上海地区健康成年人25羟维生素D水平及其与骨密度的关系  

Serum 25-hydroxy vitamin D and its correlation with bone mineral density in Shanghai healthy adults

作　　者：汪纯[1] 刘玉娟[1] 肖文金[1] 胡云秋[1] 李淼[1] 章振林[1] 

机构地区：[1]上海交通大学附属第六人民医院骨质疏松和骨病专科,200233

出　　处：《上海医学》2011年第3期166-170,共5页Shanghai Medical Journal

基　　金：上海市科学技术委员会重大科技专题攻关专项(10DZ1950100);上海市科学技术委员会上海市自然科学基金(11ZR1427300);上海市科学技术委员会攻关-生物医药(08411963100);国家自然科学基金面上项目(81070692)和国家自然科学基金青年项目(81000360)资助

摘　　要：目的通过测定452名上海市健康成年人血清25羟维生素D(25OHD)水平和骨密度,分析目前上海地区健康成年人的维生素D状况,并评价其与骨密度的关系。方法于2010年1-4月采集受试者的血清后,采用竞争性放射免疫分析的方法测定血清25OHD水平,并同时应用双能X线吸收仪(DXA)测定L1～4及髋部骨密度。根据血清25OHD水平分为维生素D严重缺乏(<10ng/mL)、缺乏(≥10且<20ng/mL)、不足(≥20且<30ng/mL)和充足(≥30ng/mL)4组。根据年龄分为<50岁组、≥50且<70岁组和≥70岁组。结果 389名女性受试者中,维生素D严重缺乏83名(21.3%),缺乏200名(51.4%),不足70名(18.0%),充足仅36名(9.3%);维生素D严重缺乏组的股骨颈骨密度为(0.694±0.112)g/cm2,显著低于维生素D缺乏组的(0.732±0.128)g/cm2(P=0.020);不同血清25OHD水平组间L1～4、大转子区、转子间及全髋部骨密度的差异均无统计学意义(P值均>0.05)。女性≥50且<70岁组的血清25OHD水平为(16.88±12.65)ng/mL,显著低于≥70岁组的(20.02±16.37)ng/mL(P=0.033);<50岁组的L1～4骨密度显著高于≥50且<70岁组和≥70岁组(P值均<0.01);随着年龄的增长,股骨颈、大转子区、转子间和全髋部骨密度逐渐降低,各组间的差异均有统计学意义(P值均<0.01)。63名男性受试者中,维生素D严重缺乏13名(20.6%),缺乏32名(50.8%),不足11名(17.5%),充足仅7名(11.1%),不同血清25OHD水平组间L1～4、股骨颈、大转子区、转子间和全髋部骨密度的差异均无统计学意义(P值均>0.05)。男性≥70岁组的L1～4骨密度为(1.079±0.316)g/cm2,显著高于≥50且<70岁组的(0.977±0.152)g/cm2(P=0.041)。结论在中国上海健康成年人群中存在严重的维生素D不足和缺乏状况,维生素D的状态与骨密度可能无直接关联,必须进一步进行大样本的研究来探讨维生素D与骨质疏松症及骨折的关系。Objective To determine the serum Vitamin D status in Shanghai population and investigate its correlation with bone mineral density（BMD）by studying 452 unrelated healthy adults.Methods The serum 25OHD level of all participants（389 women and 63 men）was measured by competitive radioimmunoassay from January to April 2010.Simultaneously,their BMD of lumbar spine 1-4（L1-4）and hip sites were measured by Dual-energy X-ray energy absorptiometry（DXA）.Serum vitamin D status was classified into 4 groups according to its serum 25OHD levels,severe deficiency（10 ng/mL）,deficiency（≥10-20 ng/mL）,insufficiency（≥20-30 ng/mL）and sufficiency（≥30 ng/mL）,The participants were divided into 3 age groups,50 years group,≥50 and 70 years group and ≥70 years group.Results Among the 389 females,the prevalence of vitamin D severe deficiency,deficiency,insufficiency and sufficiency were 83 cases（21.3%）,200 cases（51.4%）,70 cases（18.0%）and 36 cases（9.3%）,respectively.The BMD of femoral neck was significantly lower in the vitamin D severe deficiency subgroup than in the vitamin D deficiency subgroup（[0.694±0.112] g/cm2 vs.[0.732±0.128] g/cm2,P=0.020）.But there was no significant difference in the BMD values of L1-4,greater trochanter,intertrochanter or hip（P0.05）The serum 25OHD level was lower in the subjects aged from 50 to 69 years than in those aged ≥70 years group（[16.88±12.65] ng/mL vs.[20.02±16.37] ng/mL,P=0.033）.The BMD at L1-4 and hip were significantly higher in ≥50 and 70 years group than in ≥70 years group（P0.05）.With the increase of age,the BMD values of femur,neck trochanter,intertrochanter and total hip were gradually decreased,with significant difference among different age groups（P0.01）.In the 63 males,the prevalence of vitamin D severe deficiency,deficiency,insufficiency and sufficiency were 13 cases（20.6%）,32 cases（50.8%）,11 cases（17.5%）,and 7 cases（11.1%）,respectively.There was no significant difference in BMD values at L1-4,n

关 键 词：25羟维生素D 维生素D缺乏 维生素D不足 骨密度 

分 类 号：R580[医药卫生—内分泌]