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维生素 D 缺乏与台湾髋部骨折老年患者低血清白蛋白的相关性:一项前瞻性的横断面研究。

Association of Vitamin D Deficiency with Low Serum Albumin in Taiwanese Older Adults with Hip Fracture: A Prospective Cross-Sectional Study.

机构信息

Department of General Medicine, Kaohsiung Chang Gung Memorial Hospital.

Department of Orthopedic Surgery, Wan Fang Hospital, Taipei Medical University.

出版信息

J Nutr Sci Vitaminol (Tokyo). 2021;67(3):153-162. doi: 10.3177/jnsv.67.153.

Abstract

The world's population is aging, and the prevalence of hip fracture is rising. Vitamin D deficiency is a risk factor for hip fracture and predicts functional recovery and survival following hip fracture surgery. This cross-sectional study identified the prevalence of vitamin D deficiency in Taiwanese older patients with hip fracture and potential risk factors for vitamin D deficiency. Data from older adults with hip fracture admitted to a single medical center in Taipei, Taiwan were prospectively collected. The preoperative serum 25-hydroxyvitamin D [25(OH)D] concentration and comprehensive clinical history of each patient were examined. A multinomial logistic regression model was used to compare the clinical characteristics of deficient, insufficient, and sufficient 25(OH)D concentration groups. The cohort comprised 310 older adults with hip fracture. The mean age was 80±10 y. The deficient, insufficient, and sufficient groups comprised 180, 84, and 46 patients (58.1%, 27.1%, and 14.8%), respectively. Univariate analysis revealed significant intergroup differences in serum albumin level and body fat percentage and marginally significant differences in serum albumin, estimated glomerular filtration rate, body mass index, and comorbidities of affective or psychotic disorders. In the multinomial logistic regression model, albumin level was the only factor significantly correlated with higher 25(OH)D concentrations in the sufficient and insufficient groups compared with the deficient group. No variable, including preinjury functional status, was significantly correlated with vitamin D deficiency except malnutrition. Our findings may aid the establishment of a robust screening and treatment program for vitamin D deficiency.

摘要

世界人口正在老龄化,髋部骨折的患病率也在上升。维生素 D 缺乏是髋部骨折的一个危险因素,并预测髋部骨折手术后的功能恢复和生存。这项横断面研究确定了台湾髋部骨折老年患者维生素 D 缺乏的患病率以及维生素 D 缺乏的潜在危险因素。前瞻性收集了来自台湾台北一家医疗中心的髋部骨折老年患者的数据。检查了每位患者术前血清 25-羟维生素 D [25(OH)D]浓度和全面的临床病史。使用多项逻辑回归模型比较了维生素 D 缺乏、不足和充足 25(OH)D 浓度组的临床特征。该队列包括 310 名髋部骨折的老年人。平均年龄为 80±10 岁。维生素 D 缺乏、不足和充足组分别有 180、84 和 46 名患者(58.1%、27.1%和 14.8%)。单因素分析显示,血清白蛋白水平和体脂百分比在各组间存在显著差异,血清白蛋白、估计肾小球滤过率、体重指数和情感或精神病合并症差异有统计学意义。在多项逻辑回归模型中,白蛋白水平是与充足和不足组相比,维生素 D 充足组和不足组血清 25(OH)D 浓度较高的唯一相关因素。除了营养不良外,包括受伤前功能状态在内的任何变量均与维生素 D 缺乏无关。我们的研究结果可能有助于建立一个强大的维生素 D 缺乏筛查和治疗计划。

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