中国组织工程研究

中国组织工程研究 ›› 2017, Vol. 21 ›› Issue (28): 4448-4453.doi: 10.3969/j.issn.2095-4344.2017.28.004

• 骨组织构建 bone tissue construction • 上一篇    下一篇

中国南方地区中老年患者血清维生素D水平与骨密度的相关性

张良明，杨 阳，陈振翔，何天威，何 磊，刘 斌，戎利民   

  1. 中山大学附属第三医院脊柱外科，广东省广州市 510630
  • 修回日期:2017-09-08 出版日期:2017-10-08 发布日期:2017-11-10
  • 通讯作者: 戎利民，医学博士，教授，主任医师，博士生导师。中山大学附属第三医院脊柱外科，广东省广州市 510630
  • 作者简介:张良明，男，1983年生，广东省化州市人，2012年中山大学毕业，医学博士，主治医师，主要从事骨科的基础与临床研究。
  • 基金资助:

    国家自然科学基金 (81301524，81472122)；广东省自然科学基金(S2013040015484)；高校基本科研业务费-中山大学青年教师培育项目(15ykpy23)

Association of serum vitamin D with bone mineral density of middle-aged and elderly patients in southern China

Zhang Liang-ming, Yang Yang, Chen Zhen-xiang, He Tian-wei, He Lei, Liu Bin, Rong Li-min   

  1. Department of Spine Surgery, the Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, Guangdong Province, China
  • Revised:2017-09-08 Online:2017-10-08 Published:2017-11-10
  • Contact: Rong Li-min, M.D., Professor, Chief physician, Doctoral supervisor, Department of Spine Surgery, the Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, Guangdong Province, China
  • About author:Zhang Liang-ming, M.D., Attending physician, Department of Spine Surgery, the Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, Guangdong Province, China
  • Supported by:

    the National Natural Science Foundation of China, No. 81301524 and 81472122; the Natural Science Foundation of Guangdong Province, No. S2013040015484; the Fundamental Research Fund for Universities-Young Teachers Cultivation Project of Sun Yat-Sen University, No. 15ykpy23

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摘要：

文章快速阅读：

文题释义：
维生素D：维生素D是固醇类衍生物，是人体必需的重要营养物质，其家族家族中最重要的成员包括维生素D2(麦角钙化醇)和维生素D3(胆钙化醇)，主要通过食物摄入和阳光照射获取。人体皮下储存有从胆固醇生成的7-脱氢胆固醇，受紫外线的照射后，可转变为维生素D3。
维生素D与钙磷代谢：人体吸收的维生素D没有活性，血液转送至肝脏后，经25-羟化酶羟化后生成25(OH)D，然后在肾脏进一步羟化成为活化的1，25(OH)D。活化维生素D可以促进小肠上皮吸收钙和磷；通过调节破骨和成骨细胞活性，维持血钙稳定；通过甲状旁腺素间接作用，在肾脏促进肾小管对钙、磷的重吸收。

 

摘要
背景：维生素D是促进钙吸收和维持人体骨骼系统健康的重要物质，但其血清水平与人体骨密度的关系仍存在争议。
目的：探索中国南方地区中老年患者血清维生素D水平与骨密度的相关性。
方法：连续采集中国南方地区一个大型三甲医院于2014年7月至2016年12月就诊的50岁以上门诊或住院患者的临床数据，分析患者的血清25-羟基维生素D[25(OH)D]水平与骨密度(腰椎、股骨颈和全髋)的关系。  
结果与结论：①纳入对象资料分析：共纳入1 154例患者，年龄(64.62±10.48)岁，女性占77.2%，平均血清25(OH)D水平为(62.07±37.40) nmol/L。血清25(OH)D随着年龄增大逐渐降低，50-59岁、60-69岁和70岁以上患者25(OH)D不足/缺乏的比例分别为71.3%，77.0%和80.1%；②相关性分析显示，总体患者的血清25(OH)D水平与腰椎骨密度无相关性，但与股骨颈和全髋骨密度存在弱正相关性(r =0.09，0.08，P < 0.01)。在维生素D缺乏[25(OH)D ≤ 50 nmol/L]患者群中，血维生素D水平与腰椎骨、股骨颈和全髋骨密度呈显著正相关(r=0.117，0.120，0.146，P < 0.01)；③以性别做亚组分析，男性维生素D缺乏患者，其维生素D水平与腰椎、股骨颈和全髋骨密度都不存在相关性；女性维生素D缺乏患者，其维生素D水平与腰椎、股骨颈和全髋骨密度存在显著正相关性(r =0.105，0.135，0.171，P < 0.01)；④结果证实，中国南方地区中老年患者普遍存在维生素D不足或缺乏，但男性患者血清维生素D水平与骨密度无相关，女性患者维生素D水平与骨密度正相关。

中国组织工程研究杂志出版内容重点：组织构建；骨细胞；软骨细胞；细胞培养；成纤维细胞；血管内皮细胞；骨质疏松；组织工程
ORCID: 0000-0003-0315-1456(戎利民)

关键词: 组织构建, 骨组织工程, 维生素D, 25-羟基维生素D, 1, 25-羟基维生素D, 维生素D缺乏, 骨密度, 骨代谢, 骨量减少, 骨质疏松症, 中国南方地区, 国家自然科学基金

Abstract:

BACKGROUND: Vitamin D is a key substance that promotes calcium absorption and maintains the health of skeletal system, but its relationship with bone mineral density remains controversial.
OBJECTIVE: To determine the relationship between serum level of vitamin D and bone mineral density in the middle-aged and elderly patients in southern China.
METHODS: The patients aged over 50 years old admitted in the clinic and in-patient department of a large-scale 3A hospital from July 2014 to December 2016 were enrolled and the clinical data were collected. Then, the association between the serum level of 25-hydroxy vitamin D (25(OH)D) and bone mineral density (at the lumbar spine, femoral neck and total hip) was analyzed.
RESULTS AND CONCLUSION: A total of 1 154 patients (77.2% female) were enrolled with a mean age of (64.62±10.48) years, and the mean serum level of 25(OH)D was (62.07±37.40) nmol/L. The serum level of 25(OH)D decreased with age increasing, and the proportion of vitamin D insufficiency/deficiency in patients aged 50-59, 60-69 and ≥ 70 years old was 71.3%, 77.0% and 80.1%, respectively. Correlation analysis showed that the serum level of 25(OH)D was not associated with bone mineral density at the lumbar spine, but had a weakly positive correlation with bone mineral density at the femoral neck and total hip (r=0.09 and 0.08, P < 0.01). For patients with vitamin deficiency (25(OH)D ≤ 50 nmol/L), there was a significantly positive correlation between serum level of vitamin D and bone minerat density at the lumbar spine, femoral neck and total hip (r =0.117, 0.120 and 0.146, P < 0.01). After subgroup analysis, vitamin D level was not associated with bone mineral density in male, but was significantly associated with that in female (r=0.105, 0.135 and 0.171 for the lumbar spine, femoral neck and total hip, respectively, P < 0.01). Therefore, the prevalence of vitamin D deficiency is common in middle-aged and elderly patients in southern China. The serum level of vitamin D is not related to bone mineral density in male, but was positively correlated with that in female.

中国组织工程研究杂志出版内容重点：组织构建；骨细胞；软骨细胞；细胞培养；成纤维细胞；血管内皮细胞；骨质疏松；组织工程

Key words: Vitamin D, Bone Density, Bone Diseases, Metabolic, Osteoporosis

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