济南城镇居民维生素D水平及分布

摘要

目的 探讨济南城镇居民维生素D的营养状况,为防治与维生素D不足有关的慢性疾病提供依据. 方法 在本院所管辖的3个医疗保健社区分层随机抽取受检者1478例,年龄30～90岁,平均(58.4±13.0)岁;其中男性602例,平均年龄(59.8±13.0)岁;女性876例,平均年龄(57.4±12.9)岁;按10岁间隔年龄段分组.用酶联免疫吸附法(ELISA)测定血25羟维生素D[25(OH)D]水平.维生素D水平分布的界定:[25(OH) D]≥75.0 nmol/L为维生素D营养充足,50.0～74.9nmol/I为临界,25.0～49.9 nmol/L为不足,＜25.0 nmol/L为缺乏.应用SPSS13.0软件进行统计分析. 结果 (1)男性[25(OH) D]水平58.6 nmol/L(95％ CI:56.7～60.5 nmol/L),女性54.2nmol/L(95％ CI:52.8～55.8 nmol/L),均低于75 nmol/L;70～79岁女性[25(OH) D]为49.1 nmol/L(95％CI:45.7～52.5 nmol/L);80～90岁为41.7 nmol/L(95％ CI:38.2～46.7 nmol/L),低于50nmol/L; (2)维生素D缺乏、不足、临界和充足,男性分别为5.6％、33.4％、36.5％和24.4％,女性分别为6.5％、42.9％、32.6％和18.1％;维生素D缺乏及不足发生率随年龄的增长而上升(男性:x2=33.68,P=0.004;女性:x2=55.7,P＜0.001);60岁以上女性维生素D缺乏及不足较男性高,差异有统计学意义(60～69岁:x2=9.387,P=0.025;80～90岁:x2=8.896,P=0.031);(3) [25(OH) D]水平以冬季最低[48.8 nmol/L(95％CI:46.8～50.9 nmol/L)],秋季最高[60.2 nmol/L(95％CI:58.0～62.3 nmol/L)];维生素D缺乏及不足发生率以冬季最高为7.6％及46.2％,秋季最低为5.5％及29.0％,差异有统计学意义(x2=18.36,P=0.031). 结论 城镇居民普遍存在维生素D缺乏及不足,以老年人群及其女性较为严重.血[25(OH) D]水平及分布与季节变化有关,冬季维生素D缺乏及不足发生率较高.%Objective To explore the vitamin D nutritional status of urban residents in Jinan,in order to provide the basis for the prevention and treatment of chronic diseases associated with vitamin D insufficiency.Methods 1478 cases aged 30-90 years,including 602 men (59.8± 13.0) years on average and 876 women (57.4±12.9) years on average were selected by a stratified random sampling from 3 community medical care institutions in Jinan.Subjects were divided into six groups according to the 10-year interval.Serum 25-hydroxyvitamin D [25(OH) D] level was measured by enzyme-linked immunosorbent assay (ELISA).Serum [25(OH) D] level ≥ 75 nmol/L was defined as vitamin D sufficient,(50.0 ～ 74.9) nmol/L as vitamin D critical value,25.0 ～ 49.9 nmol/L as vitamin D insufficiency,＜ 25 nmol/L as vitamin D deficiency.All data processing and statistical analysis were finished by SPSS 13.0.Results The average level of [25 (OH) D] was 58.60 nmol/L in males [95％ CI:56.7-60.5 nmol/L] and 54.17 nmol/L in females [95％ CI:52.8-55.8 nmol/L],which were less than 75 nmol/L.The average level of [[25(OH) D] was 49.1nmol/L in females aged 70-79 years (95％CI:45.7～52.5 nmol/L),41.7 nmol/L in females aged 80-90 years (95％CI:38.2 ～46.7 nmol/L),which were less than 50 nmol/L.The percentage of cases with vitamin D deficiency,insufficiency,critical value,and sufficiency was 5.6％,33.4％,36.5％,24.4％ in males,and 6.5％,42.9％,32.6％,18.1％ in female respectively.The incidence of vitamin D deficiency and insufficiency was increased with ageing (male:x2 =33.68 P＜0.01,female:x2 =55.7,P＜0.001).The percentage of vitamin D deficiency and insufficiency was more in females than in males (60-69 years old:x2=9.387,P＜0.05,80-90 years old:x2=8.896,P＜0.05).The [25 (OH) D] level was lowest in winter (48.8 nmol/L,95％CI:46.8～50.9 nmol/L) and highest in autumn (60.2 nmol/L,95％ CI:58.0～62.3 nmol/L).The incidence of vitamin D deficiency and insufficiency was highest in winter (x2 =18.364,P＜0.05).Conclusions Vitamin D deficiency and insufficiency are widely prevalent in urban residents,which is more severe in the elderly and females.Serum [25(OH) D] level is related to season,and the vitamin D deficiency and insufficiency are severe in winter.