骨质疏松基础防治措施对老年人25羟基维生素D水平和下肢肌力及平衡功能的影响

Influence of basic osteoporosis intervention on 25-hydroxy vitamin D level, lower limb muscle strength and its balance function among Chinese elderly people

目的 探讨我国骨质疏松基础防治措施对老年人的25羟基维生素D[25（OH）D]水平与下肢肌力和平衡功能影响的现状。 方法 采用横断面调查的方法,对国内16家三级甲等医院老年科1026例65岁以上患者进行每日奶制品摄人、日照、运动、服用钙剂、普通维生素D等情况调查;测定血25（OH）D水平,下肢肌力和平衡功能测试,并进行统计学分析. 结果 42.0％（430例）老年人奶制品摄入不足;日照平均时间（1.2±0.8）h/d;锻炼平均时间（1.2±0.7）h/d;37.7％（387例）选择补充普通维生素D加钙剂;36.8％（278例）选择补充钙剂.受试者25（OH）D水平小于50nmol/L占77.2％（792例）;50～75 nmol/L占16.7％（171例）;6.1％（63例）受试者25（OH）D水平＞75 nmol/L.跌倒高风险检出率起立行走测试（TUG）、站起测试（CRT）、走直线步态测试（TGT）分别为48.7％（474/973）、64.6％（624/966）、63.6％（614/966）.TUG、CRT、TGT测试结果表明,25（OH）D水平与老年人跌倒风险呈正相关. 结论 在老年人群中奶制品摄入、日照、钙剂及维生素D补充仍显不足;25（OH）D＜50 nmol/L者跌倒高风险明显高于≥50 nmol/L者,老年人肌力和平衡功能力下降与体内25（OH）D水平相关;坚持锻炼可增加老年人下肢的肌力和平衡功能,降低老年人跌倒的风险。

Objective To observe influence of basic osteoporosis intervention on the 25-hydroxy vitamin D[25（OH）D] levels,low limb muscle strength and its balance function among Chinese elderly people.Methods Cross sectional study and statistics analysis were performed among total 1026 elderly （≥65years） patients from 16 hospitals throughout China.Daily taking amount of dairy products,calcium,vitamin D supplement,sunlight and physical exercise were recorded.Serum 25 （OH） D level was measured.Limb muscle strength and balance tests were performed.Results Daily intake of dairy products was insufficient in more than 42.0% （430 cases） participating patients.The average sunlight time of participating patients was （1.2 ± 0.8） h per day.The average physical exercise time was （1.2 ± 0.7） h per day.37.7 % （387 cases） participating patients took supplemental calcium and vitamin D.36.8% （278 cases）participating patients took supplemental calcium.The 25 （OH） D level was less than 50 nmol/L in 77.2% （792 cases） participating patients,while 50～75 nmol/Lin 16.7%（171 cases）.48.7% （474/973）,64.6%（624/966）and 63.6% （614/966） patients were in high fall risk according to the timed up and go test（TUG）,chair rising test（CRT） and tandem gait test（TGT）,which showed that the levels of 25 （OH） D deficiency were positively correlated with the elderly fall risk.Conclusions Daily intake of dairy products,sunlight,calcium and ordinary vitamin D supplement are insufficient among Chinese elderly people.Decreases of muscle strength and balance function among elderly people are related to 25 （OH） D levels.Exercise,not Vitamin D supplement,can reduce fall risk through improving muscle strength and balance function in elderly people.