中国骨质疏松杂志

乌鲁木齐老年人血清维生素D水平与骨质疏松症的相关性研究

Study of the correlation between the serum level of vitamin D and osteoporosis in the elderly people in Urumqi

DOI：10.3969/j.issn.1006-7108.2015.02.012

英文关键词:Vitamin D Bone mineral density Osteoporosis The population in Urumqi

基金项目:新疆维吾尔自治区老年学学会自然科学基金课题组（2013-001）

作者	单位
吴冬梅* 刘培成徐作兰古丽江王春艳李婷李俊	新疆维吾尔自治区职业病医院，乌鲁木齐 830091

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中文摘要:

目的探讨乌鲁木齐老年人维生素D营养状况及其与骨质疏松的关系。方法收集2013年7月至2014年1月在我院老年医学科住院的65岁以上老年患者200例，年龄65～92岁，平均（78.2±10.2）岁。采用美国HOLOGIC公司生产的Discovery wi(S/N86451)型号的双能X线骨密度测定仪（DXA）分别测定腰椎(1-4)、股骨近端骨密度。使用罗氏公司型号为E411的电化学发光检测仪用电化学发光法进行血清25(OH)D水平测定。根据25(OH)D水平分为维生素D严重缺乏(A组)、缺乏(B组)、不足(C组)和充足(D组)。根据年龄分为60～69岁组、70～79岁组及≥80岁以上组。结果女性受试者中，维生素D严重缺乏30名(26.5%)，缺乏56名(49.6%)，不足18名(15.9%)，充足9名(8.0%)；男性受试者中，维生素D严重缺乏18名(20.6%)，缺乏42名(48.3%)，不足17名(19.5%)，充足10名(11.5%)。女性及男性维生素D严重缺乏组股骨颈的骨密度均显著低于维生素D缺乏组，差异有统计学意义（P值均＜0.05）。女性各年龄段间25(OH)D水平及腰椎骨密度无统计学差异（P=0.215、P=0.036），股骨颈、大转子区、转子间及全髋部骨密度随年龄增长降低，差异有统计学意义（P＜0.01）。男性各年龄段间25(OH)D水平及各部位BMD组间差异无统计学意义（P值均＞0.05）。结论乌鲁木齐老年人存在严重的维生素D缺乏或不足状况，维生素D的状态与骨质疏松可能无直接关联，必须进一步进行大样本的研究来探讨维生素D与骨质疏松的关系。

英文摘要:

Objective To study the association between vitamin D status and osteoporosis in the elderly people in Urumqi. Methods Two hundred patients over 65 years old were collected from July 2013 to January 2014 in the Department of Geriatrics of our hospital. The age ranged from 65 to 92 years old, with an average of 78.2 ±10.2 years old. The BMD of the lumbar spine (L1-4) and the femoral neck was measured using dual-energy X-ray absorptiometry (DXA, HOLOGIC Discovery wi S/N86451 model). Serum 25(OH)D was determined using chemiluminescence method with an electrochemical luminescence detector (Roche, E411 model). Serum vitamin D status was classified into 4 groups according to the serum 25(OH)D levels, severe deficiency (group A), deficiency (group B), insufficiency (group C), and sufficiency (group D). The participants were divided into 3 age groups, 60-69 year group, 70-79 year group, and over 80 year group. Results Among the females, the prevalence of vitamin D severe deficiency, deficiency, insufficiency, and sufficiency was 26.5% (30 cases), 49.6% (56 cases), 15.9% (18 cases), and 8.0% (9 cases), respectively. Among the males, the prevalence of vitamin D severe deficiency, deficiency, insufficiency, and sufficiency was 20.6% (18 cases), 48.3% (42 cases), 19.5% (17 cases), and 11.5% (10 cases), respectively. BMD of femoral neck in vitamin D severe deficiency subgroup was significantly lower than that in vitamin D deficiency subgroup, and the difference was statistically significant (P<0.05). 25(OH)D levels and BMD values of the lumbar vertebrae in women among all age groups were not significantly different (P=0.215, P=0.036). BMD values of the femoral neck, the greater trochanter, the intertrochanter, and the hip were gradually decreased with the increase of age, with significant difference among the groups (P<0.01). No significant difference of 25(OH)D levels and BMD values of the lumbar vertebrae and the hip in men among all age groups was observed (P>0.05). Conclusion Vitamin D deficiency and insufficiency is a quite serious problem in the elderly in Urumqi. There is no evidence that the serum 25(OH)D level is associated with BMD. A large sample study is needed to explore the correlation between vitamin D status and osteoporosis in the future.

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