上海地区人群维生素D状态研究

目的调查居住在上海地区人群的维生素D状态,探索和建立维生素D"正常"与"适宜"状态测定参考值,为骨质疏松症的防治提供依据。方法 2008年10月至2009年4月、2009年10月至2010年4月用自动电子发光免疫法对在上海地区居住超过5年的2607名健康成人进行血清25羟化维生素D(250HD)和甲状旁腺素(17TH)检测。选择250HD≤12、≤15、≤20和≤30 ng/mL等不同测定值计算低维生素D状态。结果 2607名受试者年龄20～102岁,平均年龄(60.4±20.9)岁,其中男性1150名(44.42%),女性1449名(55.58%),血清250HD平均值为(17.96±6.43)ng/mL,PTH为(2.14±17.10)pg/mL,呈近似正态分布。应用血清250HD4个测定值评估低维生素D状态结果显示:维生素D缺乏或不足的发生率分别为20.85%、32.45%、66.12%和97.36%,15 ng/mL测定值组有明显的增龄性低维生素D状态。2008年10月至2009年4月和2009年10月至2010年4月测定的血清250HD平均值差异有统计学意义。结论结合上海地区人群总体健康水平,维生素D"适宜"状态测定值宜采用20～30 ng/mL,低维生素D状态测定值宜采用15 ng/mL,低维生素D状态的流行率为32.45%。

Vitamin D status in healthy man and woman in Shanghai

Objective Vitamin D status is an important factor for osteoporosis prevention and treatment, and the efficacy of anti-osteoporosis treatment, also important for many chronic diseases with aging. Great discrepancy morbidity of hypovitaminosis was showed in different analytic methods and cut-off values. This study is aimed to determine serum 25-hydroxyvitamin D （25OHD） level and the relationship between 25OHD and PTH level, to establish the 250HD normal reference value and evaluate epidemiology of hypovitaminosis D for providing evidence of osteoporosis prevention and health care in Shanghai （31°N） located in east China. Methods In this prospective cohort study, 2607 of adults living in Shanghai more than 5 years were recruited, serum level of 25OHD and PTH were obtained in October 2008 to April 2009 （1999 cases） and in October 2009 to April 2010 （607 cases） respectively. All the subjects were divided into 4 groups based on the 25OHD cut-off values： ≤ 12 ng/mL, ≤ 15 ng/mL, ≤20 ng/mL and ≤30 ng/mL to evaluate prevalence of hypovitaminosis D. Serum 25OHD and PTH levels were measured by direct competitive electrolumineseent immunoassay （Modular Analytics El70 Roche）. Results Serum 25OHD and PTH were measured and stratified with age in 2607 subjects （ 1449 females （55.58%） and 1150 males （44. 42% ） aged 20 - 102 years, mean ± SD, 60. 4 ± 20. 9 years）. The average of 25OHD was 17.96±6.43 ng/mL, PTH was 32. 14 ± 17. 10 pg/mL showing a particular measure year difference. The level of 25OHD and PTH is showing approximate Gousse contribution respectively. The weak relationship between 25OHD and PTH was found （ P = 0. 032）. Hypovitaminosis D morbidity were 20. 85%, 32. 45% , 66. 12% and 97. 36% according to serum 25OHD 4 different cut-off value （ ≤ 12 ng/mL, ≤ 15 ng/mL,≤20 ng/mL and ≤30 ng/mL）. The prevalence of the group with serum level 25OHD 〈 15 ng/mL was significantly increased with age. Conclusion Optimum level of serum 25OH 20 - 30 ng/mL in Shanghai is suggested. Hypovitaminosis D status may be defined as 〈 15 ng/mL. Based on the definition, the prevalence of hypovitaminosis D was 32. 45%.