Vitamin D status in postmenopausal women living at higher latitudes in the UK in relation to bone health, overweight, sunlight exposure and dietary vitamin D
Vitamin D status in postmenopausal women living at higher latitudes in the UK in relation to bone health, overweight, sunlight exposure and dietary vitamin D
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DOI：
10.1016/j.bone.2008.01.011
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发表时间：
2008-05-01
期刊：
影响因子：
4.1
通讯作者：
Reid, David M.
中科院分区：
文献类型：
--
作者：
Macdonald, Helen M.;Mavroeidi, Alexandra;Reid, David M.
英国一年有5个月的日照不足，无法让皮肤合成维生素D，冬季所需的维生素D只能从去年夏天储存的维生素D中获得。虽然很少有天然的膳食来源，但饮食摄入可能有助于维持维生素D的状态。我们调查了1998-2000年间生活在北纬57度的3113名妇女（年龄54.8 [SD 2.3]岁）25(OH)D （25(OH)D）与骨骼健康、超重、阳光照射和膳食维生素D之间的关系。采用高效液相色谱法（HPLC）测定血清25(OH)D，测定膳食摄入量（食物频率问卷，n = 2598）、日照量（问卷，n = 2402）和骨骼标志物。在抽样访问时和6年前，通过双x线吸收仪测量所有女性的骨密度（BMD）。25(OH)D的季节变化不大，秋季最高（23.7 [9.9]ng/ml），春季最低（19.7 [7.6]ng/ml）。每天从食物中摄入的维生素D为4.2 [2.5]μ g，从鱼肝油和多种维生素中摄入的维生素D为5.8 [4.0]μ g。后者在每个季节都与25(OH)D有关，而单纯从食物中获取的维生素D仅在冬季和春季与25(OH)D有关。夏季和秋季阳光照射与25(OH)D相关。25(OH)D与骨吸收增加和骨质流失呈负相关（P < 0.05），在校正混杂因素（年龄、体重、身高、绝经状态/HRT使用情况、身体活动和社会经济地位）后仍然显著。使用不足临界值< 28 ng/ml 25(OH)D，显示较高类别的骨吸收标记物浓度较低（fDPD/Cr为5.1 [1.7]nmol/mmol，而fDPD/Cr为5.3 [2.1]nmol/mmol， P=0.03）， bid或骨质流失无差异。体重指数前五分位数的25(OH)D较低（P < 0.01），甲状旁腺激素较高（P < 0.01）。总之，维生素D水平低与骨质流失、骨质流失和肥胖有关。饮食似乎减弱了北纬地区早期绝经后妇女维生素D状态的季节性变化，因为北纬地区产生维生素D的阳光质量降低了。(c) 2008爱思唯尔公司版权所有。
For 5 months a year the UK has insufficient sunlight for cutaneous synthesis of vitamin D and winter requirements are met from stores made the previous summer. Although there are few natural dietary sources, dietary intake may help maintain vitamin D status.We investigated the relationship between 25-hydroxyvitamin D (25(OH)D), bone health, overweight, sunlight exposure and dietary vitamin D in 3113 women (age 54.8 [SD 2.3] years) living at latitude 57 degrees N between 1998-2000. Serum 25(OH)D was measured by high performance liquid chromatography (HPLC), dietary intakes (food frequency questionnaire, n = 2598), sunlight exposure (questionnaire, n = 2402) and bone markers were assessed. Bone mineral density (BMD) was measured by dual x-ray absorptiometry in all women at the sampling visit and 6 years before. Seasonal variation in 25(OH)D was not substantial with a peak in the autumn (23.7 [9.9] ng/ml) and a nadir in spring (19.7 [7.6] ng/ml). Daily intake of vitamin D was 4.2 [2.5] mu g from food only and 5.8 [4.0] mu g including vitamin D from cod liver oil and multivitamins. The latter was associated with 25(OH)D at each season whereas vitamin D simply from food was associated with 25(OH)D in winter and spring only. Sunlight exposure was associated with 25(OH)D in summer and autumn. 25(OH)D was negatively associated with increased bone resorption and bone loss (P < 0.05) remaining significant after adjustment for confounders (age, weight, height, menopausal status/HRT use, physical activity and socioeconomic status). Using an insufficiency cut-off of < 28 ng/ml 25(OH)D, showed lower concentrations of bone resorption markers in the upper category (fDPD/Cr 5.1 [1.7] nmol/mmol compared to 5.3 [2.1] nmol/mmol, P=0.03) and no difference in BNID or bone loss. 25(OH)D was lower (P < 0.01) and parathyroid hormone higher (P < 0.01) in the top quintile of body mass index. In conclusion, low vitamin D status is associated with greater bone turnover, bone loss and obesity. Diet appears to attenuate the seasonal variation of vitamin D status in early postmenopausal women at northerly latitude where quality of sunlight for production of vitamin D is diminished. (c) 2008 Elsevier Inc. All rights reserved.