Vitamin D-binding protein and vitamin D status of black Americans and white Americans.
Vitamin D-binding protein and vitamin D status of black Americans and white Americans.
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DOI：
10.1056/nejmoa1306357
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发表时间：
2013-11-21
期刊：
影响因子：
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通讯作者：
Thadhani R
中科院分区：
文献类型：
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作者：
Powe CE;Evans MK;Wenger J;Zonderman AB;Berg AH;Nalls M;Tamez H;Zhang D;Bhan I;Karumanchi SA;Powe NR;Thadhani R
总25 - 羟基维生素D水平低在非裔美国人中很常见。在评估维生素D缺乏时，维生素D结合蛋白一直未被考虑在内。
在“不同生活环境下的健康老龄化”黑人和白人队列研究（2085名参与者）中，我们测量了总25 - 羟基维生素D、维生素D结合蛋白、甲状旁腺激素水平以及骨矿物质密度（BMD）。我们对研究参与者的维生素D结合蛋白基因的两种常见多态性（rs7041和rs4588）进行了基因分型。我们估算了纯合子参与者的生物可利用25 - 羟基维生素D水平。
非裔美国人的总25 - 羟基维生素D和维生素D结合蛋白的平均（±标准误）水平均低于白人（总25 - 羟基维生素D，每毫升15.6±0.2纳克对比每毫升25.8±0.4纳克，P < 0.001；维生素D结合蛋白，每毫升168±3微克对比每毫升337±5微克，P < 0.001）。基因多态性似乎分别独立地解释了维生素D结合蛋白和总25 - 羟基维生素D水平变异的79.4%和9.9%。非裔美国人的骨矿物质密度高于白人（每平方厘米1.05±0.01克对比每平方厘米0.94±0.01克，P < 0.001）。甲状旁腺激素水平随着总25 - 羟基维生素D或生物可利用25 - 羟基维生素D水平的降低而升高（两种关系均P < 0.001），然而在甲状旁腺激素浓度的每个五分位数内，非裔美国人的总25 - 羟基维生素D水平均显著低于白人。在纯合子参与者中，非裔美国人和白人总体上的生物可利用25 - 羟基维生素D水平相似（分别为每毫升2.9±0.1纳克和每毫升3.1±0.1纳克；P = 0.71），并且在甲状旁腺激素浓度的五分位数内也是如此。
与白人相比，居住在社区的非裔美国人总25 - 羟基维生素D和维生素D结合蛋白水平较低，导致估计的生物可利用25 - 羟基维生素D浓度相似。常见基因多态性流行率的种族差异为这一观察结果提供了一种可能的解释。（由美国国家老龄研究所等资助）
Low levels of total 25-hydroxyvitamin D are common among black Americans. Vitamin D–binding protein has not been considered in the assessment of vitamin D deficiency. In the Healthy Aging in Neighborhoods of Diversity across the Life Span cohort of blacks and whites (2085 participants), we measured levels of total 25-hydroxyvitamin D, vitamin D–binding protein, and parathyroid hormone as well as bone mineral density (BMD). We genotyped study participants for two common polymorphisms in the vitamin D–binding protein gene (rs7041 and rs4588). We estimated levels of bioavailable 25-hydroxyvitamin D in homozygous participants. Mean (±SE) levels of both total 25-hydroxyvitamin D and vitamin D–binding protein were lower in blacks than in whites (total 25-hydroxyvitamin D, 15.6±0.2 ng per milliliter vs. 25.8±0.4 ng per milliliter, P<0.001; vitamin D–binding protein, 168±3 μg per milliliter vs. 337±5 μg per milliliter, P<0.001). Genetic polymorphisms independently appeared to explain 79.4% and 9.9% of the variation in levels of vitamin D–binding protein and total 25-hydroxyvitamin D, respectively. BMD was higher in blacks than in whites (1.05±0.01 g per square centimeter vs. 0.94±0.01 g per square centimeter, P<0.001). Levels of parathyroid hormone increased with decreasing levels of total or bioavailable 25-hydroxyvitamin D (P<0.001 for both relationships), yet within each quintile of parathyroid hormone concentration, blacks had significantly lower levels of total 25-hydroxyvitamin D than whites. Among homozygous participants, blacks and whites had similar levels of bioavailable 25-hydroxy vitamin D overall (2.9±0.1 ng per milliliter and 3.1±0.1 ng per milliliter, respectively; P = 0.71) and within quintiles of parathyroid hormone concentration. Community-dwelling black Americans, as compared with whites, had low levels of total 25-hydroxyvitamin D and vitamin D–binding protein, resulting in similar concentrations of estimated bioavailable 25-hydroxyvitamin D. Racial differences in the prevalence of common genetic polymorphisms provide a likely explanation for this observation. (Funded by the National Institute on Aging and others.)