上海市50岁及以上人群维生素D水平与握力的关联研究

Association between vitamin D level and grip strength in adults aged 50 and older in Shanghai

目的探讨上海市≥50岁人群维生素D水平与握力的关系。方法数据来源于WHO全球老龄化与成人健康研究我国上海市2018-2019年数据,采用logistic回归模型分析维生素D水平与握力的关系,进一步按照性别、年龄及乳制品摄入情况进行分层;采用限制性立方样条曲线绘制维生素D水平与低握力的剂量-反应曲线。结果共4391人纳入研究,其中男性2054人(46.8%);年龄(67.02±8.81)岁;低握力1421人(32.4%);维生素D不足及缺乏分别为1533人(34.9%)和401人(9.1%)。在调整相关混杂因素后,logistic回归分析结果显示,维生素D缺乏的人群发生低握力的风险更高(OR=1.41,95%CI:1.09~1.83);在男性中,调整相关混杂因素后,维生素D缺乏与低握力发生风险呈显著正相关(OR=1.67,95%CI:1.12~2.50),而女性中两者之间无关联(OR=1.30,95%CI:0.97~1.74);在60~69岁及≥80岁年龄组中,调整相关混杂因素后,维生素D缺乏与低握力发生风险呈显著正相关(OR=1.57,95%CI:1.05~2.35;OR=2.40,95%CI:1.08~5.31),在乳制品摄入<250 ml/d的人群中,调整相关混杂因素后,二者之间呈显著正相关(OR=1.57,95%CI:1.17~2.09),而在乳制品摄入≥250 ml/d的人群中无明显关联。限制性立方条样图显示,低握力的发生风险可能随维生素D含量的上升而降低,但差异无统计学意义(P>0.05)。结论维生素D水平与握力存在一定的关系,维生素D缺乏人群出现低握力的风险更高。

Objective To understand the association between vitamin D level and grip strength in people aged≥50 years in Shanghai.Methods Data were obtained from the WHO's Study on Global Ageing and Adult Health in Shanghai during 2018-2019.Logistic regression model was used to analyze the association between vitamin D level and grip strength, and a stratifiedanalysis was conducted for different gender, age and dairy product intake groups. Restricted cubicspline was used to evaluate the dose-response association between vitamin D level and low gripstrength. Results A total of 4 391 participants were included in the study, including 2 054 men(46.8%), with an average age of (67.02±8.81) years. And 1 421 individuals (32.4%) had low gripstrength;1 533 individuals (34.9%) had vitamin D deficiency, and 401 individuals (9.1%) hadvitamin D deficiency. After adjusted for confounding factors, the logistic regression results analysisshowed that individuals with vitamin D deficiency had a higher risk for low grip strength (OR=1.41,95%CI: 1.09-1.83). In men, after adjusting for confounding factors, vitamin D deficiency waspositively associated with the risk for low grip strength (OR=1.67, 95%CI: 1.12-2.50), but there wasno significant association between vitamin D level and grip strength in women (OR=1.30, 95%CI:0.97-1.74). In age group 60-69 years and ≥80 years, there was significant association betweenvitamin D deficiency and low grip strength after adjusting for confounding factors (OR=1.57, 95%CI:1.05-2.35;OR=2.40, 95%CI: 1.08-5.31). In people who had daily intake of dairy product <250 ml,there was positive association between vitamin D deficiency and low grip strength, but there was nosignificant association in people who had daily dairy product ≥250 ml after adjusting forconfounding factors. The restrictive cubic spline demonstrated that risk of low grip strength mightdecreased with the increase of vitamin D levels, however, the difference was not significant (P>0.05).Conclusions This study demonstrated that there is association between vitamin D level and gripstrength. People with vitamin D deficiency have higher risk for low grip strength.