CAJ | 학술논문

目的了解贵阳市城区中老年女性维生素D营养状况及其对骨密度的影响.方法采用整群抽样方法,调查贵阳市主城区所辖一社区中40～79岁女性511名,以放射免疫法检测血清25-羟维生素D[25(OH)D]及完整甲状旁腺素(iPTH)水平,应用双能X线骨密度仪检测髋部、腰椎前后位(L1-4)、左侧股骨颈骨密度.结果受试者总体血清25(OH)D浓度为(21.3±7.9)ng/ml,血清iPTH水平为(29.3±16.5) pg/ml;贵阳市城区中老年女性维生素D严重缺乏[25(OH) D＜10 ng/ml]、缺乏[10≤25 (OH) D＜20ng/ml]、不足[20≤25 (OH)D≤30 ng/ml]、正常[25(OH)D＞30 ng/ml]的比例依次为5.3％、42.3％、37.9％和14.5％；4.7％的受试者存在继发性甲状旁腺功能亢进.血清25(OH)D浓度与股骨颈、L1-4骨密度呈正相关(均P＜0.01)；血清iPTH水平与股骨颈、L1-4骨密度呈负相关(均P＜0.05).结论贵阳市城区中老年女性维生素D不足及缺乏现象普遍,其血清25(OH)D水平与腰椎、股骨近端骨密度正相关;血清iPTH在血清25(OH)D浓度低于20 ng/ml时表现出升高趋势,骨质疏松症患病风险增加.
목적 료해귀양시성구중노년녀성유생소D영양상황급기대골밀도적영향.방법 채용정군추양방법,조사귀양시주성구소할일사구중40～79세녀성511명,이방사면역법검측혈청25-간유생소D[25(OH)D]급완정갑상방선소(iPTH)수평,응용쌍능X선골밀도의검측관부、요추전후위(L1-4)、좌측고골경골밀도.결과 수시자총체혈청25(OH)D농도위(21.3±7.9)ng/ml,혈청iPTH수평위(29.3±16.5) pg/ml;귀양시성구중노년녀성유생소D엄중결핍[25(OH) D＜10 ng/ml]、결핍[10≤25 (OH) D＜20ng/ml]、불족[20≤25 (OH)D≤30 ng/ml]、정상[25(OH)D＞30 ng/ml]적비례의차위5.3％、42.3％、37.9％화14.5％；4.7％적수시자존재계발성갑상방선공능항진.혈청25(OH)D농도여고골경、L1-4골밀도정정상관(균P＜0.01)；혈청iPTH수평여고골경、L1-4골밀도정부상관(균P＜0.05).결론 귀양시성구중노년녀성유생소D불족급결핍현상보편,기혈청25(OH)D수평여요추、고골근단골밀도정상관;혈청iPTH재혈청25(OH)D농도저우20 ng/ml시표현출승고추세,골질소송증환병풍험증가.
Objective To evaluate vitamin D status of the middle and old aged women in the urban area of Guiyang,and to explore the impact of vitamin D status on the bone mineral density.Methods A total of 511 healthy women,aged 40 to 79 years old,living in one of the urban communities in Guiyang,were selected by means of stratified cluster sampling.The levels of serum 25-hydroxyvitamin D [25 (OH) D] and intact parathyroid hormone (iPTH) were detected by radioimmunoassay.In addition,the bone mineral density (BMD) of hip,lumbar vertebrae 1-4 (L1-4),and neck of left femur were detected by Dual energy X ray absorptiometry.Results The average serum level of 25(OH)D in all subjects was (21.3 ± 7.9) ng/ml and that of iPFH was (29.3 ± 16.5) pg/ml.Severe deficiency [25 (OH) D＜ 10 ng/ml],deficiency [10 ≤ 25 (OH) D＜20 ng/ml],insufficiency [20 ≤ 25 (OH) D ≤ 30ng/ml],and sufficiency [25 (OH) D＞ 30 ng/ml] of vitamin D were ascertained in 5.3％,42.3％,37.9％,and 14.5％ of the total cases respectively.The morbidity of secondary hyperparathyroidism was 4.7％.The level of 25 (OH) D was positively correlated with the BMD of L1-4 and neck of left femur (both P＜0.01).The level of iPTH was negatively correlated with BMD of neck of left femur and L1-4 (both P＜0.05).Conclusion The majority of middle and old aged women in the urban area of Guiyang city were found to be of vitamin D deficiency and insufficiency.Vitamin D status is positively correlated with BMD at lumbar spine and proximal femur.Serum 25 (OH) level below 20 ng/ml is associated with raised parathyroid hormone,which increases the risk of osteoporosis.