JCEM：老年男性维生素D缺乏可预测全因死亡率

2013-07-15 desperado-c dxy

老年人群中维生素D缺乏和虚弱是常见的。为了确定25–羟维生素D[25(OH)D]浓度是否与虚弱和死亡率有关，来自澳大利亚西澳大学的Yuen Yee Elizabeth Wong教授及其团队进行了一项研究，该研究发现维生素D缺乏与虚弱的发生和流行有关，同时可预测全因死亡率。该研究结果在线发表在2013年6月20日的《临床内分泌代谢杂志》（The journal of clinical endocri

老年人群中维生素D缺乏和虚弱是常见的。为了确定25–羟维生素D[25(OH)D]浓度是否与虚弱和死亡率有关，来自澳大利亚西澳大学的Yuen Yee Elizabeth Wong教授及其团队进行了一项研究，该研究发现维生素D缺乏与虚弱的发生和流行有关，同时可预测全因死亡率。该研究结果在线发表在2013年6月20日的《临床内分泌代谢杂志》（The journal of clinical endocrinology & metabolism）上。

该研究是一项前瞻性队列研究，受试者由来自西澳洲佩斯市的4203例年龄70–88岁老年男性组成。通过免疫分析测定25(OH)D。用5点虚弱尺度（疲劳、抵抗力、步行、疾病和体重下降）评估虚弱。通过西澳洲数据连接系统的死亡登记确定死亡率。

该研究结果表明，在基线，确定676例（16.1%）例男性受试者虚弱，定义为有≥3项缺陷（虚弱分值≥3）。在多元横断面分析中，低维生素D状态，定义为25（OH）D值的最低四分位数（＜52.9nmol/l），与25（OH）D值的最高四分位数相比（＞81.6nmol/l），与虚弱发病率增加有关（比值比[OR] 1.96，95%可信区间[CI] 1.52至2.52）。在平均为期5.3年后，基线时维生素D低和有0项缺陷的男性（虚弱分值=0）随访期间发生虚弱的校正比值比为1.56（95%CI 1.07至2.27）。同时，在为期9.2年期间，低维生素D可预测全因死亡率（风险比1.20，95%CI 1.02至1.42），独立于基线虚弱和其他协变量。

该研究发现，在老年男性，维生素D缺乏与虚弱的发生和流行有关。维生素D缺乏同时可预测全因死亡率，且独立于虚弱。维生素D和死亡率的关系不完全依赖虚弱的发生。

专家点评：老年人受维生素D缺乏的影响最大

Robert P. Heaney 医生表示，Sohl医生及其同事的研究结果再次证明维生素D缺乏可产生不良的结局，尤其是对维生素D储备逐渐减少的老年人。这些研究结果延伸了既往研究的结果：维生素D水平与功能水平呈剂量依赖性关系，对维生素D缺乏者补充维生素D可能有益。“惟一的现实问题不是这种方法是否有效，而是获得预期效果需要补充到什么水平”，他强调了尽量达到祖辈的摄入量水平的重要性。在本研究的荷兰人口中，祖辈的水平，即农业社会前的祖先从环境中获取的水平(是今天最佳水平的一个良好指标)可能高达50 ng/ml，这远高于研究者们认为的足量水平——30 ng/ml。

几年前美国老年病学会和疾病预防控制中心曾召开专家组会议，制订老年人补充指南，Heaney医生曾参加这次会议，并对专家组的9名成员进行了有关他们自身维生素补充量的调查，结果发现其摄入量为5,500 IU/d，足以支持祖辈的摄入量水平。现有的数据也支持这个水平的摄入量。该专家小组制订的指南即将出版。

Heaney医生是一名临床内分泌专家，拥有内布拉斯加州奥马哈市克瑞顿大学教授职称，他报告称无相关利益冲突。

Low vitamin D status is an independent predictor of increased frailty and all-cause mortality in older men: the Health In Men Study

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2014-06-20 achengzhao

#JCE#

58 0
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2013-09-15 smallant2015

#JCEM#

77 0
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2013-07-16 cathymary

#老年男性#

63 0
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2013-07-17 lvliquan

#全因死亡率#

67 0

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