乌鲁木齐市某社区人群血清25(OH)D水平与血脂的相关性分析

目的 探讨乌鲁木齐市某社区维吾尔（维）、汉族血清25 - 羟维生素D[25(OH)D]水平与血脂的关系。方法 本研究共纳入1 871例,年龄18～82岁,维族859人、汉族1 012人。测量身高、体重、腰围（WC）、颈围,计算体重指数（BMI）,测定血清25(OH)D、总胆固醇（TC）、高密度脂蛋白胆固醇（HDL - C）、低密度脂蛋白胆固醇（LDL - C）及甘油三酯（TG）水平。应用偏相关分析血清25(OH)D水平与血脂指标的相关性。结果 (1)血清25(OH)D平均水平为（16.11±8.20）ng/ml,血清维生素D充足、不足、缺乏、严重缺乏分别占6.5%、21.0%、52.5%、20.0%;血脂正常、异常分别占48.3%、51.2%;（2）按血清25(OH)D水平分为4组,按民族、性别分层,在维族女性中,不同血清25(OH)D组间TC、HDL - C、LDL - C差异有统计学意义,有随着25(OH)D水平的升高而升高的趋势;在汉族女性中,不同血清25(OH)D组间TC差异有统计学意义。校正年龄、BMI、WC后,仅在维族女性中血清25(OH)D与TC、HDL - C、LDL - C呈正相关。结论 乌鲁木齐市某社区人群存在普遍血清25(OH)D缺乏及血脂异常,血清25(OH)D可能与血脂代谢异常相关,且在维族女性中尤为显著。     

北京地区老年男性维生素D营养状态调查及与心血管危险因素相关性初探

目的了解老年男性维生素D营养状态,并初步探讨25-羟基维生素D[25(OH)D]与心血管危险因素的相关性。方法选取2013年1月~2013年5月在解放军总医院门诊查体的老年男性472名,评估北京地区老年男性血清维生素D水平,并分析25(OH)D水平与血脂、血压、体质量指数(BMI)、全血糖化血红蛋白(Hb A1C)、空腹血糖(FBP)的相关性。结果472名老年男性的血清25(OH)D水平平均为(19.47±11.32)ng/ml,其中严重缺乏、缺乏、不足、充足者所占比例分别为20.97%、39.20%、24.36%、15.47%。25(OH)D与总胆固醇/高密度脂蛋白(TC/HDL-C)、低密度脂蛋白/高密度脂蛋白(LDL-C/HDL-C)水平呈显著负相关,与HDL-C呈显著正相关。25(OH)D水平与收缩压(SBP)呈显著负相关,与舒张压(DBP)未见明显相关性。不同25(OH)D水平组有显著差异,进一步分析不同BMI水平组25(OH)D变化,将研究对象根据BMI水平分为正常组、超重组、肥胖组,结果发现,随BMI上升,25(OH)D水平显著下降。非糖尿病组及糖尿病组25(OH)D与Hb A1C均呈负相关,与FBP无明显相关性。多元逐步回归结果显示,25(OH)D与Hb A1C、HDL-C、SBP均显著相关。结论北京市老年男性维生素D缺乏现象普遍,且维生素D营养状态与多项心血管疾病危险因素均有显著相关性。     

太原社区非糖尿病人群血清维生素D与腹型肥胖的相关性

目的　旨在评估太原社区非糖尿病人群的维生素D水平状况,探讨血清25-羟基维生素D3［25(OH)D3］与肥胖、腹型肥胖的相关性。方法　纳入2011年7至9月太原社区非糖尿病者417名［男225名,女192名,平均年龄（47.6±7.8）岁］,所有对象均完成一般体格检查、病史询问及血糖、血脂、25(OH)D3、空腹胰岛素（Fins）检测,计算胰岛素抵抗指数（HOMA-IR),双能X线吸收测量法（DEXA）测定体脂含量（%）,采集第4到第5腰椎间盘水平的MRI图像并计算腹内脂肪组织（IAAT）和腹部皮下脂肪组织（SCAT）,IAAT≥80 cm2即为腹型肥胖。分析血清25(OH)D3与各生化指标及体脂的相关性。结果　417名研究对象平均血25(OH)D3水平为44.5 nmol/L,其中维生素D缺乏和不足分别为62.6%（261例）和26.1%（109例）。维生素D缺乏和不足人群中,根据腹内脂肪面积,腹型肥胖（IAAT≥.80 cm2）占77.6%。Pearson 相关分析显示lg 25(OH)D3与.lg Fins、.lg HOMA-IR、腰围、收缩压、舒张压、腹部脂肪组织（TAAT）、IAAT呈显著负相关（均P＜0.05）;与腰臀比、体质量指数及体脂含量（%）呈负相关,但差异无统计学意义（均P＞0.05）。逐步多元线性回归分析显示lg HOMA-IR（t=-4.278,P=0.001）、TAAT（t=-5.146,P=0.002）与.lg 25(OH)D3独立相关。结论　太原社区非糖尿病人群约90%存在维生素D缺乏和不足,在维生素D缺乏和不足人群中约4/5为腹型肥胖。血清25(OH)D3水平与腹部脂肪面积呈显著负相关,而与体质量指数无明显相关。HOMA-IR、.TAAT.是25(OH)D3缺乏的独立危险因素。     

温岭市中老年人群高尿酸血症的相关因素分析

目的了解沿海地区中老年人高尿酸血症(hyperuricemia,HUA)与年龄、血脂、血压等危险因素的相关性。方法收集在内科门诊就诊的1 236例中老年高尿酸血症患者。实验室检测其尿酸(UA)、甘油三酯(TG)、同型半胱氨酸(Hcy)、游离脂肪酸(FFA)等水平,并统计年龄、性别、身体质量指数(BMI)、血压等指标,用Logistic回归分析高尿酸血症伴心血管疾病(CVD)的危险因素,研究高尿酸血症与各因素之间的相关性。结果高尿酸血症伴CVD患者与高尿酸血症不伴CVD患者在年龄、性别、血压、吸烟、饮酒、Hcy水平上相比较,差异有统计学意义(P0.05)。Logistic回归结果显示,年龄、高血压、吸烟、饮酒、高Hcy水平等10个因素是高尿酸血症患者伴发CVD的危险因素。结论沿海地区高尿酸血症以男性中老年人为主。年龄、高血压、高血脂、高Hcy水平等均与高尿酸血症有关联。长期饮酒、吸烟是高尿酸血症伴CVD的危险因素。     

慢性肾脏病1～3期患者25（OH）D水平的影响因素

目的 通过调查慢性肾脏病（CKD）1～3期患者25（OH）D水平,探讨25（OH）D的影响因素,为CKD患者早期进行维生素D缺乏的预防及治疗提供依据.方法 采用放射免疫法检测89例CKD 1 ～3期患者25（OH）D水平,采用自动生化仪测定血钙、磷、碱性磷酸酶、总蛋白、白蛋白、肌酐,24 h尿蛋白定量及微量清蛋白、尿钙等.采用单因素相关分析探讨25 （OH）D的影响因素.25（OH）D的独立影响因素采用多元线性回归分析.结果 89例CKD患者25（OH）D水平中位数11.0 μg/L,全距3.0 ～ 39.0 μg/L,维生素D不足者占28.1％（25/89）,缺乏者占68.5％（61/89）.CKD1～3期各期间25（OH）D比较差异无统计学意义（P＞0.05）.单因素相关分析提示：25（OH）D与激素使用、校正钙、促甲状腺激素、24 h尿蛋白定量、24 h尿微量白蛋白呈负相关,与总蛋白及白蛋白呈正相关.多元线性回归分析提示：校正钙、白蛋白是25（OH）D水平的独立影响因素.结论 CKD 1 ～3期患者普遍存在维生素D缺乏,校正钙、白蛋白是25（OH）D水平的独立影响因素.     

医务人员维生素D水平与血脂的相关性研究

目的探讨医务人员维生素D水平与血脂的相关性。方法于2015年纳入在某三甲医院体检的754名医务人员为研究对象,抽取静脉血检测25(OH)D和血生化指标等,并分析25(OH)D与血脂相关指标水平的相关性。结果754名医务人员的血清25(OH)D平均为(15.94±7.41)ng/mL,其中维生素D严重缺乏156人,占20.69%;维生素D缺乏418人,占57.89%;维生素D不足147人,占19.50%;维生素D充足33人,占4.38%。相关分析结果显示,校正性别、年龄后,25(OH)D分别与体质指数(BMI)(r=-0.090,P=0.013)、总胆固醇(TC)(r=-0.309,P0.001)、三酰甘油(TG)(r=-0.079,P=0.030)、低密度脂蛋白(LDL-C)(r=-0.143,P0.001)呈负相关,与高密度脂蛋白(HDL-C)(r=0.004,P=0.922)、尿酸(UA)(r=-0.024,P=0.504)和空腹血糖(FPG)(r=-0.048,P=0.187)未见统计学关联。多重线性回归分析结果显示,25(OH)D与TC呈负相关(β'=-0.298,P0.001)。结论医务人员维生素D缺乏状况较为普遍,需引起重视;维生素D缺乏与TC升高呈负相关。     

512名6～13岁儿童维生素D营养状况与体质指数的关系

目的了解广西学龄儿童维生素D营养状况与生长发育关系,为防治儿童维生素D缺乏提供科学依据。方法采用横断面研究的方法,随机选取广西融水县512名6～13岁儿童,采集静脉血,用酶联免疫吸附法测定血清25-羟维生素D[25-(OH)D]浓度,测量身高、体重,计算体质指数（BMI）。结果研究对象血清25-(OH)D平均浓度为（22.86±0.41）ng/mL。血清25-(OH)D浓度与性别、身高、体重、BMI呈正相关（R2=0.046,P＜0.05）。研究对象血清25-（OH）D水平各年龄组间差异有统计学意义（F=2.382,P＜0.05）。各年龄段维生素D营养状况分布不同,13岁组血清25-(OH)D水平处于正常或充足状态的比例最高,占33.30%;而7岁组最低仅占3.20%,8～9岁组血清25-(OH)D缺乏者较多,分别占61.90%和44.70%。结论维生素D营养状况与学龄儿童BMI呈正相关,维生素D缺乏状况不容忽视。     

足月小于胎龄儿和适于胎龄儿脐血25（OH）D水平的变化

目的：探讨小于胎龄（SGA）和适于胎龄（AGA）两种类型足月新生儿脐血25－羟维生素D[25（OH）D]水平及其与胎儿宫内生长发育的关系，为孕期维生素D补充干预提供科学依据。方法选取2014年1月至2015年12月广州市妇女儿童医疗中心637例足月新生儿为研究对象，于分娩后收集新生儿脐带血，采用酶联免疫法检测脐血的25（OH）D水平，并分析脐血25（OH）D水平的在SGA和AGA组之间的变化规律及其与新生儿出生体重的相关性。结果 AGA和SGA组之间25（OH）D水平分别为（31．58±12．72）ng／mL和（25．00±11．13）ng／mL，差异有统计学意义（t＝3．98，P＜0．0001）。在控制了产妇年龄和BMI，以及新生儿胎龄、性别和分娩季节等潜在混杂因素之后，多因素Logistic回归分析结果显示：与脐血25（OH）D＜20ng／mL组相比，20～32ng／mL组和≥32ng／mL组SGA发生的风险分别降低了83％（OR＝0．17，95CI＝0．07～0．41）和90％（OR＝0．10，95％CI＝0．04～0．28）。结论 SGA的发生与新生儿脐血25（OH）D水平缺乏或不足密切相关，SGA出生后应及时补充维生素D和保证充足的户外活动，从而改善维生素D的不足或缺乏现状。     

脐血维生素D与婴儿维生素D水平的相关性分析

目的了解新生儿脐血维生素D与婴儿维生素D水平及其相关性。方法收集340名新生儿脐血及与其配对的9个月婴儿血,采用酶联免疫法检测新生儿脐血及婴儿血的血清25（0H）D水平。通过问卷调查收集婴儿喂养方式、母乳喂养的时间、添加维生素D的时间、剂量、户外活动时间等资料;并采用直线相关分析、单因素方差分析及Y。检验等进行新生儿脐血与婴儿血清维生素D水平相关性分析等。结果新生儿脐血和婴儿的25-（0H）D水平分别是（30．03±11．24）nmol／L、（79．05±28．96）nmol／L;92．94％的新生儿和9．71％的9个月婴儿的25～（OH）D水平低于50nmol／L,33．82％的新生儿25-（OH）D水平低于25nmol／L,9个月婴儿的25-（0H）D水平无一例低于25nmol／L。新生儿脐血与9个月婴儿血清25-（0H）D水平无相关性,spearman相关系数r=0．036,P-0．504。新生儿脐血及9个月婴儿血清的25-（OH）D水平均存在明显季节性差异（F分别-20．845,3．565;P分别为0．000,0．014）。维生素D水平在秋季最高,春季最低。结论新生儿脐血维生素D缺乏或不足普遍存在,尤其在春季。婴儿维生素D水平相对较高,尤其是在秋季。新生儿脐血与9个月婴儿血清25-（OH）D水平无相关性。提示婴幼儿维生素D缺乏可防可控,只要合理及时的补充维生素D,即可以有效的预防。必须加强妇幼保健工作管理,重视孕期维生素D的补充;冬春季节的孕妇（尤其是孕晚期）和新生儿以及婴儿应该多参加户外活动,特别重视维生素D的补充。     

阿尔茨海默病与维生素D水平的关系

目的,了解阿尔茨海默病（AD）患者体内维生素D营养状况,分析其血清25羟维生素D[25(OH)D ]水平与认知功能的关系,为临床补充维生素D制剂的干预研究提供依据。方法 回顾性分析本院113例住院AD患者血清总25(OH)D浓度与认知功能的关系。采用液相色谱-串联质谱法（LC-MS／MS）,定量测定AD患者血清25(OH)D2、25(OH)D3 和总25(OH)D浓度。按2011年美国医学科学院(IOM)的维生素D营养状况分级标准分组：维生素D充足组［25(OH)D≥75 nmol/L］、维生素D不足组［25(OH)D 50～75 nmol/L］、维生素D缺乏组［25(OH)D 25～50 nmol/L］和维生素D严重缺乏组［25(OH)D≤25 nmol/L］。结果 （1）113例AD患者血清总25(OH)D为（27.08±15.33）nmol/L,其中血清25(OH)D2为（1.23±0.93）nmol/L和25(OH)D3为（24.50±13.04）nmol/L;（2）60.18 %（68/113）患者维生素D严重缺乏、30.97 %（35/113）患者维生素D缺乏、7.97%（9/113）患者维生素D不足和0.88%（1/113）患者维生素D充足;（3）AD患者血清总25(OH)D浓度与MMSE总分的Spearman秩和相关分析呈正相关关系（r=0.202,P=0.032）。结论 住院AD患者严重缺乏维生素D,需要补充维生素D;血清总25(OH)D浓度与认知功能有正相关关系;补充维生素D制剂是否能提高认知功能,需要进一步进行随机双盲、安慰剂对照临床研究证实。     

Vitamin D status: measurement, interpretation, and clinical application

Vitamin D, the sunshine vitamin, is now recognized not only for its importance in promoting bone health in children and adults but also for other health benefits, including reducing the risk of chronic diseases such as autoimmune diseases, common cancer, and cardiovascular disease. Vitamin D made in the skin or ingested in the diet is biologically inert and requires 2 successive hydroxylations first in the liver on carbon 25 to form 25-hydroxyvitamin D [25(OH)D], and then in the kidney for a hydroxylation on carbon 1 to form the biologically active form of vitamin D, 1,25-dihydroxyvitamin D [1,25(OH)(2)D]. With the identification of 25(OH)D and 1,25(OH)(2)D, methods were developed to measure these metabolites in the circulation. Serum 25(OH)D is the barometer for vitamin D status. Serum 1,25(OH)(2)D provides no information about vitamin D status and is often normal or even increased as the result of secondary hyperparathyroidism associated with vitamin D deficiency. Most experts agree that 25(OH)D of <20 ng/mL is considered to be vitamin D deficiency, whereas a 25(OH)D of 21-29 ng/mL is considered to be insufficient. The goal should be to maintain both children and adults at a level >30 ng/mL to take full advantage of all the health benefits that vitamin D provides.     

Vitamin D Status and Risk of Cystic Fibrosis-Related Diabetes: A Retrospective Single Center Cohort Study

Objective: Cystic fibrosis-related diabetes (CFRD) affects up to half of the people with cystic fibrosis (CF) by adulthood. CFRD is primarily caused by pancreatic dysfunction that leads to insufficient insulin release and/or insulin resistance. Exocrine pancreatic insufficiency in people with CF is associated with fat-soluble vitamin malabsorption, including vitamins A, D, E, and K. This study examined the relationship between vitamin D status, assessed by serum 25-hydroxyvitamin D (25(OH)D), and the development of CF-related diabetes (CFRD) in adults with CF. Methods: This was a retrospective cohort study of adults seen at a single CF center. The data were extracted from the electronic medical records and the Emory Clinical Data Warehouse, a data repository of health information from patients seen at Emory Healthcare. We collected age, race, the first recorded serum 25-hydroxyvitamin D (25(OH)D) concentration, body mass index (BMI), and onset of diabetes diagnosis. Log-rank (Mantel–Cox) tests were used to compare the relative risk of CFRD onset in the subjects with stratified vitamin D status and weight status. A sub-group analysis using chi-square tests assessed the independence between vitamin D deficiency and CFRD risk factors, including gender and CF mutation types (homozygous or heterozygous for F508del, or others). Unpaired t-tests were also used to compare the BMI values and serum 25(OH)D between the CF adults based on the CFRD development. Results: This study included 253 subjects with a mean age of 27.1 years (±9.0), a mean follow-up time period of 1917.1 (±1394.5) days, and a mean serum 25(OH)D concentration of 31.8 ng/mL (±14.0). The majority (52.6%) of the subjects developed CFRD during the study period. Vitamin D deficiency (defined as 25(OH)D < 20 ng/mL) was present in 25.3% of the subjects. Close to two thirds (64.1%) of the subjects with vitamin D deficiency developed CFRD during the study. Vitamin D deficiency increased the risk of developing CFRD (chi-square, p = 0.03) during the course of the study. The time to the onset of CFRD stratified by vitamin D status was also significant (25(OH)D < 20 ng/mL vs. 25(OH)D ≥ 20 ng/mL) (95% CI: 1.2, 2.7, p < 0.0078). Conclusion: Our findings support the hypothesis that adults with CF and vitamin D deficiency are at a higher risk of developing CFRD and are at risk for earlier CFRD onset. The maintenance of a serum 25(OH)D concentration above 20 ng/mL may decrease the risk of progression to CFRD.     

Ethnic disparities in the clustering of risk factors for cardiovascular disease among the Kazakh, Uygur, Mongolian and Han populations of Xinjiang: a cross-sectional study

ABSTRACT: BACKGROUND: Chinese Uygur, Kazakh, Mongolian and Han populations represent >90% of the total population of Xinjiang Uygur Autonomous Region, and their genetic backgrounds, customs, culture, and food consumption are different. The effect of ethnic differences on cardiovascular disease risk factors (CRFs; hypertension, obesity, diabetes, dyslipidemia, smoking) can be striking but is rarely studied. We report here the findings of the relationship among these ethnic groups and their CRFs across the four largest ethnic groups of Xinjiang. METHODS: A cross-sectional survey of representative samples was conducted 2002-2008 in Chinese Uygur, Kazakh, Mongolian and Han populations (age >30 years; 4,421 Kazakh, 3884 Han, 3,218 Uygur, and 892 Mongolian individuals) in Xinjiang. RESULTS: A total of 90.4% of Kazakh, 91.9% of Uygur, 90.4% of Mongolian, 85.1% of Han individuals had at least one CRF. Clustering of [greater than or equal to]2 or [greater than or equal to]3 of these risk factors was noted in 65.2% or 32.1% of Kazakh, 64.8% or 33.0% of Uygur, 66.9% or 36.5% of Mongolian as well as 62.0% or 28.3% of Han subjects, respectively. Compared with the Han population, the adjusted odds ratios of [greater than or equal to]1, [greater than or equal to]2, and [greater than or equal to]3 CRFs for Kazakh, Uygur and Mongolian populations were higher (all P<0.001). The age-standardized prevalence of the clustering of [greater than or equal to]1, [greater than or equal to]2, and [greater than or equal to]3 CRFs in Kazakh, Uygur, Mongolian, and Han populations was lower than their counterparts in the NHANES Sha study (USA) but higher than in the InterASIA Study (China). CONCLUSIONS: Ethnic groups living in Xinjiang had striking differences in CRFs. Ethnic-specific strategies should be developed to prevent cardiovascular disease in different ethnic groups.     

Estimate of a predictive cut-off value for serum 25-hydroxyvitamin D reflecting abdominal obesity in Korean adolescents

Vitamin D deficiency is a serious global issue. Although the serum 25-hydroxyvitamin D [25(OH)D] test is generally the most accurate way to assess vitamin D levels, the optimal range of 25(OH)D has yet to be established. Moreover, the optimal level may vary according to race, region, and age. Suboptimal vitamin D status is associated with obesity and metabolic syndrome, which are the major risk factors for cardiovascular disorders; however, these relationships in children and adolescents have yet to be clearly determined. Therefore, we identified the best predictive cut-off value for reflecting abdominal obesity and, based on this value, we investigated the relationship between suboptimal 25(OH)D status and the risk for having abdominal obesity, being overweight or obese, and having metabolic syndrome in Korean adolescents. We performed a cross-sectional analysis of 713 Korean adolescents, between 12-19 years of age, and used data collected from the 2008 Korea National Health and Nutrition Examination Survey (KNHANES). Receiver operation characteristic curve analysis was used to identify the cut-off value that reflected abdominal obesity. The cut-off value of serum 25(OH)D that reflected abdominal obesity in Korean adolescents was 17.6 ng/mL. After making adjustments for gender, age, and regular physical exercise, the group that had lower levels of serum 25(OH)D compared to the cut-off value had a significantly higher risk for abdominal obesity, obesity, and metabolic syndrome than the group with 25(OH)D levels higher than the cut-off value. Suboptimal vitamin D status based on this value is associated with increased risk for abdominal obesity, obesity, and metabolic syndrome among Korean adolescents.     

A High Prevalence of Vitamin D Deficiency Observed in an Irish South East Asian Population: A Cross-Sectional Observation Study

At northern latitudes, non-ethnic population groups can be at an increased risk of vitamin D deficiency (defined as a 25-hydroxyvitamin D [25(OH)D] status ≤30 nmol/L). The vitamin D status of ethnic minority groups has been examined both in UK and European populations, but not in the Irish context. The aim of this study is to assess the vitamin D status from a selection of the Dublin population of South East Asian descent. A search was conducted, using the laboratory information system of St James’s Hospital, Dublin, for vitamin D requests by General practitioners. From 2013 to 2016, 186 participants were identified and 25(OH)D analysis was quantified using liquid chromatography-tandem mass spectrometry (LC-MS-MS). Overall, the median age was 32 years, 51% were male, and the 25(OH)D concentration ranged from 10 to 154 nmol/L. In total, 66.7% of the total sample were vitamin D deficient and 6.7% had a 25(OH)D status greater than 50 nmol/L (the 25(OH)D concentration defined by the EU as ‘sufficient’). Females had a significantly higher 25(OH)D concentration than males (25.0 vs. 18.0 nmol/L; p = 0.001) but both groups had a significant proportion with deficient status (56% and 76.8%, respectively). Seasonal variation of 25(OH)D was not evident while high rates of deficiency were also observed in those aged <18 years and >50 years. Given the importance of vitamin D for health, this sub-population could be at a significantly increased risk of rickets, impaired bone metabolism, and osteoporosis. In addition, vitamin D deficiency has been associated with several non-bone related conditions, including cardiovascular disease and diabetes. Currently, there is no unique vitamin D intake or vitamin D status maintenance guidelines recommended for adults of non-Irish descent; this needs to be considered by the relevant public health bodies in Ireland.     

乌鲁木齐市维吾尔族和汉族中学生近视遗传度调查

目的 了解乌鲁木齐维吾尔族、汉族中学生近视状况,探讨新疆维、汉中学生近视遗传的影响因素。方法 采用整群抽样方法抽取乌鲁木齐市中学生2 380人进行近视筛查和问卷调查,用Falconer法计算维汉近视与非近视学生一、二级亲属的近视遗传度。结果 中学生总体近视患病率为60.12%,维吾尔族中学生近视患病率为37.80%,明显低于汉族中学生的77.36%(P<0.05);维吾尔族男生近视患病率为31.31%,低于女生的42.08%(P<0.05),汉族女生近视患病率为82.40%,高于男生的71.61%(P<0.05);维吾尔族中学生近视组一级亲属的近视患病率为10.23%,高于对照组一级亲属的4.87%(OR=1.921),汉族中学生近视组一级亲属的近视患病率为18.90%,高于对照组一级亲属的10.82%(OR=2.225),一级亲属近视是中学生近视的危险因素;汉族中学生一级亲属近视遗传度为36.86%,维吾尔族中学生一级亲属近视遗传度为36.27%。结论 中学生近视的病因十分复杂,是遗传和环境多种因素综合作用的结果。     

Determinants of vitamin D status in adult Crohn's disease patients, with particular emphasis on supplemental vitamin D use

OBJECTIVE: To investigate determinants (pathophysiologic and physiologic, behavioural and lifestyle) of vitamin D status in Irish Crohn's disease (CD) patients. DESIGN: A cross-sectional observational study. SETTING: Cork City, Ireland (52 degrees N). SUBJECTS: Crohn's Disease patients (n=58; mean age 38.1 years) were recruited from Cork University Hospital. RESULTS: Fifty and nineteen percent of Irish CD patients were vitamin D deficient (defined by serum 25 hydroxyvitamin (OH) D levels <50 nmol/l) during winter and summer, respectively. Multiple regression analysis showed that summer-time serum 25 (OH) D levels were positively associated with use of vitamin D supplements (P=0.033) and negatively associated with smoking (P=0.006) and being male (P=0.063). During winter-time, use of vitamin D supplements (P=0.041) and sun habits (P=0.066) were positively associated, whereas small intestinal involvement (P=0.005) and body mass index (BMI) (P=0.083) were negatively associated with serum 25 (OH) D levels. There was no significant association between other non-pathophysiologic (age, dietary calcium or vitamin D) or pathophysiologic factors (steroid use, resection), and serum 25 (OH) D levels, at either season. Approximately 41 and 60% of the total variation in summer- and winter-time serum 25 (OH) D, respectively, was explained by this model. CONCLUSION: A high proportion of Irish CD patents had some level of vitamin D deficiency (<50 nmol/l) during late-wintertime. Use of regular low-dose supplemental vitamin D, particularly by patients with small intestinal involvement, cessation of smoking and adequate, but responsible, exposure to summer sunlight as well as maintaining BMI in the normal range could help maintain adequate vitamin D levels during wintertime.     

Live Longer with Vitamin D?

The global burden of vitamin D deficiency or insufficiency is of great concern for public health. According to recent studies, vitamin D deficiency is an important etiological factor in the pathogenesis of many chronic diseases. Whether or not there is a connection between 25-hydoxyvitamin D (25(OH)D) status and overall mortality is a matter of considerable debate. A new meta-analysis confirmed that low 25(OH)D levels were associated with a significant increased risk for all-cause mortality. Individuals with severe vitamin D deficiency have almost twice the mortality rate as those with 25(OH)D level ≥ 30 ng/mL, (≥75 nmol/L). Unlike previous meta-analyses which suggested that serum 25(OH)D > 50 ng/mL was associated with increased mortality, this new analysis found that there was no increased risk even when 25(OH)D levels were ≥70 ng/mL. In general, closer attention should be paid to vitamin D deficiency in medical and pharmaceutical practice than has been the case hitherto. The results of these studies are consistent with the recommendation to improve the general vitamin D status in children and adults by means of a healthy approach to sunlight exposure, consumption of foods containing vitamin D and supplementation with vitamin D preparations.