合肥某三甲医院4 311例体检人群血清25-羟维生素D水平与相关因素的分析

高晓蔓; 何建乐; 许夕海; 陈逸青; 肖融; 邓大同

doi:10.16766/j.cnki.issn.1674-4152.003108

合肥某三甲医院4 311例体检人群血清25-羟维生素D水平与相关因素的分析

doi: 10.16766/j.cnki.issn.1674-4152.003108

1.
安徽医科大学第一附属医院全科医学科，安徽合肥 230022
2.
安徽医科大学第一附属医院健康管理中心
3.
安徽医科大学第一附属医院内分泌科

基金项目:

安徽省自然科学基金青年项目 2208085QH242

详细信息

通讯作者:
邓大同，E-mail：13855134251@163.com

中图分类号: R589.9 R591.44
计量
- 文章访问数: 321
- HTML全文浏览量: 179
- PDF下载量: 15
- 被引次数: 0
出版历程
- 收稿日期: 2022-10-12
- 网络出版日期: 2023-09-13

Analysis of serum 25-hydroxyvitamin D levels and related factors in a population of 4 311 physical examinations in a tertiary hospital in Hefei

1.
Department of General Practice, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230022, China

摘要

摘要: 目的利用安徽医科大学第一附属医院体检中心数据研究血清25-羟维生素D[25(OH)D]浓度与季节、性别、年龄等因素的关系，为临床合理补充维生素D提供参考。方法选取2017年4月—2022年6月(缺少2020年4、5、6三个月数据)4 311例(＞20岁)体检者信息。采用Spearman相关系数进行每月平均血清25(OH)D浓度与每月的平均气温，日照时长，紫外线强度大小的相关性分析，计算25(OH)D充足[25(OH)D≥75 nmol/L]、25(OH)D不足[50 nmol/L≤25(OH)D＜75 nmol/L]、25(OH)D缺乏[25(OH)D＜50 nmol/L]的检出率。结果体检者血清25(OH)D的平均水平为59.7 nmol/L，整体25(OH)D充足率为22.5%，不足率为38.6%，缺乏率为38.9%；女性体内血清25(OH)D中位数浓度低于男性；血清25(OH)D浓度在5年间呈季节性变化，差异有统计学意义(P＜0.05)。冬春季节人群体内25(OH)D中位数浓度比夏秋季节低；超过60岁人群体内平均25(OH)D的浓度、充足率均高于其他2个年龄段。结论体检人群血清25(OH)D浓度与季节变化、性别、年龄等因素有关。应根据不同季节和年龄段补充维生素D，预防骨质疏松、病理性骨折等疾病的发生。
- 体检人群 /
- 25-羟维生素D /
- 季节变化 /
- 日照时数
Abstract: Objective To study the relationship between serum 25-hydroxyvitamin D [25(OH)D] concentration and season, gender and age using data from the physical examination centre of the First Affiliated Hospital of Anhui Medical University, and to provide a reference for rational clinical vitamin D supplementation. Methods Data of 4 311 subjects (> 20 years old) who underwent physical examination from April 2017 to June 2022 (The data of April, May, June 2020 were missing) were selected. Spearman ' s rank correlation coefficient was used to analyze the correlation between monthly average serum 25(OH)D concentration and monthly average temperature, sunshine duration and UV intensity. The detection rates of 25(OH)D sufficiency [25(OH)D ≥75 nmol/L], 25(OH)D insufficiency [50 nmol/L ≤ 25(OH)D < 75 nmol/L] and 25(OH)D deficiency [25(OH)D < 50 nmol/L] were calculated. Results The mean serum 25(OH)D level was 59.7 nmol/L and the overall 25(OH)D sufficiency rate was 22.5%, insufficiency rate was 38.6% and deficiency rate was 38.9%. The median serum 25(OH)D concentration in women was lower than that in men. The serum 25(OH)D concentration showed a seasonal variation over the 5-year period and the difference was statistically significant (P < 0.05). Median 25(OH)D concentrations were lower in winter and spring than that in summer and autumn; mean 25(OH)D concentrations and sufficiency rates were higher in people over 60 years of age than in the other two age groups. Conclusions Serum 25(OH)D concentrations in the physical examination population are statistically significant in relation to seasonal changes, gender and age. Vitamin D should be supplemented according to different seasons and age groups to prevent osteoporosis, pathological fractures and other diseases.
- Medical examination population /
- 25-hydroxyvitamin D /
- Seasonal changes /
- Sunshine duration

HTML全文

表 1 不同性别体检人群血清维生素D浓度及含量比较

Table 1. Comparison of serum vitamin D concentrations and content in different sex physical examination population

性别	例数	25(OH)D [M(P₂₅, P₇₅)，nmol/L]	25(OH)D含量[例(%)]
性别	例数	25(OH)D [M(P₂₅, P₇₅)，nmol/L]	充足	不足	缺乏
男性	2 997	59.3(45.2, 75.8)	780(26.1)	1 209(40.3)	1 008(33.6)
女性	1 314	49.6(38.4, 64.9)	190(14.5)	455(34.6)	669(50.9)
统计量		-12.041^a	132.154^b
P值		＜0.001	＜0.001
注：^a为Z值，^b为χ²值。

下载: 导出CSV

表 2 不同年龄组体检人群血清维生素D浓度及含量比较

Table 2. Comparison of serum vitamin D concentrations and content in different age groups

年龄	例数	25(OH)D [M(P₂₅, P₇₅)，nmol/L]	25(OH)D含量[例(%)]
年龄	例数	25(OH)D [M(P₂₅, P₇₅)，nmol/L]	充足	不足	缺乏
21~40岁	1 321	52.7(40.4, 70.7)	263(19.9)	476(36.0)	582(44.1)
41~60岁	2 410	56.6(43.1, 72.1)^a	512(21.2)	971(40.3)	927(38.5)
＞60岁	580	63.7(46.8, 80.5)^ab	195(33.6)	217(37.4)	168(29.0)
统计量		56.194^c	65.623^d
P值		＜0.001	＜0.001
注：与21~40岁年龄组比较，^aP＜0.05;与41~60岁年龄组比较，^bP<0.05。^c为H值，^d为χ²值。

下载: 导出CSV

表 3 各年龄组体检人群不同性别血清维生素D含量比较[例(%)]

Table 3. Comparison of serum vitamin D content in different sexes among all age groups[cases(%)]

组别	例数	VitD充足	VitD不足	VitD缺乏	χ²值	P值
21~40岁					87.664	＜0.001
男性	867	214(24.7)	349(40.2)	304(35.1)
女性	454	49(10.8)	127(28.0)	278(61.2)
41~60岁					45.471	＜0.001
男性	1 758	421(23.9)	724(41.2)	613(34.9)
女性	652	91(14.0)	247(37.9)	314(48.1)
>60岁					16.321	＜0.001
男性	372	145(39.0)	136(36.5)	91(24.5)
女性	208	50(24.0)	81(39.0)	77(37.0)

下载: 导出CSV

表 4 不同季节体检人群血清维生素D浓度及含量比较

Table 4. Comparison of serum vitamin D concentration and content in different seasons

季节	例数	25(OH)D [M(P₂₅, P₇₅)，nmol/L]	25(OH)D含量[例(%)]
季节	例数	25(OH)D [M(P₂₅, P₇₅)，nmol/L]	充足	不足	缺乏
春季	1 042	50.1(38.4, 64.9)	121(11.6)	400(38.4)	521(50.0)
夏季	1 030	70.0(53.4, 87.4)^a	443(43.0)	365(35.4)	222(21.6)
秋季	1 821	55.5(44.3, 70.2)^ab	349(19.2)	779(42.8)	693(38.0)
冬季	418	46.5(34.6, 61.5)^abc	57(13.6)	120(28.7)	241(57.7)
统计量		431.850^d	443.375^e
P值		＜0.001	＜0.001
注：与春季比较, ^aP<0.05;与夏季比较, ^bP<0.05;与秋季比较，^cP<0.05。^d为H值，^e为χ²值。

下载: 导出CSV

参考文献(23)

[1]	LEI M, LIU Z, GUO J. The emerging role of vitamin D and vitamin D receptor in diabetic nephropathy[J]. Biomed Res Int, 2020, 2020: 4137268. DOI: 10.1155/2020/4137268.
[2]	LOPEZ A, KERLAN V, DESAILLOUD R. Non-classical effects of vitamin D: non-bone effects of vitamin D[J]. Ann Endocrinol-paris, 2021, 82(1): 43-51. doi: 10.1016/j.ando.2020.12.002
[3]	MEDRANO M, CARRILLO-CRUZ E, MONTERO I, et al. Vitamin D: effect on haematopoiesis and immune system and clinical applications[J]. Int J Mol Sci, 2018, 19(9): 2663-2687. doi: 10.3390/ijms19092663
[4]	JONES G. Historical aspects of vitamin D[J]. Endocr Connect, 2022, 11(4): e210594. DOI: 10.1530/EC-21-0594.
[5]	ILLESCAS-MONTES R, MELGUIZO-RODRÍGUEZ L, RUIZ C, et al. Vitamin D and autoimmune diseases[J]. Life Sci, 2019, 233: 116744. DOI: 10.1016/j.lfs.2019.116744.
[6]	LIN L, ZHANG L, LI C, et al. Vitamin D and vitamin D receptor: new insights in the treatment of hypertension[J]. Curr Protein Pept Sci, 2019, 20(10): 984-995. doi: 10.2174/1389203720666190807130504
[7]	MENEZES- J U ' NIOR L A A D, SABIÀO T D S, MOURA S S D, et al. Influence of sunlight on the association between 25-hydroxyvitamin D levels and sleep quality in Brazilian adults: a population-based study[J]. Nutrition, 2023, 110: 112008. DOI: 10.1016/j.nut.2023.112008
[8]	LV L, TAN X, PENG X, et al. The relationships of vitamin D, vitamin D receptor gene polymorphisms, and vitamin D supplementation with Parkinson ' s disease[J]. Transl Neurodegener, 2020, 9(3): 13.
[9]	SREEDHAR S, RHODES J M, TAYLOR J M, et al. Vitamin D, D-binding protein, free vitamin D and COVID-19 mortality in hospitalized patients[J]. Am J Clin Nutr, 2022, 115(5): 1367-1377. doi: 10.1093/ajcn/nqac027
[10]	MONTENEGRO K R, CRUZAT V, CARLESSI R, et al. Mechanisms of vitamin D action in skeletal muscle[J]. Nutr Res Rev, 2019, 32(2): 192-204. doi: 10.1017/S0954422419000064
[11]	ASHCROFT S P, FLETCHER G, PHILP A M, et al. Diet-induced vitamin D deficiency reduces skeletal muscle mitochondrial respiration[J]. J Endocrinol, 2021, 249(2): 113-124. doi: 10.1530/JOE-20-0233
[12]	ZHAO J, WANG H, ZHANG Z, et al. Vitamin D deficiency as a risk factor for thyroid cancer: a meta-analysis of case-control studies[J]. Nutrition, 2019, 57: 5-11. doi: 10.1016/j.nut.2018.04.015
[13]	APOSTOLAKIS M, ARMENI E, BAKAS P. Vitamin D and cardiovascular disease[J]. Maturitas, 2018, 115: 1-22. doi: 10.1016/j.maturitas.2018.05.010
[14]	LINCOLN M R, SCHNEIDER R, OH J. Vitamin D as disease-modifying therapy for multiple sclerosis?[J]. Expert Rev Clin Immu, 2021, 17(7): 691-693. doi: 10.1080/1744666X.2021.1915772
[15]	MANOUSAKI D, HARROUD A, MITCHELL R E, et al. Vitamin D levels and risk of type 1 diabetes: a Mendelian randomization study[J]. PLos Med, 2021, 18(2): e1003536. DOI: 10.1371/journal.pmed.1003536.
[16]	LI H, MA J, HUANG R, et al. Prevalence of vitamin D deficiency in the pregnant women: an observational study in Shanghai, China[J]. Arch Public Health, 2020. DOI: 10.1186/s13690-020-00414-1.
[17]	WANG L, HUNG K, LIN Y, et al. Age, gender and season are good predictors of Vitamin D status independent of body mass index in office workers in a subtropical region[J]. Nutrients, 2020, 12(9): 2719. doi: 10.3390/nu12092719
[18]	MENA-BRAVO A, CALDERÓN-SANTIAGO M, LOPE V, et al. Vitamin D₃ levels in women and factors contributing to explain metabolic variations[J]. J Steroid Biochem Mol Biol, 2021, 211: 105884. DOI: 10.1016/j.jsbmb.2021.105884.
[19]	GARRAHAN M, GEHMAN S, RUDOLPH S E, et al. Serum 25-Hydroxyvitamin D is associated with bone microarchitecture and strength in a multiracial cohort of young adults[J]. J Clin Endocrinol Metab, 2022, 107(9): 3679-3688. doi: 10.1210/clinem/dgac388
[20]	张明, 邱蕾, 贺玉霜, 等. 潍坊地区5 132例6岁以下儿童维生素D水平调查及相关危险因素分析[J]. 中华全科医学, 2020, 18(5): 779-782. doi: 10.16766/j.cnki.issn.1674-4152.001355 ZHANG M, QIU L, HE Y S, et al. Investigation of vitamin D levels and analysis of related risk factors in 5132 children under 6 years old in Weifang area[J]. Chinese Journal of General Practice, 2020, 18(5): 779-782. doi: 10.16766/j.cnki.issn.1674-4152.001355
[21]	MAATAOUI1 A E, OUZZIF Z. Vitamin D status in the North African population: a review[J]. Clin Rev Bone Miner Metab, 2018, 16: 67-73. doi: 10.1007/s12018-018-9247-y
[22]	PEREIRA-SANTOS M, SANTOS J Y G, CARVALHO G Q, et al. Epidemiology of vitamin D insufficiency and deficiency in a population in a sunny country: geospatial meta-analysis in Brazil[J]. Crit Rev Food Sci Nutr, 2019, 59(13): 2102-2109. doi: 10.1080/10408398.2018.1437711
[23]	赵滢, 苏艳丹, 唐睿珠, 等. 昆明地区2 563例人群维生素D营养的状况[J]. 昆明医科大学学报, 2022, 43(4): 19-25. https://www.cnki.com.cn/Article/CJFDTOTAL-KMYX202204004.htm ZHAO Y, SU Y D, TANG R Z, et al. Vitamin D Status of 2563 Subjects in Kunming[J]. Journal of Kunming Medical University, 2022, 43(4): 19-25. https://www.cnki.com.cn/Article/CJFDTOTAL-KMYX202204004.htm