Serum 25-hydroxyvitamin D concentrations and risk for hip fractures.
Serum 25-hydroxyvitamin D concentrations and risk for hip fractures.
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DOI：
10.7326/0003-4819-149-4-200808190-00005
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发表时间：
2008-08-19
影响因子：
39.2
通讯作者：
Cummings SR
中科院分区：
文献类型：
--
作者：
Cauley JA;Lacroix AZ;Wu L;Horwitz M;Danielson ME;Bauer DC;Lee JS;Jackson RD;Robbins JA;Wu C;Stanczyk FZ;LeBoff MS;Wactawski-Wende J;Sarto G;Ockene J;Cummings SR
维生素D水平和骨折之间的关系尚不确定.验证血清25-羟基维生素D（25（OH）维生素D）水平与社区妇女髋部骨折风险相关的假设。巢式病例对照研究。40个美国临床中心。我们研究了400例髋关节骨折病例和400例年龄、种族和抽血日期相匹配的对照组（平均随访时间为7.1年）。受试者选自39,795名绝经后妇女，既往无髋部骨折，未使用雌激素或其他骨活性治疗。使用DiaSorin试剂的放射免疫测定法在基线血清上测量血清25（OH）维生素D，并分成四分位数。条件Logistic回归用于估计比值比和95%置信区间（CI）。多变量模型包括年龄、体重指数、父母和个人骨折史、吸烟、酒精和钙摄入、地理位置和皮质类固醇使用。病例组的平均（标准差，SD）25（OH）维生素D（nM）为56.2（20.3），对照组为59.7（18），p=0.007。在多变量模型中，25（OH）维生素D减少25 nM（10 ng/ml）与髋部骨折风险增加33%相关（优势比=1.33; 95%CI，1.06，1.68）。与25（OH）维生素D ≥70.7 nM的女性相比（四分位数4），髋部骨折的比值比为1.71（1.05，2.79），1.09（0.70，1.71）和0.82（0.51，1.31），分别在25（OH）维生素D <47.5 nM，47.5至60 nM，60至<70 nM的女性中，p趋势=0.015。这种关联部分由骨吸收标志物介导，但仍具有统计学显著性。调整福尔斯、身体功能、虚弱、肾功能或性类固醇激素对这种关联没有影响。没有测量骨密度。血清25（OH）维生素D浓度低与髋部骨折风险较高相关。测量25（OH）维生素D可能有助于识别髋部骨折高危女性。
The association between and vitamin D levels and fractures is uncertain. To test the hypothesis that serum 25-hydroxyVitamin D (25(OH) vitamin D) levels are associated with the risk of hip fracture in community dwelling women. Nested case-control study. 40 US clinical centers. We studied 400 cases of incident hip fractures and 400 controls matched on age, race/ethnicity and date of blood draw (average follow-up time, 7.1 years). Subjects were selected from 39,795 postmenopausal women without previous hip fractures, not using estrogens or other bone-active therapies. Serum 25(OH) vitamin D was measured on baseline serum using radioimmunoassay with DiaSorin reagents and divided into quartiles. Conditional logistic regression was used to estimate the odds ratio with 95% confidence intervals (CI). Multivariable models included age, body mass index, parental and personal history of fractures, smoking, alcohol and calcium intake, geographic location and corticosteroid use. The mean (standard deviation, SD) 25(OH) vitamin D (nM) was lower in cases, 56.2(20.3) compared to controls, 59.7(18), p=0.007. A 25 nM (10ng/ml) decrease in 25(OH) vitamin D was associated with a 33% increased risk of hip fracture (odds ratio=1.33; 95%CI,1.06, 1.68) in multivariable models. Compared to women with 25(OH) vitamin D ≥70.7 nM (Quartile 4), the odds ratio of hip fracture was 1.71 (1.05, 2.79), 1.09 (0.70, 1.71) and 0.82 (0.51, 1.31) in women with 25(OH) vitamin D <47.5 nM, 47.5 to 60 nM, 60 to <70 nM, respectively, p trend =0.015. This association was in part mediated by a marker of bone resorption but remained statistically significant. Adjustment for falls, physical function, frailty, renal function, or sex steroid hormones had no effect on this association. No measure of bone density. Low serum 25(OH) vitamin D concentrations are associated with a higher risk of hip fracture. Measurement of 25(OH) vitamin D may be useful in identifying women at high risk of hip fracture.
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影响因子：
158.5
作者：
Cummings, SR;Browner, WS;Ettinger, B
通讯作者：
Ettinger, B
影响因子：
4.1
作者：
Macdonald, Helen M.;Mavroeidi, Alexandra;Reid, David M.
通讯作者：
Reid, David M.
影响因子：
5.8
作者：
Colin, EM;Uitterlinden, AG;Pols, HAP
通讯作者：
Pols, HAP
影响因子：
5.6
作者：
Anderson, GL;Manson, J;Prentice, RL
通讯作者：
Prentice, RL
影响因子：
5.8
作者：
Holick, MF;Siris, ES;de Papp, AE
通讯作者：
de Papp, AE