老年慢性肾病患者血清25-羟基维生素D水平与骨量减低相关性研究  

Correlation between serum 25-hydroxyvitamin D level and osteopenia in elderly patients with chronic kidney disease

作　　者：范忠诚[1] 王琮仁[1] FAN Zhong-cheng;WANG Cong-ren(Division of Orthopedic,Haikou Municipal People’s Hospital and Central South University Xiangya Medical College Affiliated Hospital,Haikou 570208,China)

机构地区：[1]中南大学湘雅医学院附属海口医院骨科中心,海南海口570208

出　　处：《创伤与急危重病医学》2023年第5期317-322,共6页Trauma and Critical Care Medicine

基　　金：海南省卫生健康行业科研项目(19A200123、20A200518);海南省科技专项资助项目(ZDYF2020122)。

摘　　要：目的 探讨老年慢性肾病(CKD)患者血清25-羟基维生素D[25(OH)D]水平与骨量减低相关性。方法 基于美国国家健康与营养检查调查(NHANES)数据,以年龄≥60岁参与者为研究对象。应用加权Logistic回归,通过调整可能的混杂因素(年龄、性别、种族、体质量指数、休闲运动、吸烟、血糖、总胆固醇、甘油三酯、高血压、糖尿病、心血管疾病),分析25(OH)D水平与骨量减低的相关风险,以及CKD对这种相关关系的修饰效应。结果 最终6 851例参与者纳入研究,CKD患者1 502例,非CKD患者5 349例。CKD患者骨量减低患病率高于非CKD患者,差异有统计学意义(P<0.05)。与25(OH)D缺乏组(水平<50 nmol/L)比较,25(OH)D不足组(50~75 nmol/L)和25(OH)D充足组(水平≥75 nmol/L)均与较低的骨量减低率相关(OR=0.82,95%可信区间:0.69~0.97;OR=0.81,95%可信区间:0.68~0.98),这种相关性在CKD组和非CKD人群同样适用,交互作用P值为0.292。结论 与非CKD老年患者相比较,合并CKD老年患者骨量减低发生率更普遍。较高25(OH)D水平与较低的骨量减低发生率相关。Objective To investigate the correlation between serum 25-hydroxyvitamin D[25(OH)D]level and osteopenia in elderly patients with chronic kidney disease(CKD).Methods Participants aged 60 years or older were selected based on data from the National Health and Nutrition Examination Survey(NHANES).Weighted Logistic regression was used to analyze the association between 25(OH)D levels and the risk of osteopeniaby adjusting for possible confounders(age,sex,race,body mass index,recreational exercise,smoking,blood glucose,total cholesterol,triglycerides,hypertension,diabetes,and cardiovascular disease).The modification effect of CKD on this correlation was analyzed.Results A total of 6851 participants were included in the analysis,including 1502 patientswith CKD and 5349 patients without CKD.CKD group had a higher prevalence of osteopenia,the difference was statistically significant(P<0.05).Compared with 25(OH)D deficiency group(levels<50 nmol/L),25(OH)D insufficient group(50-75 nmol/L)and sufficient group(levels≥75 nmol/L)were associated with a lower rate of osteopenia[OR=0.82,95%confidence interval(CI)0.69 to 0.97;OR=0.81,95%CI 0.68 to 0.98)],this association was consistent across CKD and non-CKD populations(P for interaction was 0.292).Conclusion Compared with non-CKD elderly patients,the incidence of osteopenia is more common in elderly patients with CKD.Higher 25(OH)D level is associated with a lower incidence of osteopenia.

关 键 词：老年人 骨量减低 25-羟基维生素D 慢性肾病 

分 类 号：R692[医药卫生—泌尿科学]