中国老年人维生素D水平多中心调查分析  

Multicenter survey and analysis of vitamin D level in elderly people in China

作　　者：李海侠[1] 龚美亮[2] 邓新立[2] 裘宇容[1] 丛玉隆[2] Li Haixia;Gong Meiliang;Deng Xinli;Qiu Yurong;Cong Yulong(Department of Laboratory Medicine,Nanfang Hospital,Southern Medical University,Guangzhou 510515,China;Department of Clinical Laboratory,Second Medical Center of Chinese PLA General Hospital,Beijing 100853,China)

机构地区：[1]南方医科大学南方医院检验科,广州510515 [2]解放军总医院第二医学中心检验科,北京100853

出　　处：《中华检验医学杂志》2021年第1期39-44,共6页Chinese Journal of Laboratory Medicine

基　　金：国家卫生健康委员会老龄健康司项目(2019年);军委后勤保障部卫生局保健专项课题(17BJZ45)。

摘　　要：目的利用全国多家中心临床大数据来评估我国老年人群不同性别及年龄段维生素D水平的分布特征。方法 2017年5月至2018年2月,采集全国10家三甲医院的5 464名年龄≥60岁体检和入院老年人群的血清标本,排除恶性肿瘤、严重感染性疾病以及肾功能衰竭的患者。其中男性2 971名,女性2 493名,并分为60~69、70~79、≥80岁3个年龄组。采用罗氏、新产业的化学发光分析仪及配套试剂测定血清25羟维生素D[25(OH)D]水平。根据美国内分泌学会推荐标准,评估我国老年人群维生素D水平状态。结果年龄≥60岁以上老年人中25(OH)D罗氏和新产业的检测值分别为22.81(15.83,31.18)和16.90(13.60,21.30)ng/ml,二者比较差异有统计学意义(P<0.01)。对男性25(OH)D检测值,罗氏和新产业分别为24.50(17.54,33.02)和17.60(14.20,22.50)ng/ml;女性分别为20.71(13.98,28.72)和16.00(12.90,20.00)ng/ml,男性25(OH)D水平明显高于女性(P<0.01)。60~69、70~79、≥80岁3个年龄组的25(OH)D检测值,罗氏为23.76(17.02,31.90)、22.23(15.20,30.38)和20.98(13.60,29.87)ng/ml,年龄组间比较差异有统计学意义(P<0.01);新产业为17.30(14.00,22.10)、16.70(13.60,20.80)和15.60(12.40,20.40)ng/ml,年龄组间比较差异也有统计学意义(P<0.01)。罗氏及新产业两种仪器在10家医院之间测得的25(OH)D水平差异均有统计学意义(P均<0.01),2种检测结果在10家医院中的整体趋势一致。罗氏检测分析老年人群维生素D充足率为28.04%(1 532/5 464),不足率为31.92%(1 744/5 464),缺乏率为40.04%(2 188/5 464);新产业检测分析老年人群维生素D充足率为7.01%(383/5 464),不足率为24.18%(1 321/5 464),缺乏率为68.81%(3 760/5 464)。结论血清25(OH)D水平在不同年龄段和性别的老年人中分布不同,我国老年人群整体存在25(OH)D水平不足或缺乏状态;罗氏与新产业两个不同检测系统25(OH)D检测结果没有可比性。建议各医学实验室出据25(OH)D检验报告时应附有该�Objective To evaluate the distribution of vitamin D levels in the elderly population in China using clinical big data from multiple centers across the country.Methods From May 2017 to February 2018,a total of 5464 serum samples from elderly people over 60 years of age were collected from 10 central hospitals across the country.Patients with malignant tumors,severe infectious diseases,and renal failure were excluded.There were 2971 males and 2493 females in this cohort,and participants were divided into three age groups:60-69 years old,70-79 years old,and≥80 years old.Roche and Snibe chemiluminescence analyzers and supporting reagents were used to determine the serum 25(OH)D levels.The vitamin D level of the elderly people in our country was assessed according to the recommendations of the American Society of Endocrinology.Results The results showed that,the serum 25(OH)D level of Roche and Snibe in this cohort was 22.81(15.83,31.18)and 16.90(13.60,21.30)ng/ml,respectively and there was statistically significant difference between the values derived from these two methods(P<0.01).The serum 25(OH)D level of Roche and Snibe was 24.50(17.54,33.02)and 17.60(14.20,22.50)ng/ml in males,20.71(13.98,28.72)and 16.00(12.90,20.00)ng/ml in females,the 25(OH)D level was significantly higher in males than in females(P<0.01).Among the three age groups,the serum 25(OH)D level was 23.76(17.02,31.90),22.23(15.20,30.38)and 20.98(13.60,29.87)ng/ml,respectively by Roche method,the differences were statistically significant(P<0.01).The serum 25(OH)D level measured by Snibe was 17.30(14.00,22.10),16.70(13.60,20.80)and 15.60(12.40,20.40)ng/ml,respectively and the differences between age groups were also statistically significant(P<0.01).The serum 25(OH)D level measured by Roche and Snibe were significantly different among 10 hospitals(P<0.01).The overall trends of the two test results were consistent in 10 hospitals.In the Chinese elderly residents over 60 years,the prevalence of vitamin D sufficiency,insufficiency and deficiency was 2

关 键 词：维生素D 老年人 参考范围 

分 类 号：R151.42[医药卫生—营养与食品卫生学]