引用本文:徐国玲,颜晓东.中老年人不同季节血25羟维生素D水平变化及其与骨代谢关系的研究[J].中国临床新医学,2018,11(12):1202-1205.
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中老年人不同季节血25羟维生素D水平变化及其与骨代谢关系的研究
徐国玲,颜晓东
530021 南宁,广西壮族自治区人民医院内分泌代谢科
摘要:
[摘要] 目的 探讨中老年人不同季节血25羟维生素D[25(OH)D]水平变化及其与骨代谢指标的关系。方法 对2017-08~2018-08在内分泌代谢科就诊的117例绝经后女性及老年男性患者进行血清25(OH)D、电解质、甲状旁腺激素(PTH)、β胶原降解产物(β-CTX)及1型胶原氨基端延长肽(P1NP)检测。按照检测时间分为春组36例(3~5月份)、夏组32例(6~8月份)、秋组23例(9~11月份)、冬组26例(12~2月份),分析不同季节组血25(OH)D水平变化。同时,将患者按照25(OH)D水平分为维生素D缺乏组34例,25(OH)D<50 nmol/L;维生素D不足组53例,50 nmol/L≤25(OH)D≤75 nmol/L;维生素D充足组30例,25(OH)D>75 nmol/L。分析各组电解质、PTH及骨转换指标的差异。结果 春组与夏组、春组与秋组、夏组与冬组、秋组与冬组之间比较,25(OH)D差异有统计学意义(P<0.01)。按维生素D水平分组的三组患者之间年龄、转氨酶、血肌酐、PTH、β-CTX差异均无统计学意义(P>0.05)。维生素D缺乏组与维生素D充足组比较,血钙(P<0.01)、lnP1NP(P<0.05)差异有统计学意义。各组25(OH)D水平与年龄呈负相关(P<0.01)。结论 中老年人夏季血25(OH)D水平高,冬季最低。在绝经后女性和老年男性患者中,25(OH)D与年龄呈负相关,25(OH)D缺乏的患者血钙水平下降,骨形成减少。
关键词:  25羟维生素D  骨代谢  钙磷代谢  季节
DOI:10.3969/j.issn.1674-3806.2018.12.07
分类号:R 589
基金项目:
Relationship between changes of serum 25-hydroxyvitamin D and bone metabolism in middle-aged and elderly people in different seasons
XU Guo-ling, YAN Xiao-dong
Department of Endocrinology and Metabolism, the People′s Hospital of Guangxi Zhuang Autonomous Region, Nanning 530021, China
Abstract:
[Abstract] Objective To observe the changes of serum 25-hydroxyvitamin D levels in middle-aged and elderly people in different seasons, and the relationship between the vitamin D levels and bone metabolism indexes. Methods The serum levels of 25-hydroxyvitamin D, electrolyte, parathyroid hormone(PTH), beta-collagen degradation product(β-CTX) and type 1 collagen amino-terminal prolongation peptide(P1NP) were detected in 117 postmenopausal women and elderly men collected in the Department of Endocrinology and Metabolism of the People′s Hospital of Guangxi Zhuang Autonomous Region from August 2017 to August 2018. According to different detection time, the patients were divided into spring group(from March to May, n=36), summer group(from June to August, n=32), autumn group(from September to November, n=23) and winter group (from December to February of the following year, n=26). The changes of serum 25-hydroxyvitamin D levels in different seasons were analyzed. Meanwhile, the patients were divided into vitamin D deficiency group[25(OH)D<50 nmol/L, n=34], vitamin D insufficiency group[50 nmol/L≤25(OH)D≤75 nmol/L, n=53] and vitamin D adequacy group[25(OH)D>75 nmol/L, n=30] according to different levels of 25(OH)D, and the differences of electrolyte, PTH and bone turnover markers were analyzed and compared among the groups. Results There were significant differences in the levels of 25(OH)D between the spring group and the summer group, the spring group and the autumn group, the summer group and the winter group, the autumn group and the winter group(P<0.01). There were no significant differences in age, aminotransferase, serum creatinine, PTH, and β-CTX among the three groups with different levels of vitamin D(P>0.05). There were significant differences in serum calcium(P<0.01) and lnP1NP(P<0.05) between the vitamin D adequacy group and the vitamin D deficiency group. The level of 25(OH)D in each group was negatively correlated with age(P<0.01). Conclusion The level of serum 25-hydroxyvitamin D in the middle-aged and elderly people was high in summer, but the lowest in winter. In the postmenopausal women and the elderly men, the levels of 25-hydroxyvitamin D are negatively correlated with age. The patients with vitamin D deficiency have decreased levels of serum calcium and reduced bone formation.
Key words:  25-hydroxyvitamin D  Bone metabolism  Calcium and phosphorus metabolism  Seasons