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血清 25-羟维生素 D 与多民族青年成年人的骨微结构和骨强度相关。

Serum 25-Hydroxyvitamin D is Associated With Bone Microarchitecture and Strength in a Multiracial Cohort of Young Adults.

机构信息

Endocrine Unit, Massachusetts General Hospital, Boston, MA 02114, USA.

Harvard Medical School, Boston, MA 02215, USA.

出版信息

J Clin Endocrinol Metab. 2022 Aug 18;107(9):e3679-e3688. doi: 10.1210/clinem/dgac388.

Abstract

PURPOSE

To determine whether 25-hydroxyvitamin D (25-OH D) levels are associated with bone outcomes in a multiracial cohort of young adults.

METHODS

This cross-sectional study included 165 participants (83 men, 82 women, 18-30 years of age) who self-identified as Asian, Black, or White. We measured bone microarchitecture and strength of the distal radius and tibia using high-resolution peripheral quantitative computed tomography. We used linear regression to estimate the association between 25-OH D (ng/mL) and bone measurements, adjusting for race, sex, age, weight, height, calcium intake, physical activity, and season.

RESULTS

A total of 43.6% of participants were 25-OH D deficient (<20 ng/mL) with greater prevalence in Asian (38.9%) and Black (43.1%) compared with White (18.0%) participants (P < 0.001). At the distal radius, 25-OH D was positively associated with cortical area, trabecular density, cortical thickness, cortical porosity, and failure load (P < 0.05 for all). At the distal tibia, higher 25-OH D was associated with higher cortical area, trabecular density, trabecular number, failure load, and lower trabecular separation and cortical density (P < 0.05 for all). After multivariable adjustment, those with 25-OH D deficiency had generally worse bone microarchitecture than those with 25-OH D sufficiency. Black individuals had largely more favorable bone outcomes than Asian and White individuals, despite higher prevalence of 25-OH D deficiency.

CONCLUSIONS

We found a high prevalence of 25-OH D deficiency in a multiracial cohort of young adults. Lower 25-OH D was associated with worse bone outcomes at the distal radius and tibia at the time of peak bone mass, warranting further attention to vitamin D status in young adults.

摘要

目的

确定在一个多民族的年轻成年人队列中,25-羟维生素 D(25-OH D)水平是否与骨结局相关。

方法

这项横断面研究纳入了 165 名参与者(83 名男性,82 名女性,年龄 18-30 岁),他们自认为是亚洲人、黑人或白人。我们使用高分辨率外周定量计算机断层扫描来测量桡骨远端和胫骨的骨微结构和强度。我们使用线性回归来估计 25-OH D(ng/mL)与骨测量值之间的关联,调整种族、性别、年龄、体重、身高、钙摄入量、身体活动和季节。

结果

共有 43.6%的参与者存在 25-OH D 缺乏症(<20ng/mL),其中亚洲人(38.9%)和黑人(43.1%)的患病率高于白人(18.0%)(P<0.001)。在桡骨远端,25-OH D 与皮质面积、骨小梁密度、皮质厚度、皮质孔隙率和断裂负荷呈正相关(所有 P 值均<0.05)。在胫骨远端,较高的 25-OH D 与较高的皮质面积、骨小梁密度、骨小梁数量、断裂负荷以及较低的骨小梁间距和皮质密度相关(所有 P 值均<0.05)。经多变量调整后,25-OH D 缺乏症患者的骨微结构通常比 25-OH D 充足症患者更差。尽管黑人的 25-OH D 缺乏症患病率较高,但黑人的骨结局大多比亚洲人和白人更有利。

结论

我们在一个多民族的年轻成年人队列中发现了较高的 25-OH D 缺乏症患病率。较低的 25-OH D 与桡骨远端和胫骨的骨结局较差相关,在峰值骨量时需要进一步关注年轻人的维生素 D 状态。

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