摘要
目的调查北京市某社区春季中老年男性维生素D营养状态分布并初步探讨其与其他骨代谢生化标志物的相关性。方法调查北京市某社区中老年男性人群502例,年龄40~70岁,于3~4月期间测定相关骨代谢生化标志物,根据血清25（OH）D3水平将患者分为维生素D严重缺乏组、缺乏组、不足组和充足组。进行统计分析比较各组间一般资料,分析维生素D与其他骨代谢生化指标的关系及骨转换标志物的影响因素。结果该中老年男性人群春季25（OH）D3平均水平为18.80±7.66（5.0~44.50）ng/m L。维生素D缺乏与不足占89.93%,其中严重缺乏6.18%、缺乏62.01%,充足仅占10.07%。排除既往半年内服用维生素D制剂的人群50例后,25（OH）D3平均水平为16.99±5.53ng/m L,缺乏及不足人群占到97.42%。按维生素D水平分组的四组间比较,在校正年龄、BMI等混杂因素后,四组间i PTH随25（OH）D3升高而降低,血Ca随25（OH）D3升高而升高。Pearson相关分析显示25（OH）D3与i PTH呈负相关（相关系数r=-0.229,P〈0.001）,与Ca呈正相关（相关系数r=0.095,P=0.086）。拟合曲线结果可见,维生素D与i PTH、血钙与i PTH之间有负相关趋势（P〈0.001）。BTMs多元线性回归分析显示OC与25（OH）D3、ALP呈正相关（分别β=0.102,P=0.041;β=0.142,P〈0.001）,与BMI、Hb A1c呈负相关（分别β=-0.348,P=0.030;β=-3.275,P=0.004）;PINP与Pi、ALP呈正相关（分别β=0.742,0.013;P均〈0.001）,与FBG呈负相关（β=-0.097,P=0.013）;β-CTX与Cr、Pi、ALP呈正相关（分别β=0.009,P=0.045;β=0.938,P=0.002;β=0.009,P=0.045）,与FBG呈负相关（β=-0.054,P=0.032）。结论北京春季中老年男性尤其是未补充维生素D制剂者维生素D缺乏现况严重。25（OH）D3水平与i PTH呈负相关,与Ca呈正相关。BTMs与BMI、Cr、Hb A1c、FBG、25（OH）D3、ALP、Pi相关。
Objective To investigate vitamin D status of community-dwelling medium-elderly men in Beijing during spring time and to explore the relationship between bone metabolism biochemical markers and Vitamin D. Methods The levels of 25 （ OH ） D3 and other relative bone biochemical markers in 502 cases of community- dwelling medium- elderly men over 40 years old in Beijing from March to May were measured. They were divided into four groups according to 25 （ OH ） D3 levels, including severe deficiency group （ 〈 lOng/mL）, deficiency group （ 10 - 20ng/mL）, insufficiency group（20 - 30ng/mL）, and sufficiency group（〉30ng/mL）. The correlation of vitamin D and other bone biochemical markers were analyzed. Multiple linear regression analysis was used for influencing factor of BTMs analysis. Results The mean value of serum 25 （OH）D3 was 18.80 ± 7.66 ng/mL. The proportion of 25（OH） D3 less than 30 ng/mL was 89.93%, including 6.18% of severe deficiency and 62.01% of deficiency. There were only 10.07% men with vitamin D sufficiency. The mean value of serum 25 （OH）D3in rest of people excluding 50 cases who have taken vitamin D supplements during the past half year was 16.99 _＋ 5.53 ng/mL, and there were 97.42% men with 25 （OH） D3 less than 30ng/mL. The corrected mean of iPTH decreased and the one of Ca increased with 25 （OH）D3 rising in all four groups. Pearrnan analysis showed that serum 25 （OH）D3 level was correlated negatively with iPTH and positively with Ca（ r = 0. 095 ,P = 0.086）. There was a positive relationship between 25 （OH） D3 and iPTH as well as Ca and iPTH. Multiple linear regression analysis showed that OC was correlated positively with 25（OH） D3 and ALP, inversely with BMI and HbAlc, PINP was correlated positively with Pi and ALP, inversely with FBG./3-CTX was correlated positively with Cr, Pi and ALP, inversely with FBG. Conclusion The findings in this study indicate that the vitamin D insufficiency is highly prevalent among community-dwelling medium-elderly men in Beijing during springtime, especially those who have not taken vitamin D supplements. The serum 25 （OH） D3 level is negatively correlated with iPTH and positively with Ca. BTMs are associated with BMI, Cr, HbAlc, FBG, 25（OH）D3,ALP and Pi.
出处
《标记免疫分析与临床》
CAS
2015年第10期949-955,共7页
Labeled Immunoassays and Clinical Medicine
基金
国家高技术研究发展计划(863计划)课题(2014AA022301)
保健专项科研课题(12BJZ42)
解放军总医院百病妙决(MJ 201440)
