中老年人群25-羟维生素D与代谢综合征关系的研究  

Association between 25-hydroxyvitamin D and metabolic syndrome in middle-aged and elderly population

作　　者：林寰东[1] 高键[2] 马慧[1] 李小明[1] 宋斌斌[3] 潘柏申[3] 盛建华 陈旭昇 高鑫[1] 

机构地区：[1]复旦大学附属中山医院内分泌代谢科,上海200032 [2]复旦大学附属中山医院营养科,上海200032 [3]复旦大学附属中山医院检验科,上海200032 [4]长风社区卫生服务中心,上海200062

出　　处：《中华内分泌代谢杂志》2013年第10期840-845,共6页Chinese Journal of Endocrinology and Metabolism

基　　金：国家科技部“十一五”科技支撑计划项目（2008BAI52B03、2009BAI80B01）;上海市卫生局“临床流行病学重点学科建设”项目（08GWZX0203）;上海市科委重大项目（08dj1400601）

摘　　要：目的 探讨维生素D与代谢综合征之间的关系。方法 对536名45岁以上来自上海长风社区人群进行横断面问卷调查,形体测量,检测血脂、空腹血糖、糖负荷后2h血糖,25-羟维生素D[25（OH）D]和甲状旁腺素（PTH）。采用双能X线吸收法测定骨矿含量。代谢综合征诊断采用国际糖尿病联盟（IDF）标准。结果 代谢综合征的检出率为35.6%。与非代谢综合征组相比,代谢综合征组的25（OH）D水平降低[（42.53 ± 13.58对46.72 ± 16.83）nmol/L,P=0.004],PTH水平升高[（41.61 ± 14.06对39.25 ± 12.93）mmol/L,P=0.050]。按25（OH）D水平由高到低三分位分组后,代谢综合征的检出率逐步增高（分别为29.1%,38.9%和40.0%,趋势P=0.035）。与最高组（≥49.75nmol/L）相比,中间组（37.38～49.75nmol/L）和最低组（≤37.38nmol/L）发生代谢综合征的比值比（OR）分别为1.049（95% CI0.683～1.610）和1.621（95% CI1.040～2.532）。Logistic回归分析分别校正代谢综合征组分、PTH和骨矿含量后显示25（OH）D水平与代谢综合征呈负相关（OR=0.975,95% CI0.957～0.994）。结论 25（OH）D水平降低是除腰围、空腹血糖和甘油三酯等传统因素以及PTH和骨矿含量以外,可能为发生代谢综合征的独立危险因素。Objective To explore the relationship between vitamin D and metabolic syndrome. Methods A total of 536 subjects aged over 45 years old from Shanghai Changfeng community were included. A standard questionnaire, anthropometric parameters, and blood analysis, including lipid, fasting plasma glucose, 2 h plasma glucose after oral glucose tolerance test, 25-hydroxyvitamin D[25（OH）D], and parathyroid hormone （PTH）were conducted. Bone mineral content was examined using dual energy X-ray assay. Metabolic syndrome was diagnosed according to the International Diabetes Federation （IDF）criteria. Results Altogelher, 35.6% of 536 subjects developed metabolic syndrome. Subjects with metabolic syndrome had lower 25（OH）D and higher PTH concentration than those individuals without metabolic syndrome[25（OH）D： （42.53 ± 13.58 vs 46.72 ± 16.83）nmol/L, P=0.004; PTH： （41.61 ± 14.06 vs 39.25 ± 12.93）mmol/L, P=0.050]. From the highest to the lowest tertile of 25（OH）D, 29.1%, 38.9%, and 40.0% of participants, respectively, had metabolic syndrome （Ptrend=0.035）. Compared with the highest tertile of 25（OH）D, the odds ratios （OR）for metabolic syndrome in the middle and lowest tertile were 1.049 （95% CI 0.683-1.610）and 1.621 （95% CI 1.040-2.532）respectively. Logistic regression analysis revealed that metabolic syndrome was associated with lowered 25（OH）D （OR=0.975, 95% CI 0.957-0.994）after adjusted for simple component of metabolic syndrome, PTH, and bone mineral content. Conclusions Lowered 25（OH）D level seems to be a risk factor for metabolic syndrome, independent of traditional risk factor, such as waist circumference, fasting glucose, triglyceride, PTH, and bone mineral content.

关 键 词：25-羟维生素D 代谢综合征 甲状旁腺素 骨矿含量 

分 类 号：R589[医药卫生—内分泌]