Vitamin D sufficiency is associated with low incidence of limb and vertebral fractures in community-dwelling elderly Japanese women: the Muramatsu Study
Vitamin D sufficiency is associated with low incidence of limb and vertebral fractures in community-dwelling elderly Japanese women: the Muramatsu Study
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DOI：
10.1007/s00198-010-1213-6
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发表时间：
2011-01-01
影响因子：
4
通讯作者：
Tsuchiya, Y.
中科院分区：
文献类型：
--
作者：
Nakamura, K.;Saito, T.;Tsuchiya, Y.
关于亚洲人维生素D状况与骨质疏松性骨折之间关系的数据很少。我们对773名居住在社区的日本老年妇女进行了一项为期6年的队列研究，发现血清25-羟基维生素D（25（OH）D）a千分之71 nmol/L可降低老年性四肢和脊椎骨折的风险。本研究旨在阐明维生素D和其他营养状况标志物与日本老年妇女骨折发生率之间的关系，我们对773名69岁及以上的社区居民妇女进行了为期6年的随访队列研究。6年随访于2009年结束。我们评估了血清25-羟基维生素D、低羧化骨钙素（维生素K状态的指标）和钙摄入量。主要结局为肢体和椎骨骨折。协变量为前臂骨密度（BMD）、年龄、体重指数、骨质疏松治疗和体力活动，平均血清25（OH）D浓度为60.0 nmol/L。在4,392人年中发生了37例肢体骨折和14例椎骨骨折。前臂下部BMD与骨折发生率增加显著相关（P = 0.0242）。第一四分位数的骨折校正风险比（HR）（< 47.7 nmol/L）和第三四分位数（59.2-70.9 nmol/L）血清25（OH）D，与第四个四分位数相比（千分之71.0 nmol/L）分别为2.82（95%可信区间，1.09-7.34）和2.82（95%可信区间，1.09-7.27）。当第四个四分位数（千分之一71.0 nmol/L）的发生率与其他三个四分位数（<71.0 nmol/L）的发生率相比较时，合并的校正HR为0.42（95%CI，0.18-0.99）。维生素K和钙的摄入与骨折的发生无关。充足的维生素D，即，血清25（OH）D a千分之71 nmol/L与社区老年妇女下肢和椎骨骨折风险相关。
Data on the association between vitamin D status and osteoporotic fracture in Asians are sparse. We conducted a 6-year cohort study of 773 community-dwelling elderly Japanese women and found that serum 25-hydroxyvitamin D (25(OH)D) a parts per thousand yenaEuro parts per thousand 71 nmol/L was associated with a reduced risk of osteoporotic limb and vertebral fractures.Data on the association between vitamin D status and osteoporotic fracture in Asians are sparse. This study aimed to clarify the association between vitamin D and other markers of nutritional status with the incidence of fracture in elderly Japanese women.We conducted a cohort study with a 6-year follow-up of 773 community-dwelling women aged 69 years and older. The 6-year follow-up ended in 2009. We assessed serum 25-hydroxyvitamin D, undercarboxylated osteocalcin (an index of vitamin K status), and calcium intake. The primary outcome was incident limb and vertebral fractures. Covariates were forearm bone mineral density (BMD), age, body mass index, osteoporosis treatment, and physical activity.The mean serum 25(OH)D concentration was 60.0 nmol/L. Thirty-seven limb fractures and 14 vertebral fractures occurred in 4,392 person-years. Lower forearm BMD was significantly associated with increased incident fracture (P = 0.0242). The adjusted hazard ratios (HR) of fracture for the first quartile (< 47.7 nmol/L) and the third quartile (59.2-70.9 nmol/L) of serum 25(OH)D, compared to the fourth quartile (a parts per thousand yen71.0 nmol/L), were 2.82 (95% confidence interval (CI), 1.09-7.34) and 2.82 (95%CI, 1.09-7.27), respectively. The pooled adjusted HR was 0.42 (95%CI, 0.18-0.99) when the incidence in the fourth quartile (a parts per thousand yen71.0 nmol/L) was compared to the other three quartiles combined (< 71.0 nmol/L). Vitamin K status and calcium intake were not associated with incident fracture.Sufficient vitamin D status, i.e., serum 25(OH)D a parts per thousand yenaEuro parts per thousand 71 nmol/L, is associated with low limb and vertebral fracture risk in community-dwelling elderly women.