Biology of gait control Vitamin D involvement
Biology of gait control Vitamin D involvement
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DOI：
10.1212/wnl.0b013e318219fb08
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发表时间：
2011-05-01
期刊：
影响因子：
9.9
通讯作者：
Allali, G.
中科院分区：
文献类型：
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作者：
Beauchet, O.;Annweiler, C.;Allali, G.
背景资料：在血清25-羟基维生素D（25 OHD）浓度低的情况下，已描述了不良神经肌肉事件，表明维生素D可能与步态稳定性有关。本横断面研究的目的是检查步幅的步幅变异性（STV）和血清25 OHD浓度在65岁及以上的成年人之间的关联。方法：STV和25 OHD浓度进行了评估，在411个社区居住的老年人（平均年龄70.4 +/- 1.8岁，57.9%的妇女）。使用以下确定的25 OHD阈值：重度25 OHD不足< 10 ng/mL，中度10-30 ng/mL，正常> 30 ng/mL。年龄、每天使用的药物数量、精神活性药物的使用、抑郁症状、认知能力下降、福尔斯史、远视力、下肢本体感觉、质心运动和步行速度被认为是潜在的混杂因素。共有16.6%（n = 68）的受试者存在重度25 OHD不足，70.3%（n = 289）存在中度不足，13.1%（n = 54）存在正常浓度。在完全校正和逐步向后线性回归模型中，高STV（性能较差）与严重25 OHD功能不全（分别为p = 0.028和p = 0.044）、高CoM运动（分别为p = 0.031和p = 0.014）和低下肢本体感觉评分（分别为p = 0.017和p = 0.008）相关。逐步回归模型也表明，高STV与女性性别（p = 0.041）。结论：低血清25 OHD浓度与高STV反映了步态控制障碍。这种关联可以通过维生素D对步态控制中涉及的不同成分的可能作用来解释。神经病学（R）2011; 76：1617-1622
Background: Adverse neuromuscular events have been described in case of low serum 25-hydroxyvitamin D (25OHD) concentrations, suggesting that vitamin D may be involved in gait stability. The objective of this cross-sectional study was to examine the association between stride-to-stride variability of stride time (STV) and serum 25OHD concentration in adults aged 65 years and older.Methods: STV and 25OHD concentration were assessed in 411 community-dwelling older adults (mean age 70.4 +/- 1.8 years, 57.9% women). The following established 25OHD thresholds were used: severe 25OHD insufficiency < 10 ng/mL, moderate 10-30 ng/mL, and normal > 30 ng/mL. Age, number of drugs used per day, use of psychoactive drugs, depressive symptoms, cognitive decline, history of falls, distance visual acuity, lower limb proprioception, center of mass (CoM) motion, and walking speed were considered as potential confounders.Results: A total of 16.6% (n = 68) of subjects had severe 25OHD insufficiency, 70.3% (n = 289) moderate insufficiency, and 13.1% (n = 54) normal concentrations. In the full adjusted and the stepwise backward linear regression models, high STV (worse performance) was associated with severe 25OHD insufficiency (p = 0.028 and p = 0.044, respectively), high CoM motion (p = 0.031 and p = 0.014, respectively), and low lower limb proprioception score (p = 0.017 and p = 0.008, respectively). The stepwise backward regression model also showed that high STV was associated with female gender (p = 0.041).Conclusions: Low serum 25OHD concentrations were associated with high STV reflecting a disturbed gait control. This association could be explained by a possible action of vitamin D on different components involved in gait control. Neurology (R) 2011; 76: 1617-1622