李觅琼 邹映红 陈玉华 杨芳(上海市普陀区长风街道长风社区卫生服务中心 上海 200062)

长风社区骨量异常女性患者25羟维生素D水平及骨密度状况*

李觅琼 邹映红 陈玉华 杨芳
(上海市普陀区长风街道长风社区卫生服务中心 上海 200062)

摘 要目的：评价骨量异常女性患者血清25羟维生素D（25OHD）与骨密度的关系。方法：收集2013年9-12月首次就诊的长风社区骨量异常女性患者95例，应用双能X线吸收仪（DXA）测定腰椎L1-4和左、右股骨颈骨密度，同时测定血清25OHD水平，按血清25OHD含量分为严重缺乏、缺乏、不足和充足4组。另外按年龄分为50~59岁、60~69岁和≥70岁3组。结果：95例患者平均血清25OHD水平为（17.34±7.35）ng/ml，维生素D严重缺乏19例（20.0%），缺乏44例（46.3%），不足24例（25.3%），充足8例（8.4%），其中严重缺乏组的L1-L4骨密度为（0.831±0.062）g/ cm2，显著低于充足组的（0.902±0.084）g/cm2（P＜0.05）。60~69岁组的25OHD水平为（15.66±6.05）ng/ml，显著低于≥70岁组的（19.69±7.58）ng/ml（P＜0.05）。随着年龄的增长，3个不同年龄组的L1-L4、左股骨、右股骨的骨密度呈降低趋势，且组间差异有统计学意义（P＜0.05）。结论：骨量异常的女性患者存在严重的维生素D不足和缺乏状况，但维生素D状态与骨密度可能无直接关联，有必要进一步扩大样本量研究维生素D状态与骨质疏松及骨折风险的关系。

关键词骨质疏松 25羟维生素D 骨量异常 骨密度

*基金项目:上海市卫计委科研课题资助项目[沪卫科教(2013)018]

The level of serum 25-hydroxy vitamin D and bone mineral density status in the female patients with bone abnormality in Changfeng Community

LI Miqiong, ZOU Yinghong, CHEN Yuhua, YANG Fang
(Changfeng Community Health Service Center of Putuo District, Shanghai 200062, China)

ABSTRACTObjective: To evaluate the relationship of serum 25-hydroxy vitamin D (25OHD) with the bone mineral density (BMD) in the female patients with bone abnormality. Methods: Ninety-five female patients with BMD who firstly visited in Changfeng Community Health Service Center from Sept. to Nov. 2013 were collected. The Dual-energy X-ray absorptiometry (DXA) was used to detect BMD in lumbar spine1-4 and left and right femoral necks. Simultaneously, the level of serum 25OHD was measured and classified into 4 groups of severe deficiency, deficiency, insufficiency and sufficiency according to its level. In addition, the patients were divided into 3 groups of 50-59 years old, 60-69 years old and ≥70 years old by age. Results: The average level of serum 25OHD was(17.34±7.35)ng/ml, and the prevalence of vitamin D in the groups of severe deficiency, deficiency, insufficiency and sufficiency were 19 cases (20.0%), 44 ones (46.3%), 24 ones (25.3%), and 8 ones (8.4%), respectively. The BMD in lumbar spine1-4 was (0.831±0.062)g/cm2in the severe deficiency group which was significantly lower than (0.902±0.084) g/cm2in the sufficiency group( P＜0.05). The level of serum 25OHD was lower in the group aged from 60 to 69 years old than in the group aged ≥70 years old (15.66±6.05) ng/ml vs (19.69±7.58) ng/ml( P＜0.05). With the increase of age, there was a decreasing trend of the levels of BMD in lumbar spine1-4, and left and right femoral necks in the three different age-groups, and the differences among them had the statistical significance (P＞0.05). Conclusion: The female patients with bone abnormality have the severe deficiency and deficiency of vitamin D, but the level of vitamin D may have no direct relationship with BMD. It is necessary to further expand the sample size to study the relationship between the level of vitamin D and osteoporosis and fracture risk.

KEY WORDSosteoporosis; 25 hydroxyl vitamin D; bone abnormality; bone mineral density

维生素D是促进骨骼生长和发育的重要营养素，同时也是维护骨骼和肌肉系统正常功能的重要物质。研究表明维生素D缺乏可增加髋部骨折风险，补充维生素D可将髋部骨折发生率降低33%[1-2]。因此，维生素D的状态是防治骨质疏松症的基础环节，良好的维生素D状态对骨骼健康和长期接受抗骨质疏松治疗非常关键。……