中老年女性维生素A营养状况与骨密度关系的调查研究  

Association of vitamin A with bone mineral density in middle-aged and aged females

作　　者：刘臻[1] 赖建强[2] 谷秀芳[3] 巩建厂[4] 朱染枫[1] 刘海滨[3] 颜世义[3] 严秀丽[4] 王茵[1] 

机构地区：[1]浙江省医学科学院,杭州310013 [2]中国疾病预防控制中心慢病中心 [3]泰山医学院 [4]泰安市泰山区疾病预防控制中心

出　　处：《卫生研究》2011年第6期723-726,共4页Journal of Hygiene Research

基　　金：中国营养学会"营养科研基金"2005年度资助项目;浙江省卫生高层次创新人才培养项目;浙江省151人才培养项目;浙江省科技厅(No.2009R50028;2009F20035)

摘　　要：目的研究中老年女性膳食维生素A的摄入情况及其与骨密度(BMD)的关系。方法招募250位45～66岁之间的中老年妇女,进行基本体检、血样采集、膳食调查和BMD检测。血清视黄醇和β-胡萝卜素(β-C)的测定采用高效液相色谱(HPLC)方法,血清中骨转化标志物[骨碱性磷酸酶(BSAP)、骨钙素和25-(OH)D3)]和其他血尿指标用试剂盒进行检测。将调查对象按照BMD高低分组,比较两组之间膳食视黄醇当量(RE)摄入和血清视黄醇等指标的差异。结果人群平均RE的摄入量为455.8μg(n=169),达到RNI的65.1%。正常BMD组的血清视黄醇和血清β-C水平都略高于低BMD组,但无统计学差异。正常BMD组维生素A摄入量低于低BMD组53.0μg,而类胡萝卜素高于低BMD组107.6μg。在摄入的RE中,正常BMD组来源于类胡萝卜素的RE比例高于低BMD组。BMD和膳食视黄醇当量水平的双变量相关性分析显示两者在数值上有微弱的负相关趋势(P=0.203,r=-0.140)。正常BMD组和低BMD组之间年龄、骨矿物质含量、体质指数(BMI)和BSAP有显著差异(P<0.001或P<0.01)。双变量相关性分析显示,和BMD显著相关的因素有年龄(P<0.001,r=-0.380),绝经年龄(P<0.05,r=0.244),BMI(P<0.001,r=0.394),体重(P<0.001,r=0.434)。基本情况、血清指标和膳食摄入情况与BMD进行逐步线性回归分析,显示体重、绝经年数和BSAP进入回归方程(R2=0.552,F=24.661,P<0.001),与BMD显著性相关。结论 (1)人群视黄醇当量摄入量未达到RNI,膳食补充剂的服用情况不是很普遍(32.5%)。(2)人群奶类及奶制品、豆类及豆制品摄入量偏低,钙摄入量不到AI的50%。(3)在正常浓度范围内,较高的血清视黄醇水平可能有利于维持BMD。(4)RE摄入水平过高,可能与BMD降低有关,特别是股骨BMD。Objective To find out the vitamin A intake in middle-aged and aged females,and to investigate the relationship between retinol intake and bone mineral density（BMD）.Methods Two hundred and fifty women aged 45 to 66 were enrolled and received physical examination and BMD scanning,and their fasting blood samples and dietary records were collected.Serum retinol and beta-carotene were analyzed by HPLC.Assays for bone turnover markers（such as bone specific alkaline phosphatase,osteocalcin and 25-（OH）D3）in serum were performed by using commercially available kits.Subjects were divided into normal BMD group and low BMD group,and the dietary RE intakes and serum retinol were compared.Results The average RE intake was 455.8μg（n=169）,which reached 65.1% of RNI.Serum retinol and beta-carotene in normal BMD group were a little bit higher than the low BMD group,but there was no statistic difference.Vitamin A intake of normal BMD group was 53.0μg,which was lower than the low BMD group,and carotene intake of normal BMD group was 107.6μg,which was higher than the low BMD group.The ratio of plant sourced retinol in normal BMD group was higher than the low BMD group.Bivariate correlation analysis on BMD and dietary RE intake showed no statistic correlation,but with a slight negative trend（P=0.203,r=-0.140）.There was a significantly difference in age,bone mineral contents,BMI and BSAP between low BMD group and normal BMD group（P0.001 or P0.01）,and bivariate correlation analysis showed that the age（P0.001,r=-0.380）,BMI（P0.001,r=0.394）menopausal age（P0.05,r=0.244）and body weight（P0.001,r=0.434）were significantly correlated with BMD.The result of stepwise linear regression analysis showed that the age,menopausal years and BSAP were entered into the regression equation（R2=0.552,F=24.661,P0.001）,which indicated a strong connection with BMD.Conclusion（a）RE intake did not reach RNI,and the use of supplements was not common（32.5%）.（b）The intake of milk and milk products and beans an

关 键 词：视黄醇 维生素A 骨密度 中老年妇女 

分 类 号：R151.42[医药卫生—营养与食品卫生学] R153.1[医药卫生—公共卫生与预防医学]