上海老年男性血清维生素D水平状况调查

Study on serum vitamin D level in aged males in Shanghai

目的:调查上海老年男性血清维生素D水平及其缺乏程度。方法:收集2009年5月至9月上海瑞金医院老年病科体检和门诊的老年男性847例,平均年龄为76岁,测定其血清25-羟基维生素D[25-(OH)D]、肝肾功能、血钙(Ca)、磷(P)、血糖、血脂,部分测定甲状旁腺激素(PTH)、尿Ⅰ型胶原N端肽(NTX)、骨钙素(BGP)和骨碱性磷酸酶(BAP)。结果:①老年男性的血清25-(OH)D水平为(48.7±24.5)nmol/L,其中维生素D缺乏者(<25 nmol/L)共114例,占13.5%;维生素D不足者(25～50 nmol/L)共396例,占46.8%;血清25-(OH)D>75 nmol/L者仅99例,占11.7%。②血清25-(OH)D水平与年龄呈负相关(r=-0.215,P<0.05),90岁以上组与其他组比较差异均有统计学意义(P<0.05)。③血清25-(OH)D与PTH呈负相关(r=-0.266,P<0.05),而与体质量指数(BMI)、尿NTX、BAP、BGP、血Ca、血P、肾小球滤过率(GFR)等间无相关性(P>0.05)。GFR<50 mL/min组的血清25-(OH)D水平低于GFR≥50 mL/min组(P<0.05)。结论:上海老年男性血清维生素D水平普遍较低,缺乏和不足者高达60.2%,且血清维生素D水平随年龄增高呈降低趋势。关注老年男性维生素D营养状况与关注绝经后女性同等重要。

Objective To investigate the serum vitamin D level in aged males in Shanghai.Methods Eight hundred and forty-senven elderly men in Shanghai（mean age 76 years） joined the study performed from May to September in 2009.Serum 25-hydroxyvitamin D[25-（OH）D],liver and kidney function,serum calcium,serum phosphorus,blood glucose,and blood lipids were examined in all the subjects,and parathyroid hormone（PTH）,urinary N-terminal peptide of type Ⅰ collagen（NTX）,bone gamma-carboxyglutamic-acid-containing proteins（BGP）,bone alkaline phosphatase（BAP） were measured in part of the subjects.Results ① The mean level of serum 25-（OH）D was（48.7 ± 24.5） nmol/L;vitamin D deficiency（25 nmol/L） occurred in 13.5% of the subjects,vitamin D insufficiency（25-50 nmol/L） in 46.8% of the subjects,and only 11.7%（99 cases） were over 75 nmol/L.② Serum 25-（OH）D level was negatively correlated with age and there was significant difference in serum 25-（OH）D level between age over 90 years group and other age groups（r=-0.215,P〈0.05）.③ Level of serum 25-（OH）D was negatively correlated with PTH（r=-0.266,P〈0.05）,and had no correlation with BMI,urinary NTX,BAP,BGP,serum calcium,and serum phosphorus（P〉0.05）.Serum 25-（OH）D level in GFR 50 mL/min group was lower than that in GFR≥50 mL/min group（P〈0.05）.Conclusions Aged males in Shanghai generally have low level of vitamin D,individuals who have vitamin D insufficiency or vitamin D deficiency accounted for 60.2% of the subjects.Serum vitamin D levels decrease with the increase of age.Much attention should be paid to vitamin D status in aged men just as in postmenopausal women.