The prevalence of hypovitaminosis D and secondary hyperparathyroidism in obese Black Americans
The prevalence of hypovitaminosis D and secondary hyperparathyroidism in obese Black Americans
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DOI：
10.1111/j.1365-2265.2006.02502.x
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发表时间：
2006-05-01
影响因子：
3.2
通讯作者：
Yanovski, JA
中科院分区：
文献类型：
--
作者：
Yanoff, LB;Parikh, SJ;Yanovski, JA
研究背景肥胖（体重指数，BMI >= 30 kg/m2）和黑人都与维生素D缺乏和继发性甲状旁腺功能亢进的高风险相关。我们假设维生素D缺乏症的风险将因此是非常高的肥胖黑人adulters.Objective研究种族和肥胖对25-羟维生素D [25（OH）D]和甲状旁腺激素（iPTH）的影响设计，设置和参与者的横断面研究379黑人和白色成人从华盛顿区。BMI范围为19（.）9至58（.）主要指标维生素D [25（OH）D < 37（.）5 nmol/l]和继发性甲状旁腺功能亢进[25（OH）D < 37（.）5 nmol/l，iPTH > 4（.）结果肥胖黑人受试者平均25（OH）D、40（. 3（SD，20（.）3)nmol/l，与肥胖白人相比，64（.）5（29（.）7），P < 0（.）001，非肥胖黑人，53（.）3（26（.）0），P = 0（.）0025和非肥胖白人，78（.）0（33（.）5），P < 0（.）001.维生素D缺乏症的患病率随BMI的增加而增加，且随BMI的增加而增加（P < 0. 05）。001)在所有检查的BMI类别中，黑人比白人。在BMI >= 35 kg/m2的受试者中，59%的黑人和18%的白人患有维生素D缺乏症（比值比6（.）5，95%置信区间3（.）0-14（.）2）。iPTH与25（OH）D呈负相关（r = -0（.）31，P < 0（.）0001），提示维生素D缺乏症患者存在临床上重要的维生素D缺乏症伴继发性甲状旁腺功能亢进。对于继发性甲状旁腺功能亢进35（.）2%的黑人符合标准，而9（.）7%的白人（或3（.）6、C1 1（.）5-98（.）8).结论肥胖的美国黑人患维生素D缺乏症和继发性甲状旁腺功能亢进的风险特别高。医生应考虑定期补充维生素D或筛查维生素D缺乏症。
Context Both obesity (body mass index, BMI >= 30 kg/m(2)) and Black race are associated with a higher risk of vitamin D deficiency and secondary hyperparathyroidism. We hypothesized the risk of hypovitaminosis D would therefore be extraordinarily high in obese Black adults.Objective To study the effects of race and adiposity on 25-hydroxyvitamin D [25(OH)D] and parathyroid hormone (iPTH).Design, Setting and Participants Cross-sectional study of 379 Black and White adults from the Washington D.C. area. BMI ranged from 19(.)9 to 58(.)2 kg/m(2).Main Outcome Measures Prevalence of hypovitaminosis D [25(OH)D < 37(.)5 nmol/l] and secondary hyperparathyroidism [25(OH)D < 37(.)5 nmol/l with iPTH > 4(.)2 pmol/l].Results Obese Black subjects had lower mean 25(OH)D, 40(.)3 (SD, 20(.)3) nmol/l, compared with obese Whites, 64(.)5 (29(.)7), P < 0(.)001, nonobese Blacks, 53(.)3 (26(.)0), P = 0(.)0025 and nonobese Whites, 78(.)0 (33(.)5), P < 0(.)001. The prevalence of hypovitaminosis D increased with increasing BMI, and was greater (P < 0(.)001) in Blacks than Whites within all BMI categories examined. Among subjects with BMI >= 35 kg/m(2), 59% of Blacks vs 18% of Whites had hypovitaminosis D (odds ratio 6(.)5, 95% confidence interval 3(.)0-14(.)2). iPTH was negatively correlated with 25(OH)D (r = -0(.)31, P < 0(.)0001), suggesting those with hypovitaminosis D had clinically important vitamin D deficiency with secondary hyperparathyroidism. For secondary hyperparathyroidism 35(.)2% of Blacks met the criteria, compared to 9(.)7% of Whites (OR 3(.)6, CI 1(.)5-98(.)8).Conclusions Obese Black Americans are at particularly high risk for vitamin D deficiency and secondary hyperparathyroidism. Physicians should consider routinely supplementing such patients with vitamin D or screening them for hypovitaminosis D.