VITAMIN D SUPPLEMENTATION IN POSTMENOPAUSAL BLACK WOMEN

骨质疏松症是世界范围内的一个主要公共卫生问题。 尽管黑人女性被认为患骨质疏松症的风险较低 骨折比白人女性绝经后骨折的风险大 黑人女性仍然占很大比例。黑人一直低于25%- 羟基维生素D水平与甲状旁腺激素的升高 与白人女性相比，这一水平更高。这些发现与 维生素D缺乏，在某些情况下，是真正的缺乏。维生素D 在白种人中，随着年龄的增长，骨量不足与骨质丢失有关。 女性人口。此外，在白人老年女性和男性中， 维生素D的治疗导致了较低的骨丢失率和 骨折。补充维生素D的效果从来没有 在黑人女性身上进行了评估。我们假设， 黑人中存在的相对25(OH)D不足 绝经后妇女在衰老过程中可能会加剧骨质流失 黑人女性。为了检验这一假设，我们建议进行一项 比较维生素D补充剂的随机临床试验(1000 国际单位/天)在一项为期两年的150人研究中使用安慰剂 绝经后(5岁)的黑人女性，她们被证明是 25(OH)D不足。我们建议确定补充方案是否 维生素D(1000IU)改善矿物质代谢，增加钙 吸收，减少骨转换，减少骨丢失的速度 绝经后的黑人女性。此外，我们打算确定 生化和骨密度对维生素D的反应 黑人女性的补充剂与等位基因变异有关 维生素D受体。黑人女性较少骨折的事实 与白人女性相比，往往有更高的骨量 将这一民族排除在骨质疏松症治疗和研究之外 预防。然而，黑人女性的骨折率仍然是 相当可观。一种简单、安全的营养补充剂， 维生素D，可以降低骨质流失和骨质疏松的风险 黑人女性的骨折。

Osteoporosis is a major public health problem throughout the world. Although black women are believed to be at lower risk of osteoporotic fracture than white women, the risk of fracture in postmenopausal black women is still substantial. Blacks have consistently lower 25- hydroxy-vitamin D levels and an elevation in parathyroid hormone level compared to white women. These findings are consistent with vitamin D insufficiency, or in some, true deficiency. Vitamin D insufficiency has been implicated in bone loss with aging in the white female population. furthermore, in white elderly women and men, treatment with vitamin D has resulted in a lower rate of bone loss and fractures. The effect of vitamin D supplementation has never been evaluated in black women. We hypothesize that the presence of relative 25(OH)D insufficiency that exists among black postmenopausal women may exacerbate loss of bone among aging black women. To test this hypothesis, we propose to conduct a randomized clinical trial to compare vitamin D supplementation (1000 IU/ day) with placebo during a two year study in a population of 150 black postmenopausal (>5 years) women, who are shown to be 25(OH)D insufficient. We propose to determine whether supplemental vitamin D (1000 IU) improves mineral metabolism, increases calcium absorption, reduces bone turnover and reduces the rate of bone loss in black postmenopausal women. In addition, we intend to determine whether biochemical and bone density responses to vitamin D supplementation in black women are related to allelic variation in the vitamin D receptor. The fact that black women fracture less frequently than white woman and tend to have higher bone mass has virtually excluded this ethnic group from studies of osteoporosis treatment and prevention. However, the fracture rate in black women is still substantial. It is possible that a simple, safe nutritional supplement, vitamin D, could reduce the rate of bone loss and risk of osteoporotic fracture in black women.