青海高原成年居民血清25(OH)D水平及相关骨代谢指标的测定和影响因素  

Analysis of the level of serum 25(OH)D and bone metabolism indexes and their influence factors in adult residents in Qinghai plateau

作　　者：许海琦[1] 杨历新[1] 李金娟[1] 朱千君 朱沁芳[1] 田雨 李金霞 XU Haiqi;YANG Lixin;LI Jinjuan;ZHU Qianjun;ZHU Qinfang;TIAN Yu;LI Jinxia(Department of Endocrinology and Metabolism,Qinghai Provincial Peoples’s Hospital,Xining 810200,China)

机构地区：[1]青海省人民医院,青海西宁810200

出　　处：《中国骨质疏松杂志》2023年第3期385-389,402,共6页Chinese Journal of Osteoporosis

基　　金：青海省自然科学基金(2021-ZJ-930)。

摘　　要：目的探讨青海高原不同海拔人口聚居区常驻居民冬季和夏季血25羟基维生素D水平,分析其与高原季节和骨代谢指标的变化关系,并对其相关影响因素进行分析。方法观测本地区低温气候天数,对2020年11月至2021年7月青海不同海拔地区同一批次常住人群年龄21~45岁健康居民冬季303名(11月)及夏季253名(7月)采集基础数据并测定25(OH)D、PTH、β-CTX及PINP水平,评估不同海拔、不同季节常住人群的维生素D水平,分析不同维生素D水平状况下骨代谢指标的变化,并对相关性进行分析。结果本地区符合冬季气温天数为226 d,不同海拔常住人群夏季维生素D缺乏和不足占95.6%,冬季维生素D缺乏和不足占99%;不同海拔人群相比维生素D及PTH比较差异无统计学意义(P>0.05);同一批人群,冬季和夏季比较,25(OH)D、骨代谢指标差异有统计学意义(P<0.01);25(OH)D、PTH水平在不同季节不同性别、年龄人群中差异有统计学意义;夏季25(OH)D与年龄、PTH呈负相关(P<0.05),冬季25(OH)D与年龄、PTH、βCTX、PINP呈负相关(P<0.05);冬夏两季25(OH)D与血Ca呈正相关(P<0.01)。结论青海高原常住成年居民维生素D水平受海拔影响不明显,但该地区为长冬季气候,受到有效日光照射时间过短的影响明显,人群全年维生素D呈缺乏或不足状态,女性维生素D水平更低,冬季本地区25(OH)D缺乏的人群,血钙降低,骨代谢呈亢进状态,近三分之一的人群出现了继发性甲状旁腺功能亢进。Objective To explore the serum level of 25 hydroxyvitamin D in the residents living in different altitudes in Qinghai plateau in winter and summer,and to analyze the relationship between the changes of plateau seasons and bone metabolism indexes as well as the related influencing factors.Methods The number of low temperature days in the research areas was counted.The basic data from the same healthy residents aged 21-45 in different altitude areas between November 2020 and July 2021 were collected.The data of 303 residents were collected in winter(November)and that of 253 residents were collected in summer(July).Serum levels of 25(OH)D,PTH,β-CTX,and PINP in those residents were measured.Vitamin D levels of residents at different altitudes and in different seasons were evaluated.The changes of bone metabolism indexes under different vitamin D levels as well as their correlations were analyzed.Results The number of low temperature days corresponding to the microthermal climate was 226.In the research areas at different altitudes,the residents with vitamin D deficiency in summer were accounted for 95.6%and those residents in winter were accounted for 99%of all the subject population,respectively.There was no significant difference in the levels of vitamin D and PTH among the populations at different altitudes(P>0.05).However,in the same group of people,there were significant differences in their levels of 25(OH)D and bone metabolism indexes between winter and summer(P<0.01).The levels of 25(OH)D and PTH were significantly different among different gender and age groups in different seasons(P<0.05).The average PTH level of people over 40 years old in winter was 71.01±23.26 pg/ml,accounting for 20%of the total population.In summer,the levels of 25(OH)D were negatively correlated with age and PTH(P<0.05),while those levels were negatively correlated with age,PTH,β-CTX,and PINP(P<0.05)in winter.There was a positive correlation between the levels of 25(OH)D and serum Ca levels both in winter and summer(P<0.01).Conclus

关 键 词：高海拔 25羟基维生素D 骨代谢 季节 

分 类 号：R589[医药卫生—内分泌]