Serum vitamin D levels are inversely related with non‐alcoholic fatty liver disease independent of visceral obesity in Chinese postmenopausal women

The aim of the present study was to investigate the association between serum vitamin D levels and both visceral adipose and with non‐alcoholic fatty liver disease (NAFLD) in Chinese postmenopausal women. Four hundred and fifty‐one postmenopausal women between 45 and 74 years of age (mean (± SD) age 57.3 ± 4.6 years) were enrolled in the study. All subjects participated in the Shanghai Obesity Study between June and August 2011 and underwent abdominal magnetic resonance imaging and an abdominal ultrasonography. Patients with a visceral fat area (VFA) ≥ 80 cm² were classified as abdominally obese. Serum 25‐hydroxyvitamin D₃ (25(OH)D₃) levels were measured with an electrochemiluminescence immunoassay. The prevalence of NAFLD in the study population was 34.8% (n = 157). Women with abdominal obesity had significantly lower serum 25(OH)D₃ levels than those without abdominal obesity (median (interquartile range) 11.23 (8.64–14.12) vs 12.56 (9.41–15.98) ng/mL, respectively; P < 0.01). Regardless of abdominal obesity status, serum 25(OH)D₃ levels in patients with NAFLD were lower than those without non‐NAFLD (11.14 (8.63–13.81) vs 12.92 (9.48–16.37) ng/mL (P < 0.05) for those without abdominal obesity; 10.86 (8.61–13.56) vs 11.55 (8.82–16.38) ng/mL (P < 0.05) for those with abdominal obesity). Partial correlation analyses demonstrated a negative correlation between serum 25(OH)D₃ levels and VFA (P < 0.05). Logistic regression analysis revealed that high serum 25(OH)D₃ levels were a protective factor against NAFLD after adjusting for risk factors such as VFA. In conclusion, independent of visceral obesity, vitamin D is inversely correlated with NAFLD in Chinese postmenopausal women.     

Quantitation of serum 25(OH)D2 and 25(OH)D3 concentrations by liquid chromatography tandem mass spectrometry in patients with diabetes mellitus

Vitamin D has been considered to regulate calcium and phosphorus homeostasis and to preserve skeletal integrity. Serum 25-hydroxyvitamin D (25(OH)D) is the best indicator of vitamin D levels. The association of serum 25(OH)D deficiency with increased risk of type 1 diabetes (T1DM) and type 2 diabetes (T2DM) is controversial. We investigated serum 25(OH)D₂ and 25(OH)D₃ levels in diabetes patients by using liquid chromatography tandem mass spectrometry (LC-MS/MS). Serum 25(OH)D2 and 25(OH)D3 levels were measured with liquid chromatography tandem mass spectrometry in electrospray ionization positive mode. Chromatograms were separated using an ACE5 C18 column on a gradient of methanol. The total 25(OH)D levels were calculated as the sum of 25(OH)D3 and 25(OH)D2 levels. A total of 56 patients with T1DM and 41 patients with T2DM were enrolled in this study. There were 42 and 28 non-diabetic, age-matched volunteers who participated as the T1DM controls and the T2DM controls, respectively. The total 25(OH)D levels were lowest in the 21–40 age group. The levels of both 25(OH)D3 and the total 25(OH)D were significantly higher in the T1DM and T2DM groups than in the controls (p < 0.01 in T1DM and p < 0.05 in T2DM group, respectively). The 25(OH)D2 levels were only significantly higher in T1DM patients than in the controls. The percentages of vitamin D deficiency (total 25(OH)D less than 20 ng/mL) in the T1DM, T2DM, the T1DM controls and the T2DM controls were 7.1%, 0%, 14.3% and 3.6%, respectively. The percentages of vitamin D insufficiency (total 25(OH)D less than 30 ng/mL) in the T1DM, T2DM, the T1DM controls and the T2DM controls were 26.8%, 7.3%, 54.8% and 17.9%, respectively. The percentages of vitamin D deficiency and insufficiency were significantly lower in the T1DM patients than in the T1DM controls (p < 0.01). In the present study, both type 1 and type 2 diabetes patients had higher serum 25(OH)D levels and lower percentages of vitamin D deficiency/insufficiency.     

Serum vitamin D is associated with non-alcoholic fatty liver disease in Chinese males with normal weight and liver enzymes

Aim:

Considering the characterization of vitamin D deficiency as a risk factor of ectopic fat deposition, the association of serum 25-hydroxy vitamin D₃ [25(OH)D₃] levels with non-alcoholic fatty liver disease (NAFLD) was evaluated in Chinese men with normal body mass index (BMI) and enzyme markers of liver function.

Methods:

A total of 514 participants (22 to 79 years old) with normal BMI and liver enzymes were identified for analysis. Abdominal ultrasound was performed to diagnose NAFLD, and the fatty liver index (FLI) was calculated to quantify liver steatosis. Serum 25(OH)D₃ levels were determined by an electrochemiluminescence immunoassay.

Results:

Among the entire study population, the mean levels of serum 25(OH)D₃ were 15.32±5.77 ng/mL. However, when serum 25(OH)D₃ levels were compared between non-NAFLD subjects (n=438) and NAFLD subjects (n=76), the latter showed significantly lower levels (15.65±5.89 ng/mL vs 13.46±4.65 ng/mL, P=0.002). In addition, serum 25(OH)D₃ levels were found to be significantly correlated with FLI after adjustment for age and BMI (r=−0.108, P=0.014). Logistic regression showed that serum 25(OH)D₃ levels were independently correlated with NAFLD (OR: 0.937, 95% CI: 0.884–0.993, P=0.028). Furthermore, stepwise regression analysis revealed that serum 25(OH)D₃ levels were inversely associated with FLI (β=−0.055, P=0.040).

Conclusion:

The present study demonstrated that serum 25(OH)D₃ levels were inversely associated with NAFLD, even in subjects with normal total body fat, suggesting a potential role of lower levels of vitamin D in the occurrence and development of NAFLD.     

２型糖尿病合并高血压患者血清维生素D与血尿酸的关系

目的 观察2型糖尿病（type 2 diabetes mellitus ,T2DM）合并高血压患者血清中25羟维生素D[25 hydroxyvitamin D,25(OH)D]、尿酸(uric acid,UA)水平,并分析25(OH)D与UA的关系。方法 随机选取遵义医学院附属医院内分泌科门诊及住院的2型糖尿病患者77例按有无高血压分为正常血压组(DM组)38例(男19例,女19例)及高血压组(DH组)39例(男18例,女21例),另选同期体检中心体检的健康者(NC组)32例(男17例,女15例)。其中女性患者均未绝经,同时NC组中的女性均选择年龄及BMI匹配的未绝经健康女性。三组患者在年龄、性别构成比比较差异均无统计学意义。检测血清25(OH)D和UA水平及各项临床生化指标。结果 DM组血清25(OH)D水平[(12.48±4.01) ng/mL]低于NC组[(16.73±9.59) ng/mL],而UA水平[(316.61±85.91) ng/mL]较NC组[(273.03±60.92) ng/mL]升高,差异均具有统计学意义(P<0.05);DH组血清25(OH)D水平[(7.36±3.63) ng/mL]明显低于NC组[(273.03±60.92) ng/mL],而UA水平[( 362.07±117.76) ng/mL]较NC组[(273.03±60.92) ng/mL]明显升高,差异均具有统计学意义(P<0.05);DH组血清25(OH)D水平[(7.36±3.63) ng/mL]低于DM组[(12.48±4.01) ng/mL],而UA水平[( 362.07±117.76) ng/mL]较DM组[(316.61±85.91) ng/mL]明显升高,差异均具有统计学意义(P<0.05)。Pearson相关性分析显示25(OH)D与UA成负相关（r= -0.259,p=0.010）。结论 血清25(OH)D水平减低及UA水平升高是2型糖尿病合并高血压的重要危险因素。     

3C疗法治疗1型糖尿病儿童维生素D水平研究

目的：评估维生素D与1型糖尿病（T1DM）患儿的临床关系,为T1DM的防治提供新的依据。方法：选取我院2017-2018年新诊断及使用3C疗法治疗的T1DM患儿,分析T1DM患儿与健康体检患儿血清25-羟维生素D［25(OH)D］水平。根据25(OH) D水平,将T1DM患儿分为3组（缺乏组、不足组及充足组）,比较三个亚组的性别、年龄、居住地、体质量指数（BMI）、空腹C肽、空腹血糖及胰岛素用量等情况,探讨不同tanner分期、性别、季节、有无合并糖尿病酮症酸中毒（DKA）与血清维生素D水平的关系。结果：T1DM组患儿血清25(OH)D水平为（42.31±22.01）nmol/L,较健康对照组的（50.37±22.28）nmol/L低,差异有统计学意义（P<0.05）。T1DM组患儿中,维生素D充足组的空腹C肽水平高于维生素D不足组及维生素D缺乏组（P<0.05）;维生素D缺乏组空腹血糖水平及单位体质量胰岛素用量高于维生素D充足组（P<0.05）。按血清25(OH)D水平测定时间不同分A组（1-3月、10-12月）和B组（4-9月）,A组25(OH)D水平低于B组（P<0.05）;合并DKA组25(OH)D水平低于无DKA组（P<0.05）。结论：T1DM患儿普遍存在维生素D缺乏,尤其是合并DKA、及1-3月及10-12月的患儿;维生素D充足的T1DM患儿可减少胰岛素用量。临床上要加强T1DM患儿的维生素D的监测以及补充。     

Additional role of serum 25‐hydroxyvitamin D3 levels in atherosclerosis in Chinese middle‐aged and elderly men

相似文献   

Potencies of vitamin D analogs, 1α‐hydroxyvitamin D3, 1α‐hydroxyvitamin D2 and 25‐hydroxyvitamin D3, in lowering cholesterol in hypercholesterolemic mice in vivo

Vitamin D₃ and the synthetic vitamin D analogs, 1α‐hydroxyvitamin D₃ [1α(OH)D₃], 1α‐hydroxyvitamin D₂ [1α(OH)D₂] and 25‐hydroxyvitamin D₃ [25(OH)D₃] were appraised for their vitamin D receptor (VDR) associated‐potencies as cholesterol lowering agents in mice in vivo. These precursors are activated in vivo: 1α(OH)D₃ and 1α(OH)D₂ are transformed by liver CYP2R1 and CYP27A1 to active VDR ligands, 1α,25‐dihydroxyvitamin D₃ [1,25(OH)₂D₃] and 1α,25‐dihydroxyvitamin D₂ [1,25(OH)₂D₂]_, respectively. 1α(OH)D₂ may also be activated by CYP24A1 to 1α,24‐dihydroxyvitamin D₂ [1,24(OH)₂D₂], another active VDR ligand. 25(OH)D₃, the metabolite formed via CYP2R1 and or CYP27A1 in liver from vitamin D₃, is activated by CYP27B1 in the kidney to 1,25(OH)₂D₃. In C57BL/6 mice fed the high fat/high cholesterol Western diet for 3 weeks, vitamin D analogs were administered every other day intraperitoneally during the last week of the diet. The rank order for cholesterol lowering, achieved via mouse liver small heterodimer partner (Shp) inhibition and increased cholesterol 7α‐hydroxylase (Cyp7a1) expression, was: 1.75 nmol/kg 1α(OH)D₃ > 1248 nmol/kg 25(OH)D₃ (dose ratio of 0.0014) > > 1625 nmol/kg vitamin D₃. Except for 1.21 nmol/kg 1α(OH)D₂ that failed to lower liver and plasma cholesterol contents, a significant negative correlation was observed between the liver concentration of 1,25(OH)₂D₃ formed from the precursors and liver cholesterol levels. The composite results show that vitamin D analogs 1α(OH)D₃ and 25(OH)D₃ exhibit cholesterol lowering properties upon activation to 1,25(OH)₂D₃: 1α(OH)D₃ is rapidly activated by liver enzymes and 25(OH)D₃ is slowly activated by renal Cyp27b1 in mouse.     

2型糖尿病合并高血压病人血清维生素D与尿酸的关系

目的 观察2型糖尿病(T2DM)合并高血压病人血清中25羟维生素D[25(OH)D]、尿酸(UA)水平,并分析25(OH)D与UA的关系.方法 随机数字表法选取T2DM病人77例,按有无高血压分为正常血压组(DM组)38例(男19例,女19例)及高血压组(DH组)39例(男18例,女21例),另选同期体检中心健康体检者(NC组)32例(男17例,女15例).其中女性病人均未绝经,同时NC组中的女性均选择年龄及体质量指数(BMI)匹配的未绝经健康女性.三组病人年龄、性别构成比比较,均差异无统计学意义.检测血清25(OH)D和UA水平及各项临床生化指标.结果 DM组血清25(OH)D水平[(12.48±4.01)μg·L-1]低于NC组[(26.73±9.59)μg·L-1],而UA水平[(316.61±85.91)μmol·L-1]较NC组[(273.03±60.92)μmol·L-1]升高,均差异有统计学意义(P<0.05);DH组血清25(OH)D水平[(7.36±3.63)μg·L-1]明显低于NC组[(26.73±9.59)μg·L-1],而UA水平[(362.07±117.76)μmol·L-1]较NC组[(273.03±60.92)μmol·L-1]明显升高,均差异有统计学意义(P<0.05);DH组血清25(OH)D水平[(7.36±3.63)μg·L-1]低于DM组[(12.48±4.01)μg·L-1],而UA水平[(362.07±117.76)μmol·L-1]较DM组[(316.61±85.91)μmol·L-1]明显升高,均差异有统计学意义(P<0.05).Pearson相关性分析显示25(OH)D与UA成负相关(r=-0.259,P=0.010).结论 血清25(OH)D水平减低及UA水平升高是T2 DM合并高血压的重要危险因素.     

血清维生素D水平与2型糖尿病周围神经病变的关系

目的 探讨2型糖尿病（T2DM）患者血清25羟维生素D水平与糖尿病周围神经病变（DPN）的关系。方法 选择2016年1月至2017年4月安徽省立医院内分泌科住院的T2DM患者128例,按照有无并发症,分为合并周围神经病变组（DPN组）78例和无周围神经病变组（NDPN组）50例。收集各组临床资料如糖尿病病史、年龄,测量身高、体质量、收缩压（SBP）、舒张压（DBP）,计算体质指数（BMI）。测量血清25（OH）D、糖化血红蛋白（HbA1c）、空腹胰岛素C肽、血钙（Ca）、血磷（P）、碱性磷酸酶（ALP）、三酰甘油（TG）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）水平。分析25（OH）D与各指标的相关性及DPN发生的危险因素。结果 DPN组患者血清25（OH）D水平（13.64±3.07）ng/mL,低于NDPN组的（19.55±4.29）ng/mL,差异有统计学意义（P<0.05）;Pearson相关分析显示,25（OH）D 与HbA1c（r=-0.467, P<0.05）、病程（r=-0.432, P<0.05）、LDL-C（r=-0.439, P<0.05）呈负相关;logistic回归显示,25（OH）D是DPN发生的独立危险因素。结论 维生素D缺乏与T2DM患者周围神经病变的发生相关。     

Cystatin C measurement leads to lower metformin dosage in elderly type 2 diabetic patients

The aim of this study was to provide evidence for the hypothesis that estimated glomerular filtration rate from serum Cystatin C (eGFRcys) is better to be determined for all elderly type 2 diabetes mellitus (T2DM) patients based on eGFRcys upward and downward reclassification rate for hypothetical metformin dose reduction by eGFRcys at the GFR decision point of 45 mL/min/1.73 m². A total of 265 consecutive T2DM elderly patients (age range 65‐91 years) from outpatient diabetic clinic were included in the study. The Kidney Disease Improving Global Outcomes (KDIGO) guidelines for metformin dosing were strictly followed. Estimated glomerular filtration rate from serum creatinine (eGFRcrea) led to results of metformin eligibility. Each of the results of eGFRcrea‐based eligibility was further compared to eGFRcys‐based eligibility. Creatinine was measured by enzymatic method standardized against international reference material SRM 967. Cystatin C was determined by method traceable to DA ERM 471 international standard. eGFRcrea and eGFRcys were calculated according to Chronic Kidney Disease Epidemiology Collaboration (CKD‐EPI) equations. A downward reclassification rate was higher than upward reclassification rate (31 vs 3, respectively; P < 0.0001). The median (IQR) eGFRcrea was higher than eGFRcys (73 (58‐85) vs 63 (50‐75) mL/min/1.73 m², respectively; P < 0.0001). eGFRcys reclassified significant proportion of patients with T2DM from metformin eligible CKD stages to less or non‐eligible stages. The downward reclassification was more frequent in patients older than 80 years (P < 0.01). Cystatin C‐based eGFR selects more complicated patients, where lower doses of metformin are possibly advisable. We recommend calculating both eGFRcrea and eGFRcys for metformin dosing in elderly patients with T2DM.     

Prevalence of vitamin D inadequacy in European postmenopausal women

ABSTRACT

Objective: Inadequate vitamin D level is associated with secondary hyperparathyroidism and increased bone turnover and bone loss, which in turn increases fracture risk. The objective of this study is to assess the prevalence of inadequate serum vitamin D levels in postmenopausal European women. There are no clear international agreements on what constitutes a level of vitamin D inadequacy, but recent publications suggest that the circulating level of vitamin D should be over 80?nmol/L or at least between 50 and 80?nmol/L.

Material and methods: Assessment of 25-hydroxyvitamin D [25(OH)D] was performed in 8532 European postmenopausal women with osteoporosis or osteopenia. European countries included France, Belgium, Denmark, Italy, Poland, Hungary, United Kingdom, Spain and Germany. Two cut-offs of 25(OH)D inadequacy were fixed : < 80?nmol/L and < 50?nmol/L.

Results: Mean (SD) age of the patients was 74.2 (7.1) years, body mass index was 25.7 (4.1)?kg/m². Level of 25(OH)D was 61.0 (27.2)?nmol/L. There was a highly significant difference of 25(OH)D level across European countries (?p < 0.0001). The lowest level of 25(OH)D was found in France [51.5 (26.1)?nmol/L] and the highest in Spain [85.2 (33.3)?nmol/L]. In the whole study population, the prevalence of 25(OH)D inadequacy was 79.6% and 32.1% when considering cut-offs of 80 and 50?nmol/L, respectively and when considering patients aged less than 65 years, the prevalence reached 86% (cut-off of 80?nmol/L) and 45% (cut-off of 50?nmol/L).

Conclusion: This study indicates a high prevalence of vitamin D [25(OH)D] inadequacy in European postmeno­pausal women. The prevalence could be even higher in some particular countries. A greater awareness of the importance of vitamin D inadequacy is needed to address this public health problem.     

Inverse relationship between serum osteocalcin levels and nonalcoholic fatty liver disease in postmenopausal Chinese women with normal blood glucose levels

Aim:

Osteocalcin is involved in the progression of nonalcoholic fatty liver disease (NAFLD) in animal models and humans. In this study we investigated the relationship between serum osteocalcin levels and NAFLD in postmenopausal Chinese women.

Methods:

A total of 733 postmenopausal women (age range: 41–78 years) with normal blood glucose levels were enrolled in this cross-sectional study. Women taking lipid-lowering or anti-hypertensive drugs were excluded. Serum osteocalcin levels were assessed using an electrochemiluminescence immunoassay. The degree of NAFLD progression for each subject was assessed through ultrasonography. The fatty liver index (FLI) of each subject was calculated to quantify the degree of liver steatosis.

Results:

The median level of serum osteocalcin for all subjects enrolled was 21.99 ng/mL (interquartile range: 17.84–26.55 ng/mL). Subjects with NAFLD had significantly lower serum osteocalcin levels (18.39 ng/mL; range: 16.03–23.64 ng/mL) compared with those without NAFLD (22.31 ng/mL; range: 18.55–27.06 ng/mL; P<0.01). Serum osteocalcin levels decreased with incre¬mental changes in the FLI value divided by the quartile (P-value for trend<0.01). The serum osteocalcin levels showed a negative correlation with the FLI values, even after adjusting for confounding factors (standardized β=−0.124; P<0.01). Binary logistic regression analysis identified an individual''s serum osteocalcin level as an independent risk factor for NAFLD (odds ratio: 0.951; 95% confidence interval: 0.911–0.992; P=0.02).

Conclusion:

Serum osteocalcin levels are inversely correlated with NAFLD in postmenopausal Chinese women with normal blood glucose levels.     

Prevalence of vitamin D inadequacy in a minimal trauma fracture population

ABSTRACT

Objective: The purpose of this analysis was to report the prevalence of vitamin D inadequacy in a population of adults with minimal trauma fractures.

Research Design and Methods: 82 adults (ages 52–97 with 63% age 80+) consecutively hospitalized with hip and extremity fractures between August 2001 and January 2002 were recruited from two St. Paul, MN hospitals. Patients came from independent living and assisted living facilities. Demographics, medical history and vitamin D supplementation were obtained by the medical record and self-report. Blood specimens were collected during hospitalization within 48 hours of admission. Serum 25-hydroxyvitamin D [25(OH)D] concentrations were assessed using Diasorin 25-hydroxyvitamin D radioimmunoassay kit (RIA) at Mayo Clinic, Rochester, MN. Results were available for 78 patients and are included in the current analysis.

Results: Patients were 99% Caucasian, 63% ≥ 80 years and 78% female. 97% were admitted due to hip fracture. On admission, 50% reported using at least 400?IU per day of vitamin D through supplements (including multivitamins) and 13% of all patients were taking osteoporosis medication (3 estrogen, 5 alendronate, 1 etidronate, 1 raloxifene). The mean 25(OH)D concentration was 14.2 (SD 6.6) with a range of 5–39?ng/mL (8–38?ng/mL wintertime vales in Rochester, MN). All but two of the 78 patients (97.4%) had 25(OH)D concentrations < 30?ng/mL and the majority (81%) of the patients had 25(OH)D concentrations < 20?ng/mL, including 21% < 9?ng/mL. Mean 25(OH)D concentrations were not substantially different by gender, age, or osteoporosis medication use. Patients who reported vitamin D supplementation ≥ 400?IU/day had significantly greater mean 25(OH)D concentrations, albeit suboptimal, compared to those who did not (16.4 vs. 13.7?ng/mL; p = 0.002).

Conclusions: Nearly all patients in this study hospitalized for fracture had vitamin D inadequacy. Significant opportunity exists to ensure adequate and persistent vitamin D intake in a high risk fracture patient population.     

Vitamin D inadequacy in postmenopausal women in Eastern Asia

ABSTRACT

Objective: To review data on the prevalence of vitamin D inadequacy and its causes in postmenopausal women in Eastern Asia.

Research design and method: Data were obtained from the published biomedical literature as well as abstracts and posters presented at scientific meetings. Using MEDLINE, EMBASE and BIOSIS databases (to July 2007), epidemiological studies were identified using the search terms: ‘human’, ‘vitamin D’, ‘vitamin D deficiency’, ‘vitamin D inadequacy’, ‘vitamin D insufficiency’ and ‘hypovitaminosis D’, ‘osteomalacia’ and ‘osteoporosis’. Additional references were also identified from the bibliographies of published articles.

Results: The prevalence of vitamin D inadequacy in studies of postmenopausal women (ambulatory or with osteoporosis or related musculoskeletal disorders) in Eastern Asia ranged from 0 to 92%, depending on the cut-off level of serum 25-hydroxycholecalciferol [25(OH)D] that was applied (range ≤6–35?ng/mL [≤15–87?nmol/L]). One large international study found that 71% of postmenopausal women with osteoporosis in Eastern Asia had vitamin D inadequacy, defined as serum levels of 25(OH)D <30?ng/mL (75 nmol/L). Prevalence rates using this cut-off level were 47% in Thailand, 49% in Malaysia, 90% in Japan and 92% in South Korea. High prevalences of vitamin D inadequacy were evident in two studies using a lower 25(OH)D level cut-off value of <12?ng/mL(30?nmol/L) – 21% in China and 57% in South Korea. Dietary deficiency and inadequate exposure or reactivity to sunlight (due to lifestyle choices, cultural customs and/or aging) were identified as important risk factors for vitamin D inadequacy.

Conclusions: Non-uniform, epidemiological studies indicate a high prevalence of vitamin D inadequacy in postmenopausal women in Eastern Asia. Recommended remedial approaches are education campaigns and broad-based provision of vitamin D supplementation.     

维生素D对非酒精性脂肪性肝病患者铁代谢的影响

目的 探讨非酒精性脂肪性肝病（NAFLD）患者血清维生素D水平对血清铁（SI）、铁蛋白（SF）及铁调素（Hepc）的影响及意义。方法 单纯性NAFLD患者186例根据血清25羟维生素D［3 25（OH）D3］水平分为维生素D缺乏组［25（OH）D3≤20 μg/L，115例，］和非缺乏组（71例），比较2组患者年龄、性别、体质指数（BMI）、血压、血脂、丙氨酸氨基转移酶（ALT）、天门冬氨酸氨基转移酶（AST）、γ-谷氨酰转肽酶（GGT）、空腹血糖（FPG）、空腹胰岛素（FINS）、稳态模型胰岛素抵抗指数（HOMA-IR）、SI、SF及Hepc水平；分析25（OH）D3与SI、SF、Hepc及HOMA-IR之间的相关性。结果 2组患者SI差异无统计学意义（P＞0.05），维生素D缺乏组BMI、FINS、SF、Hepc水平及HOMA-IR均高于非缺乏组（P＜0.05）。血清 25（OH）D3水平与 SF（r=-0.328）、Hepc（r=-0.314）及 HOMA-IR（r=-0.293）呈弱负相关（P＜ 0.05）。结论 维生素D水平下降增加了NAFDL患者体内铁负荷，加重了胰岛素抵抗。     

New insights into the role of vitamin D and calcium in osteoporosis management: an expert roundtable discussion

ABSTRACT

Background: Adequate vitamin D and calcium nutrition play a critical role in the maintenance of musculoskeletal health and are considered the first step in osteoporosis treatment.

Roundtable discussion: In February 2008 Merck Sharp & Dohme sponsored a 2-day, evidence-based expert panel on the benefits of vitamin D for the patient with osteoporosis and the role of vitamin D in combination with antiresorptive therapy for the management of osteo­porosis. One of the primary objectives of the meeting was to review new data on the optimal serum 25-hydroxy­vitamin D [25(OH)D]levels. The symposium was attended by 29 researchers and clinicians from Europe and the Middle East. The discussion focused on optimizing vitamin D and calcium nutrition and reducing falls and fractures in osteoporotic patients.

Conclusions: Current evidence and expert opinion suggests that optimal serum 25(OH)Dconcentrations should be at least 50?nmol/L (20?ng/mL) in all individuals. This implies a population mean close to 75?nmol/L (30?ng/mL). In order to achieve this level, vitamin D intake of at least 20?µg daily is required. There is a wider thera­peutic window for vitamin D than previously believed, and doses of 800?IU per day, regardless of sun exposure, season or additional multivitamin use, appear to present little risk of toxicity. Apart from fracture and fall preven­tion, optimization of vitamin D status may also have additional general health benefits. Based on newly emerging data regarding calcium supplementation, and recommendations for increased vitamin D intake, the current recommendations for calcium intake in postmenopausal women may be unnecessarily high. In addition to vitamin D and calcium, treatment of patients with osteo­porosis at high risk of fractures should also include pharmacologic agents with proven vertebral and non-vertebral fracture efficacy.     

Renal function‐dependent association of serum uric acid with metabolic syndrome and hepatic fat content in a middle‐aged and elderly Chinese population

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Summary

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