI 1.26 to 2.62); low SES index was associated with elevated risk of vitamin D insufficiency (aOR: 2.40, 95% CI 1.52 to 3.80) and deficiency (aOR: 1.64, 95% CI 1.08 to 2.50); and both middle and low SES index were associated with increased risk of vitamin D severe deficiency (aOR: 1.70, 95% CI 1.02 to 2.84; aOR: 2.45, 95% CI 1.45 to 4.14).
CONCLUSIONS
Lower SES was associated with higher risk of vitamin D deficiency/insufficiency in women of childbearing age in rural northern China. More should be done to explore potential mechanisms and to narrow down SES inequalities in vitamin D status.
目的
探讨中国北方农村育龄妇女社会经济地位（SES）与维生素 D 缺乏/不足的关系。
设计
基于人群的病例对照研究。
地点
中国河南省 2009-2010 年的 4 个县。
参与者
1151 名年龄在 18 至 40 岁之间的非孕妇健康女性。
主要和次要结果措施
使用高效液相色谱-串联质谱法测量血清 25-羟维生素 D（25（OH）D）水平。维生素 D 不足定义为血清 25（OH）D≥20ng/mL 且＜30ng/mL，缺乏定义为≥10ng/mL 且＜20ng/mL，严重缺乏定义为＜10ng/mL。SES 分别通过女性及其丈夫的教育水平和职业、家庭收入和支出来衡量，以及通过主成分分析构建的 SES 指数进行综合衡量。
结果
中位血清 25（OH）D 水平为 20.90（13.60-34.60）ng/mL，维生素 D 不足、缺乏和严重缺乏的患病率分别为 20.16%、31.80%和 15.99%。调整后，家庭年收入＜¥10000 与维生素 D 不足（调整后的 OR（aOR）：2.10，95%CI 1.41 至 3.14）、缺乏（aOR：1.58，95%CI 1.09 至 2.29）和严重缺乏（aOR：2.79，95%CI 1.78 至 4.38）风险增加相关；家庭支出不足与维生素 D 不足（aOR：1.66，95%CI 1.08 至 2.54）和缺乏（aOR：1.81，95%CI 1.26 至 2.62）风险升高相关；低 SES 指数与维生素 D 不足（aOR：2.40，95%CI 1.52 至 3.80）和缺乏（aOR：1.64，95%CI 1.08 至 2.50）风险升高相关；中低 SES 指数与维生素 D 严重缺乏（aOR：1.70，95%CI 1.02 至 2.84；aOR：2.45，95%CI 1.45 至 4.14）风险增加相关。
结论
中国北方农村育龄妇女 SES 较低与维生素 D 缺乏/不足风险增加相关。应进一步探索潜在机制，并缩小维生素 D 状况方面的 SES 不平等。
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