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目的 通过测定668名北京地区老年男性血清25羟维生素D[25(OH)D]、甲状旁腺激素(parathyroid hormone,PTH)、骨钙素和骨密度水平,分析维生素D营养状况并评价其与相关因素的变化特征.方法 以668名于北京友谊医院就诊的北京地区老年男性为研究对象,检测其血清25(OH)D、PTH及骨钙素水平,并采用双能X线骨密度仪测定腰椎及髋部骨密度.将研究对象按照年龄、骨密度及25(OH)D水平分组进行统计分析.结果 受试者血清25(OH)D平均水平为(40.2±17.3)nmol/L, PTH平均水平为(45.2±15.5)ng/L.不同年龄组比较显示,≥90岁组25(OH)D水平(27.1±16.8)nmol/L均低于其他年龄组(P<0.05).不同骨密度组间比较,骨量正常、骨量低下及骨质疏松组受试者间血清25(OH)D水平逐渐减低,但差异无统计学意义(P>0.05).不同25(OH)D水平组间年龄、PTH水平比较差异均无统计学意义(P>0.05).维生素D严重缺乏组股骨颈骨密度(0.782±0.121)g/m2及缺乏组股骨颈骨密度(0.775±0.247)g/m2明显低于维生素D充足组(0.837±0.192)g/m2(P<0.05).骨钙素随25(OH)D水平增高呈下降趋势且差异有统计学意义(P<0.05).结论 北京市部分老年汉族男性25(OH)D水平普遍偏低,并与骨密度及骨钙素水平有一定关联.

Objective To evaluate the levels of serum 25 hydroxyvitamin D (25(OH)D), parathyroid hormone(PTH)and osteocalcin,as well as bone mineral density(BMD),in aged men in Beijing, and the relationship among these factors.Methods A total of 668 elderly male patients who were treated at the Beijing Friendship Hospital were evaluated, and their medical data were collected. The serum concentrations of 25(OH)D,PTH,and osteocalcin were measured.Additionally,bone mineral density at the lumbar spine1- 4(L1- 4) and left femoral neck were measured using dual-energy X-ray absorptiometry. Participants were divided into 4 groups by age,3 groups according to BMD,and 4 groups according to serum 25(OH)D levels. The relationship among these factors was investigated. Results The mean serum concentrations of 25(OH)D and PTH were (40.2 ± 17.3) nmol/L and (45.19 ± 15.54) ng/L, respectively. The serum 25(OH)D levels in the group aged≥90 years[(27.1±16.8)nmol/L]was significantly lower compared to that in the other groups. Among different BMD groups, serum 25(OH)D levels reduced gradually, but differences were not significant(P>0.05).Age and PTH levels were not significantly associated with 25(OH) D groups (P>0.05). However, BMD of the femoral neck in the groups with severe [(0.782±0.121)g/m2] and mild[(0.775±0.247)g/m2]vitamin D deficiency were significantly lower than that in the group with normal vitamin D levels [(0.837 ± 0.192) g/m2] (P<0.05). With the increase in vitamin D levels, osteocalcin levels decreased significantly(P<0.05).Conclusion Vitamin D deficiency is highly prevalent among aged men in Beijing and the 25(OH)D levels have some correlation with BMD and osteocalcin.