Vitamin D deficiency in homebound elderly persons.
Vitamin D deficiency in homebound elderly persons.
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DOI：
10.1001/jama.1995.03530210037027
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发表时间：
1996-03
期刊：
影响因子：
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通讯作者：
S. Whitmore
中科院分区：
文献类型：
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作者：
S. Whitmore
客观的。 — 评估居家、社区居住的老年人的维生素 D 状况；缺乏阳光的疗养院老年居民；以及健康、能走动的老年人。设计。 ——队列分析研究。参与者。 — 在 244 名年龄至少 65 岁的受试者中，有 116 名受试者（85 名女性和 31 名男性）被限制在室内至少 6 个月，无论是在社区的私人住宅（霍普金斯长者上门计划）还是在教学疗养院（约翰霍普金斯老年医学中心）。 128 名对照受试者（健康的流动组）来自巴尔的摩老龄化纵向研究。所有受试者均未患有可能干扰其维生素 D 状态的疾病或药物。主要成果措施。 — 测量所有受试者的 25-羟基维生素 D (25-OHD) 和 1,25-二羟基维生素 D (1,25-[OH] 2 D) 血清水平。在 80 名受试者组成的亚组中，评估了完整甲状旁腺激素 (PTH)、离子钙和骨钙蛋白的血清水平以及维生素 D 的摄入量（通过 3 天的食物记录）。随机选择的一组缺乏阳光的受试者还测量了维生素 D 结合蛋白的血清水平。结果。 —在阳光剥夺的受试者中，平均 25-OHD 水平为 30 nmol/L (12 ng/mL)（范围，2 D 水平为 52 pmol/L (20 pg/mL)（范围，18 至 122 pmol/L [7 至 47 pg/mL]）。在阳光剥夺的受试者中，54% 的社区居民和 38% 的疗养院居民的血清水平为25-OHD以下 25 nmol/L (10 ng/mL)（正常范围，25 至 137 nmol/L [10 至 55 ng/mL]）。当一起分析时，25-OHD（即 Log [25-OHD]）和 PTH 之间存在显着的负相关关系（r =-0.42；R 2 =0.18；P 结论。—尽管美国的维生素补充程度相对较高，但 居家老人很可能缺乏维生素D。 （美国医学会杂志。1995；274：1683-1686）
Objective. —To assess the vitamin D status in homebound, community-dwelling elderly persons; sunlight-deprived elderly nursing home residents; and healthy, ambulatory elderly persons. Design. —A cohort analytic study. Participants. —Of 244 subjects at least 65 years old, 116 subjects (85 women and 31 men) had been confined indoors for at least 6 months, either in private dwellings in the community (the Hopkins Elder Housecall Program) or in a teaching nursing home (The Johns Hopkins Geriatrics Center). The 128 control subjects, a healthy ambulatory group, came from the Baltimore Longitudinal Study on Aging. All subjects were free of diseases or medications that might interfere with their vitamin D status. Main Outcome Measures. —Serum levels of 25-hydroxyvitamin D (25-OHD) and 1,25-dihydroxyvitamin D (1,25-[OH] 2 D) were measured in all subjects. In a subgroup of 80 subjects, serum levels of intact parathyroid hormone (PTH), ionized calcium, and osteocalcin and intake of vitamin D (through 3-day food records) were assessed. A randomly selected cohort of sunlight-deprived subjects also had serum levels of vitamin D binding protein measured. Results. —In sunlight-deprived subjects overall, the mean 25-OHD level was 30 nmol/L (12 ng/mL) (range, 2 D level was 52 pmol/L (20 pg/mL) (range, 18 to 122 pmol/L [7 to 47 pg/mL]). In the sunlight-deprived subjects, 54% of community dwellers and 38% of nursing home residents had serum levels of 25-OHD below 25 nmol/L (10 ng/mL) (normal range, 25 to 137 nmol/L [10 to 55 ng/mL]). A significant inverse relationship existed between 25-OHD (ie, Log [25-OHD]) and PTH when they were analyzed together ( r =-0.42; R 2 =0.18; P Conclusions. —Despite a relatively high degree of vitamin supplementation in the United States, homebound elderly persons are likely to suffer from vitamin D deficiency. ( JAMA . 1995;274:1683-1686)