摘要
目的探讨北京市部分老年男性维生素D水平及其与骨代谢指标的关系。方法采用化学发光法测定血清25羟化维生素D3(25OHD_3)、甲状旁腺素(PTH)、β-Ⅰ型胶原C端肽(β-CTX)、骨钙素(osteocalcin)、1型原胶原分子N一端前肽(PINP)水平。根据血清25OHD3水平分为维生素D严重缺乏(<10ng/mL)、缺乏(≥10<20ng/mL)、不足(≥20<30ng/mL)和充足(≥30ng/mL)。结果 2010年5月至6月入选564名老年受试者,平均年龄(73.7±8.5)岁。≥60～70岁为老年1组、≥70～80岁为老年2组,≥8O岁为老年3组。老年男性总体25OHD3水平为(14.57±5.95)ng/mL,均为维生素D缺乏。各组受试者血清PTH平均水平为(34.85±12.23)ng/mL,骨钙素平均水平为(13.49±4.81)ng/mL,β-CTX平均水平为(0.30±0.15)ng/mL。K-S检验结果表明,上述骨代谢指标均呈正态分布。各年龄组25OHD3、PTH、骨钙素、PINP、β-CTX水平差异均无统计学意义(P>0.05)。老年男性维生素D严重缺乏、缺乏、不足、充足的比例分别为23.4%(132/564),56.6%(319/564),18.4%(104/564),1.6%(9/564)。不同年龄组间低维生素D状态的比例差异无统计学意义(F=15.57,P=0.076)。相关分析结果表明,25OHD3水平与PTH呈负相关(r=-0.240,P=0.000);与骨钙素呈负相关(r=-0.080,P=0.034);与β-CTX无显著相关(r=-0.044,P=0.252)。LOESS回归分析显示,25OHD3水平为9.8～15.6ng/mL时,血清PTH出现平台期。25OHD3与骨钙素尽管有较弱的负相关,但未出现明显平台期。结论北京市部分老年男性人群存在严重维生素D缺乏和不足状况。老年男性的维生索D状态与PTH、骨形成指标骨钙素水平有一定关联,但与I型胶原蛋白的形成与吸收可能无直接关系,有必要进一步探讨维生素D与骨转换的关系。
Objective To determine the serum Vitamin D status and relationships between serum 25OHD concentration and parathyroid hormone （PTH）,bone turnover markers of old men in Beijing region.Methods This was a cross-sectional analysis of baseline data in 564 elderly Chinese men, mean age 73.7±8.5 yr. The participants were divided into 3 age groups, old group1（≥60-70 years group）,old group2（≥70-80 years group）、old group3（≥80 years group）. The level of serum 25OHD3, PTH, osteocalcin, β-CTX, PINP was measured by direct competitive electroluminescent immunoassay from May to June in 2010.The relationship between 25OHD, PTH, and serum osteocalcin and serum β-CTX was evaluated. Results （1）The 25OHD3 level of total old men was 14.57±5.95 ng/mL,which indicated to be vitamin D dificience. The level of PTH, osteocalcin, β-CTX, PINP were 34.85±12.23 pg/mL,13.49±4.81 ng/mL,0.30±0.15 ng/mL,39.13±16.51 ng/mL,individualy.（2）The prevalence of vitamin D severe dificience,defience, insufficiency and sufficiency were 23.4%（132/564）,56.6%（319/564）,18.4%（104/564）,1.4%（9/564） for the total people. 3. Serum 25OHD3 level was inversely correlated with serum PTH （r=-0.240,P=0.000）, threshold as defined by suppression of serum PTH was found within the serum 25OHD3 range 9.8-15.6 ng/mL. Serum 25OHD3 was weakly inversely correlated with serum osteocalcin （r=-0.080,P=0.034）.Conclusion Vitamin D deficiency is highly prevalent among healthy Beijing old men. Bone turnover markers were not significantly associcoted to vitamin D status. This should emphasize the need for more vitamin D in ole men and further research is needed to clarify the correlation of vitamin D status with osteoporotic fracture in the future.
出处
《中华骨质疏松和骨矿盐疾病杂志》
2012年第3期186-192,共7页
Chinese Journal Of Osteoporosis And Bone Mineral Research
基金
军队医药卫生科研基金(10BJZ02)
