Serum 25-hydroxyvitamin D and clinical fracture risk in a multiethnic cohort of women: the Women's Health Initiative (WHI).
Serum 25-hydroxyvitamin D and clinical fracture risk in a multiethnic cohort of women: the Women's Health Initiative (WHI).
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DOI：
10.1002/jbmr.449
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发表时间：
2011-10
影响因子：
6.2
通讯作者：
Jackson, Rebecca D.
中科院分区：
文献类型：
--
作者：
Cauley, Jane A.;Danielson, Michelle E.;Boudreau, Robert;Barbour, Kamil E.;Horwitz, Mara J.;Bauer, Douglas C.;Ensrud, Kristine E.;Manson, JoAnn E.;Wactawski-Wende, Jean;Shikany, James M.;Jackson, Rebecca D.
白人女性 25 羟基维生素 D (25(OH)D) 水平低与髋部骨折有关。为了研究 25(OH)D 与多民族女性骨折风险的关联，我们在前瞻性女性健康倡议观察研究中进行了一项巢式病例对照研究。 381 名黑人、192 名西班牙裔、113 名亚裔和 46 名美洲印第安人女性中发现骨折，平均时间为 8.6 年。随机抽取了 400 名骨折的白人女性作为样本。每个病例选择一个对照，并根据年龄、种族/民族和抽血日期进行匹配。测定空腹基线血清中的 25(OH)D、甲状旁腺激素和维生素 D 结合蛋白 (DBP)。使用条件逻辑回归模型计算比值比 (OR) 和 95% 置信区间 (95% CI)。在多变量模型中，与 <20ng/mL 的水平相比，较高的 25(OH)D 水平与白人女性较低的骨折风险相关：(20-<30 ng/mL)，OR=0.82； (0.59, 1.16) 和 (≥30.0 ng/mL)，OR=0.55； (0.34, 0.89)，p 趋势=0.02。相比之下，与 <20ng/mL 的水平相比，较高的 25(OH)D (≥20 ng/mL) 与黑人女性较高的骨折风险相关，OR=1.45； (1.06, 1.98)，p 趋势=0.043。调整 DBP 后，较高的 25(OH)D (≥30.0 ng/mL) 与亚洲女性较高的骨折风险相关，OR=2.78； （0.99，7.88），（p 趋势=0.04）。在西班牙裔或美洲印第安人女性中，25(OH)D 与骨折之间没有关联。我们的结果表明 25(OH)D 与骨折之间的关联因种族/民族而异。白人和黑人女性骨骼健康的最佳 25(OH)D 水平可能有所不同。
Low 25 hydroxyvitamin D (25(OH)D) levels have been linked to hip fracture in White women. To study the association of 25(OH)D to risk of fracture in multiethnic women, we performed a nested case control study within the prospective Women’s Health Initiative Observational Study. Incident fractures were identified in 381 Black, 192 Hispanic, 113 Asian and 46 American Indian women over an average of 8.6 years. A random sample of 400 White women who fractured was chosen. One control was selected per case and matched on age, race/ethnicity and blood draw date. 25(OH)D, parathyroid hormone and vitamin D binding protein (DBP) were measured in fasting baseline serum. Conditional logistic regression models were used to calculate the odds ratio (OR) and 95% Confidence Intervals (95% CI). In multivariable models, higher 25(OH)D levels as compared with levels <20ng/mL were associated with a lower risk of fracture in White women: (20-<30 ng/mL), OR=0.82; (0.59, 1.16) and (≥30.0 ng/mL), OR=0.55; (0.34, 0.89), p trend=0.02. In contrast, higher 25(OH)D (≥20 ng/mL) as compared with levels <20ng/mL were associated with a higher risk of fracture in Black women, OR=1.45; (1.06, 1.98), p trend=0.043. Higher 25(OH)D (≥30.0 ng/mL) was associated with higher fracture risk in Asian women after adjusting for DBP, OR=2.78; (0.99, 7.88), (p trend=0.04). There was no association between 25(OH)D and fracture in Hispanic or American Indian women. Our results suggest divergent associations between 25(OH)D and fracture by race/ethnicity. The optimal level of 25(OH)D for skeletal health may differ in White and Black women.
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影响因子：
4.2
作者：
Fang, Yue;van Meurs, Joyce B. J.;Arp, Pascal;van Leeuwen, Johannes P. T.;Hofman, Albert;Pols, Huibert A. P.;Uitterlinden, Andre G.
通讯作者：
Uitterlinden, Andre G.
影响因子：
5.6
作者：
Anderson, GL;Manson, J;Prentice, RL
通讯作者：
Prentice, RL
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15.9
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BOUILLON, R;VANASSCHE, FA;DEMOOR, P
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DEMOOR, P
影响因子：
7.1
作者：
Nesby-O'Dell, S;Scanlon, KS;Bowman, BA
通讯作者：
Bowman, BA
影响因子：
4.5
作者：
Lai JK;Lucas RM;Clements MS;Roddam AW;Banks E
通讯作者：
Banks E