成都地区不同年龄城乡妇女维生素D和骨代谢指标及骨密度的状况分析

Investigation and analysis of vitamin D,bone metabolic markers,and bone mineral density in females of different age in Chengdu

目的评价成都市不同年龄城乡女性居民血清25-羟基维生素D水平并计算维生素D缺乏和不足的患病率,计算各种骨转换指标的平均值,研究维生素D水平与骨转换指标的关系。方法选择2个城镇社区和2个农村社区,30～90岁健康妇女376例,采用酶联免疫法测定1,25-二羟基维生素D、25-羟基维生素D,化学发光免疫分析法测定骨碱性磷酸酶、胶原C端肽、N端骨钙素、抗酒石酸酸性磷酸酶、甲状旁腺素、1型前胶原氨基,用双能X线吸收仪检测腰椎骨密度。结果 25-羟基维生素D平均值为17.2±0.7 ng/m L,N端骨钙素平均值为7.6±0.3 ng/m L,1型前胶原氨基端肽平均值为59.6±4.2 ng/m L,维生素D不足者患病率为：97.0%,缺乏者患病率为：76.86%。同时,25-羟基维生素D与胶原C端肽、抗酒石酸酸性磷酸酶呈负相关,1,25-二羟基维生素D与骨碱性磷酸酶呈正相关关系。50岁以后骨密度显著下降。结论成都市女性居民在冬季维生素D普遍不足,不良的生活方式及低维生素D的摄入应引起重视。

Objective To evaluate the level of serum 25-hydroxyvitamin D and bone metabolic markers in female residents of different age and region in Chengdu,to calculate the prevalence of vitamin D deficiency,and to study the relationship between vitamin D and bone metabolic markers. Methods A total 376 cases of 30-90 years old healthy women were selected from two urban region and two rural communities. The levels of 1,25-hydroxyvitamin D and 25-hydroxyvitamin D were detected using enzyme linked immunosorbent assay. The levels of bone alkaline phosphatase,collagen C peptide,N end of osteocalcin,resistant acid phosphatase,parathyroid hormone,and type I procollagen amino terminal peptide were determined using chemiluminescence immunoassay method. Bone mineral density of the lumbar vertebrae was measure using DXA. Results The mean values of 25-hydroxyvitamin D,N-terminal osteocalcin,and type I procollagen amino terminal peptide were 17. 2 ± 0. 7 ng / ml,7. 6 ± 0. 3 ng /ml,and 59. 6 ± 4. 2 ng / ml,respectively. The prevalence of vitamin D deficiency and insufficient was 97% and 76. 86%,respectively. There was a negative correlation between 25-hydroxyvitamin D and collagen C peptide and resistant acid phosphatase.1,25-hydroxyvitamin D and bone alkaline phosphatase were positively correlated. Conclusion This study shows that vitamin D is generally inadequate in women of Chengdu in winter. Unhealthy lifestyle and lowvitamin D intake should be taken into account.