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血清25-羟基维生素D缺乏是老年人步态速度减慢发生率的危险因素吗?来自英国老龄化纵向研究的证据。

Is serum 25-hydroxyvitamin D deficiency a risk factor for the incidence of slow gait speed in older individuals? Evidence from the English longitudinal study of ageing.

作者信息

Marques Luiz Mariane, de Oliveira Máximo Roberta, de Souza Aline Fernanda, Batista de Souza Thales, Souza Lima Sara, Coelho Silveira Leticia, Barros Pereira da Silva Thaís, Steptoe Andrew, de Oliveira Cesar, Alexandre Tiago da Silva

机构信息

Postgraduate programme in Physical Therapy, Federal University of Sao Carlos, Sao Carlos, Brazil.

Postgraduate programme in Gerontology, Federal University of Sao Carlos, Sao Carlos, Brazil.

出版信息

Diabetes Obes Metab. 2025 Jun;27(6):3104-3112. doi: 10.1111/dom.16317. Epub 2025 Mar 13.

Abstract

AIMS

Cross-sectional studies demonstrate an association between low serum levels of vitamin D and slower gait speed in older individuals. However, longitudinal studies remain inconclusive. This study investigates whether vitamin D deficiency and insufficiency are risk factors for the incidence of slowness.

MATERIALS AND METHODS

A total of 2815 participants from the English Longitudinal Study of Ageing (ELSA), aged ≥60 years and with a baseline gait speed >0.8 m/s, were followed for six years. Baseline serum levels of vitamin D [25(OH)D] were categorized as "sufficiency" (>50 nmol/L), "insufficiency" (>30 and ≤50 nmol/L) or "deficiency" (≤30 nmol/L). Gait speed was reassessed at four and six years of follow-up to identify incident cases of slowness (walking speed ≤0.8 m/s). A Poisson regression model, adjusted for sociodemographic, behavioural and clinical characteristics at baseline, was conducted to determine the association between serum 25(OH)D levels and the risk of slowness.

RESULTS

The incidence densities of slowness per 1000 person-years were 67.4 (95% CI: 60.93-74.64) for sufficiency, 76.7 (95% CI: 68.30-86.22) for insufficiency and 90.7 (95% CI: 78.46-104.92) for deficiency. Serum 25(OH)D deficiency was associated with a 22% increase in the risk of slowness (IRR: 1.22; 95% CI: 1.01-1.49) compared with serum 25(OH)D sufficiency. No significant association was observed for serum 25(OH)D insufficiency.

CONCLUSIONS

Serum 25(OH)D deficiency is a risk factor for the incidence of slowness in older individuals, suggesting that maintaining sufficient 25(OH)D levels could be a strategic approach to minimise long-term mobility impairment.

摘要

目的

横断面研究表明,老年个体血清维生素D水平低与步态速度较慢之间存在关联。然而,纵向研究尚无定论。本研究调查维生素D缺乏和不足是否是步态迟缓发生率的危险因素。

材料与方法

对来自英国老龄化纵向研究(ELSA)的2815名年龄≥60岁且基线步态速度>0.8m/s的参与者进行了为期六年的随访。基线时血清维生素D[25(OH)D]水平分为“充足”(>50nmol/L)、“不足”(>30且≤50nmol/L)或“缺乏”(≤30nmol/L)。在随访的第四年和第六年重新评估步态速度,以确定步态迟缓(步行速度≤0.8m/s)的发病病例。采用泊松回归模型,对基线时的社会人口学、行为和临床特征进行调整,以确定血清25(OH)D水平与步态迟缓风险之间的关联。

结果

每1000人年步态迟缓的发病率密度,充足组为67.4(95%CI:60.93-74.64),不足组为76.7(95%CI:68.30-86.22),缺乏组为90.7(95%CI:78.46-104.92)。与血清25(OH)D充足相比,血清25(OH)D缺乏与步态迟缓风险增加22%相关(IRR:1.22;95%CI:1.01-1.49)。未观察到血清25(OH)D不足与步态迟缓之间存在显著关联。

结论

血清25(OH)D缺乏是老年个体步态迟缓发生率的危险因素,这表明维持充足的25(OH)D水平可能是将长期活动能力损害降至最低的一种策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/45b9/12046445/de5e8c09bc7f/DOM-27-3104-g001.jpg

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