广州市区40岁以上人群夏季维生素D水平现状分析

目的调查广州市区40岁以上人群夏季体内维生素D(VitD)的水平。方法随机选取2018年5月至10月广东药科大学附属第一医院门诊及住院590例年龄≥40岁人群,所有研究对象均清晨空腹取静脉血,采用Cobase 6000型电化学发光仪(瑞士,罗氏诊断)检测血清25-羟维生素D[25(OH)D]水平,日立-7180型自动生化分析仪测定血钙(Ca)水平。结果590例年龄≥40岁人群中男性患者238例,25(OH)D平均水平为(57.09±24.06) nmol/L,女性患者352例,25(OH)D平均水平(53.71±22.63) nmol/L。其中男性VitD正常占24.79%,不足占34.45%,缺乏占33.19%,严重缺乏占7.56%;女性VitD正常占15.63%,不足占37.22%,缺乏占40.63%,严重缺乏占6.53%。广州市区40岁以上人群夏季以VitD缺乏和不足较常见,且男女两组总体25(OH)D水平差异无统计学意义,仅在80岁以上人群中,男性25(OH)D水平显著高于女性(P=0.026、0.043)。结论本研究显示广州市区40岁以上人群夏季中25(OH)D不足和缺乏现象较普遍,且无性别差异,而在80岁以上人群中,女性25(OH)D水平显著低于男性。维生素D的摄人有必要应引起重视。     

山西地区2012年至2013年我院就诊人群血清维生素D水平状况调查

目的 探讨目前山西地区不同季节人群的维生素D状况。方法 通过对2012 年6 月至2013年7月山西医科大学第二医院就诊的1313例患者血清25 羟维生素D [ 25（OH）D] 和甲状旁腺激素（PTH）水平,应用电化学发光免疫法测定血清25-羟维生素D[25（OH）D]、甲状旁腺激素（PTH）,按不同季节、性别进行分析。结果 ①所有检测人员的血清25(OH)D平均水平: 男性（11.38±6.29）ng/mL,女性（9.04±5.71）ng/mL。按照IOF维生素D水平判定标准:严重缺乏者占62.2%;维生素D缺乏者占28.46%;维生素D不足者占6.1%;维生素D充足者占3.25%。②血清25(OH)D水平与季节有显著相关性（r=0.228,P<0.05）;③血清25(OH)D与PTH 呈负相关（r=-0.272,P<0.05）。结论 受各种因素影响,目前山西地区成年人群中存在严重的维生素D不足和缺乏状况,应受到广泛的关注并改善现状,降低维生素D相关疾病的发病率。     

兰州地区22161例人群维生素D水平与性别、年龄、季节、日照时数和平均气温关系的回顾性研究

目的 基于临床数据分析甘肃省兰州市人群血清总25羟维生素D [25(OH)D]水平,并探讨其影响因素。方法 收集2016年10月到2021年10月在兰州大学第一医院检验科进行检测的22 161例受试者的血清25(OH)D的检测结果和相关临床资料,其中男性11 023例,女性11 138例。同时,调取《中国统计年鉴》官网上发布的兰州市日照时数和平均气温的数据。回顾性分析血清25(OH)D水平以及不同性别、年龄、季节、日照时数和平均气温对血清25(OH)D水平的影响。结果 (1)22 161例受试者的血清25(OH)D平均含量为13.72 (9.58,19.04) ng/mL,女性25(OH)D水平均低于男性;维生素D正常、不足和缺乏的检出率分别为22.08%、37.39%和40.53%;(2)不同性别、年龄的各组人群相比,0～6岁组血清25(OH)D含量最高,为24.30 (17.85,32.20) ng/mL,女性高于男性,但不存在差异(P>0.05);其他各个年龄组25(OH)D含量均是女性低于男性(P<0.05);18～29岁组25(OH)D含量最低,为12.00 (8...     

中老年人维生素D、骨密度水平与髋部脆性骨折的相关性研究

目的 探讨中老年人维生素D（VitD）、骨密度（bone mineral density, BMD）水平与髋部脆性骨折的相关性。方法 选取2019年1月至2020年8月在岳阳市人民医院接受治疗的50岁以上患者830例,骨折患者135例（骨折组）,非骨折患者695例（非骨折组）。采集所有研究对象的血清,用电化学发光法测定血清25(OH)D水平,应用双能X线吸收仪测定其腰椎及髋部BMD,并在测定骨密度的同时测量患者身高、体重,计算体质量指数（body mass index, BMI）,观察骨折组与非骨折组之间的VitD与BMD差异。结果 ①所有研究对象中25(OH)D严重缺乏者占16.1 %、缺乏者占34.7 %、轻度缺乏者占29.8 %、充足者占19.4 %,男性VitD水平高于女性(P<0.001)。而不同年龄和BMI的VitD水平无统计学差异（P=0.878、0.346）;②所有研究对象的腰椎、股骨颈BMD (T值)平均为–2.64±1.56及–1.43±1.24,不同性别、年龄、体质量指数研究对象的腰椎及股骨颈BMD水平差异有统计学意义(P<0.001);③髋部骨折组平均VitD为(20.26±10.76) ng/mL,非骨折组为(21.18±10.65) ng/mL,两组间无显著差异(P=0.304);④髋部骨折组腰椎、股骨颈T值低于非骨折组(P<0.001)。对骨折影响因素行单因素分析表明VitD、腰椎T值和股骨颈T值、年龄、体质量指数是髋部脆性骨折的危险因素(P＜0.05)。多因素分析表明年龄、体质量指数、股骨颈T值是髋部骨折的独立危险因素（P＜0.05）,而VitD与腰椎T值对骨折的影响呈现一定的风险增大趋势,但无统计学意义。结论 岳阳地区50岁以上人群存在较低的BMD及VitD水平。年龄、体重、体质量指数、股骨颈BMD是中老年人髋部骨折的独立危险因素,VitD不是髋部骨折的独立危险因素。     

529例成年女性维生素D水平及其影响因素研究

目的 回顾性分析529例成年女性血清25-羟维生素D［25 hydroxy vitamin D,25 ( OH) D］的水平及其影响因素,为骨质疏松症（osteoporosis,OP）及肥胖等疾病的防治提供依据。方法 选取2019年1月-2020年12月在黑龙江中医药大学附属第一医院接受血清25 (OH) D水平检测的成年女性,共计529人,其中19~28岁135人,29~38岁277人,39~48岁54人,49~58岁42人,59~68岁21人。采集受试者清晨空腹静脉血,应用酶联免疫法测定血清25 (OH) D浓度。以血清 25( OH)D＜30 nmol /L 为维生素 D缺乏;血清 25 (OH) D在30～49.9 nmol /L为维生素D不足;血清 25 (OH) D≥50 nmol /L为维生素D充足。统计数据并登记受试者性别、年龄以及采集时间等基本信息,分析血清25 (OH) D水平的影响因素。结果 529例成年女性25 (OH) D平均水平为（19.98±8.58）ng /mL,其中19~28岁组为（18.14±8.02）ng /mL,29~38岁组为（20.44±8.26）ng /mL,39~48岁组为（20.04±10.14）ng /mL,49~58岁组为（20.94±8.55）ng /mL,59-68岁组为（23.64±10.34）ng /mL。19~28岁人群维生素D水平充足的占比最低。不同年龄组相比较（完全随机方差分析one way ANOVA检验）,差异有统计学意义（F=2.88,P＜0.05）。经非参数检验,不同季节间差异有统计学意义（α=0.05）,夏季＞秋季＞春季＞冬季。结论 哈尔滨市成年女性普遍存在维生素D不足,且与年龄及季节具有相关性。     

中国男性和女性血清25羟维生素D水平与年龄、性别和骨密度之间的关系

目的观察血清25羟维生素D[25(OH)D]水平与广州地区成人年龄、性别和骨密度的关系。方法本横断面研究随机抽取了188名女性和122名男性,年龄为17~88岁的广州地区居民。采用双能X线(DXA)骨密度仪测量腰椎和股骨颈的骨密度,电化学发光免疫分析法测定血清中25(OH)D、甲状旁腺激素(parathyroid hormone,PTH)、Ⅰ型原胶原N-端前肽(procollagen type IN-terminal propeptide,PINP)、β-胶原特殊序列(β-crosslaps,β-CTX)。血清25(OH)D水平分为四个亚组:严重缺乏(10 ng/m L),缺少(10~20 ng/m L),不足(20~30 ng/m L),充分(≥30 ng/m L)。结果受试者平均年龄为(47.39±19.32)岁。女性的血清25(OH)D水平(25.35±6.59)ng/m L明显低于男性(27.25±7.94)ng/m L,P0.05。男性25(OH)D严重缺乏(10 ng/m L)的比例为1.6%,女性为0;男性25(OH)D缺少(10~20 ng/m L)的比例为22.9%,女性为20.5%;男性25(OH)D不足(20~30 ng/m L)的比例为65.6%,女性为73.4%。男性血清25(OH)D水平与年龄呈负相关(r=0.249,P0.01),而在女性中二者没有相关性(r=0.130,P0.05)。血清25(OH)D水平与老年妇女(分别为r=0.382,P0.01;r=0.384,P0.01)、青年男性(分别为r=0.332,P0.05;r=0.260,P0.05)腰椎和股骨颈的骨密度呈正相关。当校正年龄因素后,血清25(OH)D水平与老年妇女的腰椎、股骨颈骨密度之间仍存在相关性(分别为r=0.325,P0.05;r=0.323,P0.05)。但年龄校正后的血清25(OH)D水平与年轻男性的腰椎骨密度呈正相关(r=0.278,P0.05),与股骨颈骨密度没有相关性(r=0.165,P0.05)。校正年龄后的血清25(OH)D水平与中青年妇女和中老年男性腰椎和股骨颈骨密度无相关性。无论是否校正年龄,血清PTH水平和其他骨代谢指标均与受试者的血清25(OH)D水平无相关性。结论有超过2/3的广州居民存在维生素D不足。血清25(OH)D水平是老年女性和青年男性骨密度的重要生化标志物。     

岳阳地区50岁以上人群25经维生素D水平及其与骨密度的关系

目的 通过测定269名岳阳地区50岁以上人群血清25经维生素D(25(OH)D)和骨密度(BMD)水平,分析岳阳地区50岁以上人群的维生素D ( VitD)状况,并探讨其与BMD的关系。方法 采集受试者的血清后,用电化学发光法测定血清25(OH)D水平,并同时应用双能X线吸收仪测定腰椎及髓部BMD。结果 所有受试者中,VitD严重缺乏者占24. 2 %,缺乏者占45. 0%,不足者占24. 5 %,充足者占6. 3。男、女性受试者的25(OH)D水平、腰椎及髓部的BMD间有统计学差异(P<0.001),男性高于女性。男性各年龄段间25(OH)D水平及各部位BMD无统计学差异(P=0. 101 ,P = 0. 261 ,0. 055 ,0. 170 ,0. 108 ,0. 051 ) ;女性各年龄段之间25(OH)D水平及腰椎BMD无统计学差异(P = 0. 364 , 0. 063 ) ;髓部BMD有统计学差异(P < 0. 001 ),随着年龄的增长而逐步减低。男性受试者中,不同25(OH)D水平组间股骨颈、转子间区及整髓BMD无统计学差异(P = 0. 076 , 0. 425 , 0. 122 );腰椎、大转子区BMD水平间有统计学差异(P=0. 027 , 0. 017 ) , VitD充足组腰椎BMD高于其他各组(P = 0. 005 , 0. 025 , 0. 009 );不足组、严重缺乏组大转子区BMD高于缺乏组(P = 0. 021, 0. 005 )。女性受试者中,不同25(OH)D水平组各部位BMD均无统计学差异(P = 0. 616 , 0. 739 , 0. 559 ; 0. 608 , 0. 641)。结论 在湖南岳阳地区50岁以上人群存在严重的维生素D缺乏及不足;对于维生素D状况与骨密度之间可能无直接关联,需加大样本量进一步观察。     

亚热带海滨城市就医人群25(OH)维生素D水平

目的 了解亚热带海滨城市——泉州就诊病人冬季25-羟基维生素D状况。方法 在2011年12月至2012年3月，我们对282例20岁以上就诊病人进行血清25（OH）VIT-D3测定，按年龄每间隔10岁为1组共6组，按性别分2组，按检测月份分4组。结果 血清25（OH）VIT-D3 均值为14.38±9.20ng/mL，25（OH）VIT-D3<10ng/mL有104例，10ng/mL<25（OH）VIT-D3<30ng/mL有159例，25（OH）VIT-D3≥30ng/mL有19例。21~30岁组25（OH）VIT-D3 均值最低；男性明显高于女性；2011年12月高于检测其它月份。结论 维生素D不足具有很高的发生率，测定25（OH）VIT-D3有助于制定防治骨质疏松的策略和方案。     

2型糖尿病患者血清25-羟维生素D水平与骨密度的关系

目的探讨2型糖尿病患者不同血清25-(OH)D水平与骨密度的关系。方法选择住院的2型糖尿病患者288例,根据25-(OH)D水平对其进行分组:25-(OH)D30ng/mL为维生素D充足组;20ng/mL25-(OH)D≤30ng/mL为维生素D不足组;10ng/mL25-(OH)D≤20ng/mL为维生素D缺乏组;25-(OH)D≤10ng/mL为维生素D严重缺乏组。采用双能X线骨密度仪(DEXA)测量受试者腰椎L_(1-4)、股骨颈及全髋的骨密度。分析不同水平25-(OH)D与骨密度的关系。结果维生素D充足组、维生素D不足组、维生素D缺乏组、维生素D严重缺乏组的患者例数(所占比例)分别为10例(3.5%)、74例(25.7%)、177例(61.5%)、27例(9.3%)。不同性别组25-(OH)D水平无明显差异,但是女性患者的腰椎L_(1-4)、股骨颈、全髋的骨密度均较男性低。pearson相关分析显示25-(OH)D水平与腰椎L_(1-4)、股骨颈、全髋的骨密度均无相关性(分别为r=0.080 P=0.262;r=0.139 P=0.051;r=0.068 P=0.342)。结论 2型糖尿病患者25-(OH)D水平与腰椎L_(1-4)、股骨颈、全髋的骨密度均无明显相关性。     

2型糖尿病患者血清25-经维生素D水平与骨密度的关系

目的 探讨2型糖尿病患者不同血清25-( OH) D水平与骨密度的关系。方法 选择住院的2型糖尿病患者288例,根据25-( OH) D水平对其进行分组：25-( OH) D>30ng/mL为维生素D充足组;20ng/mL <25-( OH ) D≤30 ng/mL为维生素D不足组;l0 ng/mL <25-( OH) D <20 ng/mL为维生素D缺乏组;25-( OH) D <10ng/mL为维生素D严重缺乏组。采用双能X线骨密度仪(DXA)测量受试者腰椎L1-4、股骨颈及全髓的骨密度。分析不同水平25-( OH ) D与骨密度的关系。结果 维生素D充足组、维生素D不足组、维生素D缺乏组、维生素D严重缺乏组的患者例数(所占比例)分别为10例(3. 5%) ,74例(25.7%) ,177例(61.5%) ,27例(9.3%)。不同性别组25-( OH ) D水平无明显差异,但是女性患者的腰椎L1-4、股骨颈、全髋的骨密度均较男性低。pearscm相关分析显示25-( OH) D水平与腰椎L1-4、股骨颈、全髓的骨密度均无相关性(分别为r=0.080 P=0.262;r=0. 139 P=0. 051;r=0.068 P=0. 342)。结论 2型糖尿病患者25-( OH) D水平与腰椎L1-4、股骨颈、全髓的骨密度均无明显相关性。     

广州地区骨质疏松症患者冬季维生素D水平现状分析

目的调查广州地区冬季骨质疏松症患者体内维生素D(Vit D)水平的状况。方法随机选取2014年12月至2015年2月我院299例年龄≥50岁骨质疏松症患者,采集其清晨空腹静脉血,所有研究对象均采用Cobase 6000型电化学发光仪(瑞士,罗氏诊断)检测血清25-羟维生素D(25(OH)D)和甲状旁腺激素(PTH)水平,日立7180型自动生化分析仪测定钙(Ca)、磷(P)及碱性磷酸酶(ALP)水平。双能X线吸收仪检测腰椎和股骨近端骨密度(BMD),SPSS 16.0软件进行数据分析。结果299例骨质疏松症患者,其中男性患者63例,25(OH)D平均水平为(52.75±17.30)nmol/L,女性患者236例,25(OH)D平均水平(53.97±16.11)nmol/L。其中Vit D正常者仅占3.3%,缺乏者占47.6%,不足者占44.8%,严重不足者占4.3%。这些患者普遍存在着25(OH)D水平不足现象,其中Vit D缺乏和不足所占比例较大,且男女两组的25(OH)D水平无统计学差异。结论本研究显示广州地区冬季骨质疏松症患者25(OH)D不足和缺乏现象较普遍,且无性别差异,补充足量Vit D,需要重视及积极治疗,定期监测25(OH)D水平,为临床骨质疏松症的防治提供一定的数据参考。     

Treatment of vitamin D depletion after Roux-en-Y gastric bypass: a randomized prospective clinical trial

BackgroundA high prevalence (60%) of vitamin D (VitD) depletion, defined as a serum 25-hydroxyvitamin D level of ≤20 ng/mL, is present in preoperative morbidly obese patients. Despite daily supplementation with 800 IU VitD and 1500 mg calcium after Roux-en-Y gastric bypass (RYGB), VitD depletion persists in almost one half (44%) of patients. However, the optimal management of VitD depletion after RYGB and the potential benefits of such treatment are currently unknown.MethodsA total of 60 VitD-depleted morbidly obese women were randomly assigned to receive 50,000 IU of VitD weekly after RYGB (group 1; n = 30) or no additional VitD after RYGB (group 2; n = 30). All patients received a daily supplement of 800 IU VitD and 1500 mg calcium. The serum calcium, parathyroid hormone, 25-hydroxyvitamin D, bone-specific alkaline phosphatase, urinary N-telopeptide, and bone mineral density were measured preoperatively and 1 year after RYGB. Questionnaires were used to assess other potential sources of VitD, including sunlight exposure and ingestion of VitD-containing foods/liquids.ResultsAt 1 year after RYGB, VitD depletion and mean 25-hydroxyvitamin D level had improved significantly in group 1 (14% and 37.8 ng/mL, respectively) compared with the values in group 2 (85% and 15.2 ng/mL, respectively; P <.001 for both). A significant 33% retardation in hip bone mineral density decline (P = .043) and a significantly greater resolution of hypertension was seen in group 1 (75% versus 32%; P = .029). No significant adverse effects were encountered from pharmacologic VitD therapy.ConclusionThe results of our study have shown that 50,000 IU of VitD weekly after RYGB safely corrects VitD depletion in most women, attenuates cortical bone loss, and improves resolution of hypertension.     

Effect of gastric bypass surgery on vitamin D nutritional status

BACKGROUND: We previously reported a 60% prevalence of vitamin D (VitD) depletion, defined as a 25-hydroxyvitamin D (25-OHD) level of < or =20 ng/mL, in morbidly obese patients preoperatively. We now report the effect of gastric bypass (GB) on the VitD nutritional status in these patients. METHODS: We prospectively studied 108 morbidly obese patients who had undergone GB. Routine postoperative supplementation consisted of 800 IU VitD and 1500 mg calcium daily. Serum calcium, parathyroid hormone, and 25-OHD were measured before and 1 year after GB. RESULTS: The mean patient age was 46 +/- 9 years, 93% were women, and 72% were white. Preoperatively and at 1 year postoperatively, the prevalence of VitD depletion and hyperparathyroidism (HPT) and the mean 25-OHD level was 53% and 44%, 47% and 39%, and 20 and 24 ng/mL, respectively. One year after GB, the percentage of excess weight loss was 67% and demonstrated significant correlations both positively with 25-OHD and inversely with parathyroid hormone. At both intervals, blacks had a greater incidence of VitD depletion than did whites, and, at 1 year after GB, HPT was more common in patients with VitD depletion (55% versus 26%, P = .002). CONCLUSION: With customary supplementation, VitD nutrition is improved after GB, but VitD depletion persists in almost one half of patients, and blacks are at a significantly greater risk than whites. HPT did not improve, and those with VitD depletion had a significantly greater rate of HPT. Additional prospective studies are needed to determine how to optimize VitD nutrition and avoid potential long-term skeletal complications after GB.     

Optimal Serum Concentration of 25-Hydroxyvitamin D for Bone Health in Older Korean Adults

Optimal vitamin D concentrations for bone health have not been determined in the Korean population. The aim of this study was to define serum 25-hydroxyvitamin D (25[OH]D) concentrations that indicate insufficiency among older Korean adults as measured by serum intact parathyroid hormone (iPTH) concentrations and bone mineral density (BMD). We analyzed data from the Fourth Korea National Health and Nutrition Examination Survey (KNHANES IV-3), which was conducted in Korea in 2009. We enrolled 1,451 men and 1,870 women aged 49 years and above. After adjusting for variables that could potentially affect serum 25(OH)D concentrations, we found that serum iPTH concentrations began to increase at serum 25(OH)D concentrations below 12.1 ng/mL (30.2 nmol/L). In addition, total-femur BMD increased until serum 25(OH)D concentrations dropped below 20.4 ng/mL (50.9 nmol/L); no significant changes were observed thereafter. Assuming that serum 25(OH)D concentrations below 12.1 and 20.4 ng/mL represent vitamin D insufficiency, the prevalences of vitamin D insufficiency were 8.7 and 50.4 % in men and 17.9 and 66.3 % in women, respectively. Serum 25(OH)D cutoff values of 12.1 ng/mL (OR = 1.26) and 20.4 ng/mL (OR = 1.54) were associated with osteoporosis (P < 0.01); osteoporosis was not associated with a 25(OH)D cutoff value of 30 ng/mL (75.0 nmol/L). In conclusion, serum 25(OH)D concentrations of 20 ng/mL might be sufficient for bone health in older Korean adults.     

Bone turnover is not influenced by serum 25-hydroxyvitamin D in pubertal healthy black and white children

Low serum 25-hydroxyvitamin D [25 (OH) D] is common in healthy children particularly in blacks. However, serum 25 (OH) D concentrations for optimal bone turnover in children is unknown and few data exist that describe effects of increasing serum 25 (OH) D on bone turnover markers during puberty. The purpose of this study was to determine the relationships between serum 25 (OH) D and changes in serum 25 (OH) D and bone turnover in white and black pubertal adolescents. Bone turnover markers were measured in 318 healthy boys and girls from Georgia (34°N) and Indiana (40°N) who participated in a study of oral vitamin D(3) supplementation (0 to 4000IU/d). Serum 25 (OH) D, osteocalcin, bone alkaline phosphatase, and urine N-telopeptide cross-links were measured at baseline and 12weeks. Relationships among baseline 25 (OH) D and bone biomarkers, and between changes over 12weeks were determined and tested for effects of race, sex, latitude, and baseline 25 (OH) D. Median 25 (OH) D was 27.6ng/mL (n=318, range 10.1-46.0ng/mL) at baseline and 34.5ng/mL (n=302, range 9.7-95.1ng/mL) at 12weeks. Neither baseline nor change in 25 (OH) D over 12weeks was associated with bone turnover. The lack of association was not affected by race, sex, latitude, or baseline serum 25 (OH) D. Serum 25 (OH) D in the range of 10-46ng/mL appears to be sufficient for normal bone turnover in healthy black and white pubertal adolescents.     

Vitamin D status and secondary hyperparathyroidism: the importance of 25-hydroxyvitamin D cut-off levels

BACKGROUND: Serum 25-hydroxyvitamin D is the best indicator of vitamin D status. However, some controversy remains regarding "normal" and "abnormal" values. This study's aim was to assess vitamin D status and prevalence of secondary hyperparathyroidism. METHODS: A random sample of 326 subjects (164 women and 162 men, aged 68 +/- 9; range, 54 to 89) participating in the European Vertebral Osteoporosis Study (EVOS) was used to assess vitamin D status and secondary hyperparathyroidism. Only those subjects who had never received any kind of treatment for osteoporosis were included in this analysis. RESULTS: Serum 25-hydroxyvitamin D levels were "deficient" (<10 ng/mL) in 27% of subjects, "borderline" (10-18 ng/mL) in 40% of subjects, and "normal" (>18 ng/mL) in 33% of subjects. The prevalence of secondary hyperparathyroidism (PTH>65 pg/mL) according to 25-hydroxyvitamin D levels was 33% (<10 ng/mL), 16% (10-18 ng/mL), and 12% (>18 ng/mL), respectively. There were no cases of secondary hyperparathyroidism with 25-hydroxyvitamin D levels>40 ng/mL. The independent predictors for PTH were 25-hydroxyvitamin D and serum creatinine in both sexes, but age was a predictor only in men. CONCLUSION: These remarkable findings demonstrate the importance of maintaining higher 25-hydroxyvitamin D levels to avoid stimulation of the parathyroid gland.     

Taking vitamin D with the largest meal improves absorption and results in higher serum levels of 25‐hydroxyvitamin D

Many patients treated for vitamin D deficiency fail to achieve an adequate serum level of 25‐hydroxyvitamin D [25(OH)D] despite high doses of ergo‐ or cholecalciferol. The objective of this study was to determine whether administration of vitamin D supplement with the largest meal of the day would improve absorption and increase serum levels of 25(OH)D. This was a prospective cohort study in an ambulatory tertiary‐care referral center. Patients seen at the Cleveland Clinic Foundation Bone Clinic for the treatment of vitamin D deficiency who were not responding to treatment make up the stugy group. Subjects were instructed to take their usual vitamin D supplement with the largest meal of the day. The main outcome measure was the serum 259(OH)D level after 2 to 3 months. Seventeen patients were analyzed. The mean age (±SD) and sex (F/M) ratio were 64.5 ± 11.0 years and 13 females and 4 males, respectively. The dose of 25(OH)D ranged from 1000 to 50,000 IU daily. The mean baseline serum 25(OH)D level (±SD) was 30.5 ± 4.7 ng/mL (range 21.6 to 38.8 ng/mL). The mean serum 25(OH)D level after diet modification (±SD) was 47.2 ± 10.9 ng/mL (range 34.7 to 74.0 ng/mL, p < .01). Overall, the average serum 25(OH)D level increased by 56.7% ± 36.7%. A subgroup analysis based on the weekly dose of vitamin D was performed, and a similar trend was observed. Thus it is concluded that taking vitamin D with the largest meal improves absorption and results in about a 50% increase in serum levels of 25(OH)D levels achieved. Similar increases were observed in a wide range of vitamin D doses taken for a variety of medical conditions. © 2010 American Society for Bone and Mineral Research     

Low 25-Hydroxyvitamin D and Osteopenia Are Prevalent in Persons ≥55 Yr With Fracture at Any Site: A Prospective, Observational Study of Persons Fracturing in the Community

Ethnic diversity and lower socioeconomic populations are poorly captured in most studies of osteoporosis and fracture risk. This article describes a prospective, observational study designed to analyze risk factors for fracture in an ambulatory, ethnically diverse, urban population aged > or =55 yr. The goal of the study was to determine the number of fractures associated with hypovitaminosis D (< or =15 ng/mL serum 25-hydroxyvitamin D) and osteopenia (T-score <-1.5) by bone mineral density (BMD). From January 1 to July 31, 2001, we identified 262 persons who fractured in our community; 83 chose to enroll in the study. Enrolled patients had a BMD examination at two sites; their blood was drawn for 25-hydroxyvitamin D (25VitD), calcium, phosphorus, albumin, and alkaline phosphatase. At the completion of the study a letter was sent to the patients detailing the findings, and a copy sent to their physician. Of the 83 persons enrolled, 73 (88%) had evidence of osteopenia or osteoporosis (T-score <-1.5) and/or low 25VitD. All fractures in the community in person > or =55 yr, with or without a history of antecedent trauma, should be assessed with BMD and screening for 25VitD.     

25-OH-D2、25-OH-D3与股骨颈骨密度的相关性研究

目的研究人体内25羟维生素D2(25-OH-D2)、25羟维生素D3(25-OH-D3)含量与股骨颈骨密度的相关性。方法利用双能X线骨密度测量法检测205例患者股骨颈骨密度,同时用高效液相色谱法检测其血清中25-OH-D2及25-OH-D3的含量,并根据维生素D(VitD)含量分析VitD与骨密度的关系。结果人体内VitD(25-OH-D2+25-OH-D3)含量与50岁以下者的股骨颈骨矿含量无相关性(P0.05),与50岁以上者呈正向直线相关(P0.05或P0.01),男女性别均一致。结论对于50岁以上者,随着年龄的增长,其体内血清VitD的含量降低很可能会导致其股骨颈骨矿含量下降。     

Normocalcemic hyperparathyroidism in patients with recurrent kidney stones: a disease entity or vitamin D deficiency?

This retrospective data analysis was undertaken to examine the biochemical differences between renal stone formers with normocalcemic hyperparathyroidism (NHPT) and those with normal parathyroid hormone (PTH) levels. Our goal was to ascertain whether 25-hydroxyvitamin D (25(OH)D) status related to PTH levels in this patient cohort. Our findings among 74 patients with NHPT indicate that stone formers with NHPT had significantly lower 25(OH)D levels compared to 192 controls (p = 0.0001) and that 25(OH)D is positively correlated with 1,25-dihydroxyvitamin D values (R = 0.736, p = 0.015). Sequential measurements (after 3 - 5 years), among 11 patients with NHPT who did not receive vitamin D (VitD) preparations, showed a significant increase in urinary calcium (3.43 ± 1.96 vs. 5.72 ± 3.95, p = 0.0426) without a significant change in PTH levels. VitD supplementation, to 3 patients resulted in significant PTH decrease (11.8 ± 1.8 vs. 9.8 ± 1.3, p = 0.003). Prospective studies are needed to confirm the role of vitamin supplementation in renal stone formers with NHPT.