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血清 25-羟维生素 D 水平越高是否会损害骨密度?一项横断面研究。

Does higher serum 25-hydroxyvitamin D levels will harm bone mineral density?: a cross-sectional study.

机构信息

Department of Geriatrics, Wuhan Wuchang Hospital, Wuhan, 430063, China.

Department of Dermatology, Wuhan Wuchang Hospital, Wuhan, 430063, China.

出版信息

BMC Endocr Disord. 2024 Nov 18;24(1):250. doi: 10.1186/s12902-024-01760-9.

Abstract

OBJECTIVE

Vitamin D plays a critical role in the prevention and management of osteoporosis. However, there is an ongoing debate regarding the most effective vitamin D supplementation strategies for maintaining optimal bone mineral density (BMD) levels in adults. This study sought to establish the correlation between serum 25-hydroxyvitamin D [25(OH)D] levels and total BMD in a substantial population sample.

METHODS

Data from the National Health and Nutrition Examination Survey (NHANES) for the 2011-2018 cycles, encompassing 11,375 adult participants, were analyzed. The primary variables of interest were serum 25(OH)D levels and BMD. A multivariable logistic regression model was utilized to account for relevant variables associated with these correlations.

RESULTS

A U-shaped relationship between serum 25(OH)D levels and BMD was observed. In males, a significant positive association was identified for 25(OH)D levels below 84.8 nmol/L (p < 0.0001), while levels above this threshold showed no significant correlation (p = 0.3377). In females, those with 25(OH)D levels below 31.4 nmol/L exhibited a significant positive association with BMD (p = 0.0010), but this association weakened and became marginally significant above this threshold (p = 0.0650).

CONCLUSIONS

For adult males, the optimal serum 25(OH)D level is 84.8 nmol/L, beyond which higher levels do not lead to increased BMD. A deficiency threshold for adult females should be above 31.4 nmol/L, as lower 25(OH)D levels are not conducive to BMD. These findings underscore the importance of maintaining appropriate vitamin D levels for bone health in both genders.

摘要

目的

维生素 D 在预防和治疗骨质疏松症方面起着关键作用。然而,关于成人维持最佳骨矿物质密度(BMD)水平的最有效维生素 D 补充策略,目前仍存在争议。本研究旨在建立一个大样本人群中血清 25-羟维生素 D [25(OH)D]水平与总 BMD 之间的相关性。

方法

分析了 2011-2018 年国家健康和营养检查调查(NHANES)的数据,共纳入 11375 名成年参与者。主要观察变量为血清 25(OH)D 水平和 BMD。采用多变量逻辑回归模型来解释与这些相关性相关的变量。

结果

血清 25(OH)D 水平与 BMD 之间存在 U 型关系。在男性中,25(OH)D 水平低于 84.8 nmol/L 时,存在显著的正相关关系(p<0.0001),而高于此阈值时,无显著相关性(p=0.3377)。在女性中,25(OH)D 水平低于 31.4 nmol/L 时,与 BMD 呈显著正相关(p=0.0010),但高于此阈值时,相关性减弱且呈边缘显著(p=0.0650)。

结论

对于成年男性,最佳血清 25(OH)D 水平为 84.8 nmol/L,高于该水平时,更高的水平不会导致 BMD 增加。成年女性的缺乏阈值应高于 31.4 nmol/L,因为较低的 25(OH)D 水平不利于 BMD。这些发现强调了在两性中维持适当的维生素 D 水平对骨骼健康的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5499/11572519/df96a916fd5e/12902_2024_1760_Fig1_HTML.jpg

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