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| 老年男性血清维生素D水平状况及其与甲状旁腺激素的相关性研究 |
| Study on the vitamin D status of elderly men and the relationship between serum vitamin D and PTH level |
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| DOI：10.3969/j.issn.1006.7108.2015.04.009 |
| 中文关键词: 老年男性 维生素D ；甲状旁腺激素；骨转换指标 |
| 英文关键词:Elderly men Vitamin D Parathyroid hormone Bone turnover markers |
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| 中文摘要: |
| 目的 探讨老年男性血清维生素D水平及其与甲状旁腺素及骨代谢指标的相关性。方法 收集2010年9月至2013 年9月在上海瑞金医院老年病科病房住院及门诊患者895例，平均年龄为76岁。测定其血清25-羟基维生素D[25(OH)D]、血钙（Ca)、血磷(P)、甲状旁腺激素（PTH)，1型胶原分子N-端前肽（PINP)及β-1型胶原C端肽（β-CTX)水平。根据血清25 (OH) D水平将患者分为维生素D严重缺乏组（<25 nmol/L)、维生素D缺乏组（25~50 nmol/L)、维生素D不足组（50 ~75 nmol/L)和维生素D充足组（>75 nmol/L)。结果（1)895例老年男性患者年龄60 ~99岁，平均年龄76岁。血清25( OH) D 平均值为(43. 52 ±21. 97) nmol/L。维生素D缺乏者（≤50nmol/L)为592人(67% )，维生素D不足者（50 ~ 75 nmol/L)为223 人(25%)。维生素D缺乏或不足者高达92%，维生素D充足者（>75 nmol/L)仅为80人(8%)。（2)不同年龄段血清25- (OH) D的比较显示，血清25-(OH) D水平随增龄而逐渐降低。60 ~69岁组25-(OH) D值最高，为（46. 27 ± 20. 76) nmol/L，与 其它各组比较差异均有统计学意义(P <0. 05)。相关分析表明，血清25-(OH)D与年龄呈负相关（相关系数r =-0.088，P = 0. 008)。（3)甲状旁腺素（PTH)的平均水平为（55. 74 ±29. 06) pg/mL。相关分析显示，25-(OH)D与PTH、PINP、β-CTX均呈负相关（r值分别为-0.209、-0. 109、-0. 122，P 均 <0.05)。血25-(OH)D 与 Ca 呈正相关（r = 0. 206，P <0.001)。血 25-(OH) D与BMI、P均无相关性（P均>0.05)。结论 老年男性存在严重的维生素D缺乏或不足。血25-(OH) D与PTH、年龄、 PINP、β-CTX均呈负相关。 |
| 英文摘要: |
| Objective To investigate the serum vitamin D level in elderly men in Shanghai and the relationship between serum vitamin D and PTH level and bone turnover markers. Methods Eight hundred and ninety-five elderly men (mean age 76 years)， who attended the geriatric department in Shanghai Ruijin Hospital from September 2010 to September 2013，were enrolled. Serum 25-hydroxy vitamin D [ 25 –(OH) D ]，calcium ( Ca)，phosphorus ( P)，parathyroid hormone ( PTH)，procollagen type I N- terminal propeptide (PINP)，and (β-crosslaps of C-telopeptide of type I collagen (β-CTX) were measured. Four groups were divided according to their serum 25 (OH) D levels，including severe deficiency group ( <5 nmol/L)，deficiency group (25 - 50 nmol/L)，insufficiency group (50 -75 nmol/L)，and sufficiency group ( >75 nmol/L). Results (1) The mean age of the 895 subjects was 76 years old (from 60 to 99 years). The average level of 25 (OH) D was 43. 52 ±21. 97 nmol/L. Subjects of vitamin D deficiency (≤50nmol/L) and insufficiency (50 - 75 nmol/L) were 592 (67%) and 223 cases (25%)，respectively. The amount of vitamin D deficiency and insufficiency was up to 92%. Subjects of vitamin D sufficiency (75 nmol/L) were only 80 cases (8% ). (2) Serum 25 (OH) D in different ages showed that 25 (OH) D level decreased with an increase of age and the highest level was in 60 - 69 - year group (46. 27 ±20. 76). This was significant different compared to other age groups (P < 0. 05). Correlation analysis showed that serum 25 (OH) D level was negatively correlated with age ( r = -0. 088，P =0. 008). (3) The mean level of PTH was 55. 74 ± 29. 06. Correlation analysis showed that serum 25 (OH) D level was negatively correlated with PTH,PINP, and β-CTX (r = -0. 209, -0. 109, and -0. 122, P <0. 05) and had no correlation with BMI and P (P >0. 05). Serum 25 ( OH) D level was positively correlated with Ca ( r = 0. 206，P < 0. 001). Conclusion Vitamin D deficiency or insufficiency is highly prevalent in elderly men. Serum 25 (OH) D level is negatively correlated with PTH，age，PINP，and β- CTX. |
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