Highest prevalence of vitamin D inadequacy in institutionalized women compared with noninstitutionalized women: a case-control study
Highest prevalence of vitamin D inadequacy in institutionalized women compared with noninstitutionalized women: a case-control study
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DOI：
10.2217/17455057.5.1.49
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发表时间：
2009-01-01
期刊：
影响因子：
2.4
通讯作者：
Reginster, Jean-Yves
中科院分区：
文献类型：
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作者：
Bruyere, Olivier;Decock, Caroline;Reginster, Jean-Yves
在紫外线的影响下，老年人皮肤合成维生素D-3的能力下降，使老年人面临维生素D缺乏症的风险。由于住院人员的日照量较低，其风险甚至可能增加。据报道，维生素D水平不足与继发性甲状旁腺功能亢进、骨转换增加和骨丢失有关，这增加了骨折的风险。本研究的目的是评估制度化，绝经后，更年期妇女血清维生素D水平不足的患病率。对来自9个国家（澳大利亚、比利时、法国、德国、匈牙利、意大利、波兰、西班牙和英国）的445名住院的糖尿病妇女进行了25-羟基维生素D [25（OH）D]评估。对于每一个制度化的妇女，三个年龄匹配，noninstitutionalized，histopotic控制也包括在内。确定了25（OH）D不足的四个临界值：小于80、小于75、小于50和小于30 nmol/l。住院妇女的平均年龄为79.7岁（标准差[SD] = 5.8），非住院妇女的平均年龄为79.5岁（SD = 5.5）（p = 0.45）。接受维生素D补充剂的住院妇女明显较少（13.2% vs 24.0%; p < 0.0001）。在未补充维生素D的妇女中，住院妇女的25（OH）D水平（56.9 [SD = 23.9] nmol/l）显著低于非住院妇女（63.2 [SD = 22.0] nmol/l; p < 0.0001）。在住院妇女（没有维生素D补充剂），25（OH）D不足的患病率分别为10.4，41.2，80.3和84.2%时，考虑截止值为80，75，50和30 nmol/l，分别。对照组的患病率分别为2.7%、22.9%、74.4%和81.7%。当考虑75、50和30 nmol/l的临界值时，维生素D不足的患病率在机构化妇女中显著较高，但当考虑80 nmol/l的临界值时则不然。这项研究强调了维生素D不足的患病率很高，在制度化，女性。与年龄匹配的维生素D控制组相比，严重维生素D不足的患病率在机构妇女中更为重要。我们认为，需要提高对维生素D不足重要性的认识，以解决这一公共卫生问题。
The reduced capacity of older skin to synthesize vitamin D-3 under the influence of ultraviolet light makes older persons at risk of vitamin D deficiency. The risk could even be increased in institutionalized persons owing to their lower sunshine exposure. It has been reported that an inadequate vitamin D level is associated with secondary hyperparathyroidism, increased bone turnover, and bone loss, which increase fracture risk. The objective of this study was to assess the prevalence of inadequate serum vitamin D levels in institutionalized, postmenopausal, osteoporotic women. Assessment of 25-hydroxyvitamin D [25(OH) D] was performed in 445 institutionalized, osteoporotic women from nine countries (Australia, Belgium, France, Germany, Hungary, Italy, Poland, Spain and UK). For each institutionalized woman, three age-matched, noninstitutionalized, osteoporotic controls were also included. Four cutoffs of 25(OH) D inadequacy were fixed: less than 80, less than 75, less than 50 and less than 30 nmol/l. Mean age was 79.7 years (standard deviation [SD] = 5.8) for the institutionalized women and 79.5 years (SD = 5.5) for the noninstitutionalized women (p = 0.45). Significantly fewer institutionalized women received vitamin D supplements (13.2 vs 24.0%; p < 0.0001). In women without vitamin D supplements, the level of 25(OH) D was significantly lower in institutionalized women (56.9 [SD = 23.9] nmol/l) compared with noninstitutionalized women (63.2 [SD = 22.0] nmol/l; p < 0.0001). In institutionalized women (without vitamin D supplements), the prevalence of 25(OH) D inadequacy was 10.4, 41.2, 80.3 and 84.2% when considering cutoffs of 80, 75, 50 and 30 nmol/l, respectively. In the control group, the prevalence was 2.7, 22.9, 74.4 and 81.7%, respectively. The prevalence of vitamin D inadequacy was significantly higher in institutionalized women when considering the 75, 50 and 30 nmol/l cutoffs but not when considering the 80 nmol/l cutoff. This study highlights a high prevalence of vitamin D inadequacy in institutionalized, osteoporotic women. Compared with age-matched osteoporotic controls, the prevalence of severe vitamin D inadequacy was substantially more important in institutionalized women. We believe that a greater awareness of the importance of vitamin D inadequacy is needed in order to address this public health problem.