补充维生素D对骨质疏松症和骨量减少患者骨密度和骨折风险的影响  

Effect of vitamin D supplementation on bone mineral density and fracture risk in patients with osteoporosis and osteopenia

作　　者：汪思阳[1] 沈展[1] 沈婷婷[1] 曲伸[2] 席蓓莉[1] 

机构地区：[1]上海市徐汇区中心医院老年病科,上海200031 [2]上海市第十人民医院内分泌科,上海200072

出　　处：《内科理论与实践》2016年第2期80-83,共4页Journal of Internal Medicine Concepts & Practice

基　　金：2013年徐汇区医学科研课题(项目编号:SGXH201302)

摘　　要：目的 :探讨补充维生素D对骨质疏松症和骨量减少患者骨密度(BMD)和骨折风险的影响。方法:在上海市徐汇区湖南路街道社区的居民和我院老年病科及骨质疏松门诊中通过BMD的检查筛选出骨质疏松症及骨量减少的研究对象,询问病史,完成实验室检查。根据血清维生素D的水平分为维生素D缺乏组和维生素D正常组2组,以骨折风险因子评估工具(FRAX)分别估算骨折风险值。对2组患者进行健康教育和生活方式干预,所有研究对象每日补充1粒钙片,缺乏组加用骨化三醇0.25μg/d。随访1年后,复查BMD值及估算骨折风险值。结果:共纳入118例患者,维生素D正常组45例,缺乏组73例。2组在随访前后的年龄、身高差(最高身高-目前身高)、体重、体质量指数(BMI)、BMD、骨折风险值都无统计学差异(均P>0.05)。但比较干预前后,2组的BMD差值(P=0.005)及维生素D缺乏组的骨折风险值(P=0.003)均存在显著性的统计学差异。结论:骨量减少和骨质疏松症患者血清维生素D正常组较维生素D缺乏组在预防骨量进一步减少和降低骨折风险方面获益更多。Objective To evaluate the effect of vitamin D supplementation on bone mineral density and fracture risk in patients with osteoporosis and osteopenia.Methods Subjects with osteoporosis and osteopenia were identified by bone mineral density examination in residents of Hu ＇nan community,Xuhui district,Shanghai.All the subjects were questioned for their medical history and tested for lab examinations.The enrolled subjects were categorized into vitamin D deficiency and vitamin D normal group according to the serum level of vitamin D.The value of fracture risk was assessed.With health education and living style intervention,the subjects were given daily calcium supplement,and rocalirol 0.25 μg/d was added in subjects in group of vitamin D deficiency.All subjects were followed for one year and the bone mineral den-sity and value of fracture risk were re-checked.Results A total of 118 subjects were included：vitamin D deficiency group in 73 and vitamin D normal group in 45.There was no statistical significant difference in age,height reduction,weight,body mass index（BMI）,bone mineral density,and value of fracture risk between the two groups.After intervention,there were statistically significant differences in bone density（P=0.005） and value of fracture risk（P=0.003） between the two groups.Conclusions Subjects with normal vitamin D could get more benefits than subjects with vitamin D deficiency in terms of preventing osteoporosis and lowering fracture risk.

关 键 词：维生素D 骨质疏松症 骨折风险值 慢病管理 

分 类 号：R580[医药卫生—内分泌]