维生素D_(2)注射液对高龄男性维生素D缺乏患者疗效的影响因素研究

Factors associated with efficacy of vitamin D_(2)injection in elderly men with vitamin D deficiency

目的寻找维生素D2注射液对高龄男性维生素D缺乏患者疗效的影响因素。方法本研究共纳入42例高龄男性维生素D缺乏患者,并使用调查表调查其一般状况。每位患者肌注维生素D2注射液60万IU,每月1次,并进行血清骨代谢标志物、血生化和性激素等指标的检测。根据25-羟基维生素D[25-(OH)D]的变化,来评价高龄男性维生素D缺乏患者在接受20万IU维生素D2注射液后的疗效(Δ25-(OH)D/20万IU),并筛选出高龄男性Δ25-(OH)D/20万IU的独立相关因素。结果高龄男性Δ25-(OH)D/20万IU与慢性阻塞性肺疾病(COPD)有关(t=-2.09,P<0.05),而与高血压、冠心病、2型糖尿病无关(t分别=-0.18、-0.76、-0.85,P均>0.05)。高龄男性Δ25-(OH)D/20万IU与体重指数(BMI)、甘油三酯、血钙和睾酮有关(r分别=-0.51、-0.34、-0.33、0.33,P均<0.05),而与年龄、I型胶原羧基末端肽交联(CTX)、I型前胶原氨基端前肽(P1NP)、甲状旁腺素、25-(OH)D、白蛋白、丙氨酸氨基转移酶、血肌酐、血糖、总胆固醇、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、血磷和雌二醇等因素无关(r分别=0.01、0.10、-0.07、0.30、-0.17、-0.30、-0.01、-0.25、-0.17、0.06、0.27、0.09、-0.27、0.09,P均>0.05)。进一步多元回归分析显示,BMI和COPD是高龄男性Δ25-(OH)D/20万IU的独立影响因素(t分别=-2.79、-2.54,P均<0.05)。结论积极控制体重、防治COPD,可能是提高维生素D2注射液在高龄男性维生素D缺乏中疗效的重要方法。

Objective To identify factors associated with the efficacy of vitamin D2 injection in elderly men with vitamin D deficiency.Methods A total of 42 elderly men with vitamin D deficiency were included in the study,and their general conditions were obtained by using a questionnaire survey.These patients were given intramuscular vitamin D2 injections 600,000 IU once a month.The serum levels of bone metabolism markers,biochemistry,and sex hormones were determined.The efficacy(in terms of changes in serum levels of 25-hydroxyvitamin D[25-(OH)D]and expressed asΔ25-(OH)D/200,000 IU)of vitamin D supplementation with vitamin D2 injection was evaluated to and analyzed to iden-tify independent factors associated withΔ25-(OH)D/200000 IU in elderly men with vitamin D deficiency.Results TheΔ25-(OH)D/200000 IU in elderly men with vitamin D deficiency was significantly associated with chronic obstructive pulmonary disease(COPD)(t=-2.09,P<0.05),but not associated with hypertension,coronary heart disease and type 2 diabetes mellitus(t=-0.18,-0.76,-0.85,P>0.05).TheΔ25-(OH)D/200000 IU was significantly correlated with body mass index(BMI),serum levels of triglyceride,cal-cium and testosterone(r=-0.51,-0.34,-0.33,0.33,P<0.05),and not correlated with the patient age,se-rum C-terminal telopeptide of typeⅠcollagen,Nterminal propeptide of type 1 procolagen,parathyroid hormone,25-hydroxyvitamin D,albumin,alanine aminotransferase,creatinine,glucose,total cholesterol,high density lipoprotein-cholesterol,low density lipoprotein-cholesterol,phosphorus,and estradiol(r=0.01,0.10,-0.07,0.30,-0.17,-0.30,-0.01,-0.25,-0.17,0.06,0.27,0.09,-0.27,0.09,P>0.05).Further multiple regression analysis showed that BMI and COPD were independent factors associated withΔ25-(OH)D/200000 IU in elderly men with vitamin D deficiency(t=-2.79,-2.54,P<0.05).Conclusion Strategies including active prevention and treatment of COPD and weight control may be effective to improve the efficacy of vitamin D2 injection in elderly men with vitamin D deficiency.