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Effect of vitamin D supplementation on the clinical conditions in the institutionalized elderly subjects

补充维生素 D 对住院老年受试者临床状况的影响

基本信息

批准号：
20390285
负责人：
OHRUI Takashi
金额：
$ 8.07万
依托单位：
Tohoku University
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (B)
财政年份：
2008
资助国家：
日本
起止时间：
2008 至 2010
项目状态：
已结题

来源：
https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-20390285/
关键词：
感染症予防学高齢者肺炎ビタミンD 細胞性免疫虚弱高齢者ビタミンD欠乏肺炎細胞性免疫能ツベルクリン反応活性型ビタミンD 25-OHビタミンD 血中ビタミンD濃度活性型ビタミンD製剤高齢者生命予後活性型ビタミンD3

项目摘要

Pneumonia is a common cause of death among older people despite the availability of potent new antimicrobials. Vitamin D (VD) deficiency is especially common in institutionalized elderly people probably due to limited sun-exposure, skin diseases and problems of dietary intake and is associated with hip fractures and higher mortality from life-threatening conditions such as cardiovascular diseases, cancer and diabetes mellitus. Recently, 1,25-dihydroxyvitamin D, a biologically active form of VD, was reported to be a potent immune modulator of the adaptive immune system and to stimulate the innate immune response upon infection. The aim of the first study was to examine whether VD deficiency correlates with depressed cellular immunity and increases susceptibility to respiratory tract infections among older residents of long-term care facilities. We measured serum concentrations of 1,25-dihydroxyvitamin D and albumin, performed a tuberculin skin test, an indicator of cellular immunity and assessed retrospectively the incidence of both febrile respiratory illnesses and pneumonia. In the first study we showed that a lower serum level of 1,25-dihydroxyvitamin D correlated with a depressed tuberculin response and an increased susceptibility to respiratory tract infections in the institutionalized elderly subjects. In the second study, we performed a prospective study to determine the effect of VD supplementation on the febrile respiratory illnesses in frail elderly people who often have low serum VD levels and are at high risk for pneumonia. As a result, we could find no significant effects in the VD supplementation in institutionalized frail elderly subjects.

肺炎是老年人常见的死亡原因，尽管有有效的新抗菌剂可用。维生素D(VD)缺乏在住院老年人中尤其普遍，可能是由于有限的阳光照射、皮肤病和饮食摄入问题，并与髋部骨折和威胁生命的疾病(如心血管疾病、癌症和糖尿病)的较高死亡率有关。最近，1，25-二羟基维生素D是一种具有生物活性的VD，据报道是一种有效的适应性免疫系统的免疫调节剂，并在感染时刺激先天免疫反应。第一项研究的目的是检验长期护理机构的老年居民中，VD缺乏是否与细胞免疫功能低下和增加呼吸道感染的易感性相关。我们测量了血清1，25-二羟基维生素D和白蛋白的浓度，进行了结核菌素皮肤试验，这是细胞免疫的指标，并回顾评估了发热性呼吸道疾病和肺炎的发生率。在第一项研究中，我们表明，在住院的老年受试者中，血清1，25-二羟基维生素D水平较低与结核菌素反应抑制和呼吸道感染易感性增加相关。在第二项研究中，我们进行了一项前瞻性研究，以确定补充VD对虚弱老年人发热性呼吸道疾病的影响，这些老年人通常血清VD水平较低，并具有肺炎的高风险。结果，我们没有发现在机构虚弱的老年受试者中补充VD的显著效果。