体检人群25羟基-维生素D与肺功能相关的研究

A study on the relationship between 25(OH)D and pulmonary function among physical examiners

目的了解体检人群血清25羟基-维生素D(25(OH)D)含量;分析血清25(OH)D与肺功能的相关关系,以及BMI、性别对其关系的影响。方法选取2013年-2015年间我院547名成年体检者为研究对象(男性366人,女性181人);通过问卷调查收集一般人口学特征、吸烟史、既往史,检测血清25(OH)D、行肺功能检查;采用独立样本t检验分析不同水平25(OH)D人群肺功能差异,采用多重线性回归分析25(OH)D与肺功能线性关系。结果体检人群血清25(OH)D为正偏态分布,中位数12.07(8.49,16.79)ng/m L;夏秋两季血清25(OH)D显著高于春冬两季(P<0.01);547名体检人员血清25(OH)D含量正常、不足、缺乏人数分别为80人(14.6%)、199人(36.4%)、268人(48.9%);男性人群中血清25(OH)D缺乏组FEV1、FEV1/FVC、FEV1%、FEV1/FVC%均低于不足组,差异有统计学意义(P值均<0.05);超重及肥胖男性血清25(OH)D缺乏组相较不足组FEV1、FEV1/FVC、FVC%、FEV1%差异有统计学意义(P值均<0.05);春冬季超重及肥胖男性25(OH)D与FEV1/FVC(β=2.412,P=0.017)、FEV1/FVC%(β=2.376,P=0.019)呈线性关系。结论北京地区体检人群25(OH)D缺乏比例较大;血清25(OH)D水平与季节相关;血清25(OH)D降低与肺功能下降相关,此相关性在超重和肥胖的男性人群更明显。

Objective To investigate serum 25 （ OH） D levels of physical examiners and the relationship be-tween serum 25 （ OH） D and pulmonary function as well as the effect modifications of BMI and sex. Methods Wechoose 547 adult physical examiners （2013 -2015; men 366, women 181） and collected demographic data, history of smoking, medical history, serum 25（OH）D level and pulmonary function indicators via questionnaires and physi-cal examination. Independent-sample t-test was employed to analyze the difference in pulmonary function among groups with varied serum 25 （ OH） D levels. Multiple linear regression was used to fit the relationship between 25 （OH） D and pulmonary function. Results Sample 25（ OH） D level followed positive skewed distribution, with a me-dian value of 12. 07 （ 8. 49,16. 79） ng/mL. serum 25（OH）D levels were statistically higher among summer-autumn samples than among winter-spring samples （ P 〈 0. 01 ） . 268 （48. 9% ） , 199 （ 36. 4% ） and 80 （ 14. 6% ） of total subjects had a serious deficiency, moderate lack, and normal level of serum 25 （ OH） D respectively. The levels of FEV!, FEVj/FVC, FEV!% and FEV^FVC% were all lower among the seriously-lacking male subjects than among the moderately-lacking ones （P 〈 0. 05 ） . Among obese and overweight male samples, FEV!,FEVj/FVC,FVC% and FEVj % were statistically different between the seriously-lacking group and the moderately-lacking group （P 〈 0.05）. In spring and winter, for obese and overweight male samples, 25 （ OH） D was positively correlated with FEV/FVC （p = 2.412, P =0.017） and FEV/FVC% （ p = 2. 376, P =0.019）. Conclusion A considerable portion of physical examiners are subjected to low serum 25 （ OH） D, which varies with seasons. Low serum 25 （ OH）D level might be associated with a reduction in pulmonary function, which is more recognizable in obese and over-weight men.