青年男性血清25羟维生素D、PTH水平与区域骨密度的关系

Relationship among serum 25-hydroxy vitamin D,parathyroid hormone levels and regional bone mineral density in young men

目的调查广州地区青年男性维生素D、PTH状态及其与区域骨密度之间的关系。方法随机选取2011年5月-2012年8月在广州军区广州总医院门诊部体检的60名广州青年男性志愿受试者,年龄18～44岁。评估血清25(OH)D、PTH水平,并分析血清25(OH)D、PTH与骨转换指标和区域骨密度(BMD)的相关性。结果 46.7%的青年男性血清25(OH)D水平>30 ng/mL,53.3%低于30 ng/mL,5%低于20 ng/mL。血清25(OH)D水平与年龄分布无统计学差异(P>0.05)。双变量分析显示血清25(OH)D水平与PTH负相关(r=-0.264,P=0.042),与β-Crosslaps负相关(r=-0.257,P=0.047)。血清25(OH)D水平、PTH与L1-4以及单个腰椎L1、L2、L3、L4的BMD无相关性。股骨大转子BMD与血清25(OH)D正相关(r=0.271,P=0.040),校正年龄、BMI和骨生化指标后,正相关性更加明显(r=0.319,P=0.020)。多元线性回归分析显示BMI、ALP与全腰、L1、L3、L4椎BMD相关,BMI、PINP与L2椎BMD相关,BMI、25(OH)D与全髋、大转子BMD相关。结论青年男性广泛存在血清25(OH)D不足状态,血清25(OH)D水平与股骨大转子BMD明显正相关,适当补充维生素D和钙剂,对维持大转子区域的骨量至关重要。

Objective To investigate the relationship among 25 （OH） D, parathyroid hormone （PTH） levels and regional bone mineral density in young men in Guangzhou. Methods Sixty young men, aging from 18 to 44 years old, who came to the outpatient department in the General Hospital of Guangzhou Military Command of PLA for physical examination from May 2011 to August 2012, were selected. The serum levels of 25（OH）D and PTH were detected. And the correlation among serum 25 （OH） D levels, PTH levels, bone conversion metrics, and regional bone mineral density （BMD） was analyzed. Results Serum 25 （OH） D levels was higher than 30ng/mL in 46.7% young men, lower than 30 ng/mL in 53.3% young men, and lower than 20 ng/mL in 5% young men, respectively. No significant difference between serum 25 （OH） D levels and the distribution of ages was observed （P 〉 0. 05）. Bivariate correlation analysis showed that serum 25 （OH） D level was negatively correlated with PTH （ r = - 0. 264, P =0. 042） and [3-crosslaps （ r = - 0. 257, P = 0. 047）. No correlation was observed among the serum 25 （OH）D level, PTH level and BMD of L1-4 or BMD of a single lumbar L1,L2, L3, and IA was observed. BMD of the greater trochanter was positively correlated with serum 25 （OH） D level （ r = 0. 271, P =0. 040）. After adjusting for age, the positive correlation between BMI and bone biochemical markers was more obvious （r = 0. 319, P = 0.020）. Multiple linear regression analysis showed that BMI and ALP were correlated with BMD of whole lumbar vertebrae, L1, L3, and L4. BMI and PINP were correlated with BMD of L2 vertebra. BMI and 25（OH） D were correlated with BMD of the total hip and the greater trochanter. Conclusion The serum 25 （OH） D deficiency exists in a wide range of young men. The serum 25 （OH） D level is positively correlated with the BMD of the greater trochanter. Thus, appropriate supplementation of vitamin D and calcium is crucial for the maintenance of bone mass of the greater trochanter area.