Prevalence of vitamin D deficiency during autumn and winter among adults in Henan province
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摘要:
目的 了解河南省成年人维生素D缺乏(VDD)情况,为减少VDD带来的健康损害提供参考。 方法 于2018年10月— 2019年2月,采用多阶段整群随机抽样方法选择8 455名调查对象,对抽取的调查对象检测血清25羟基维生素D,应用复杂抽样加权调整方法,对河南省成年人秋冬季VDD患病率(PVDD)进行估算。 结果 估算的河南省成年居民PVDD为24.2 %(95 % CI = 19.5 %~29.6 %),男性PVDD为16.0 %,低于女性的32.0 %;在各年龄组中,18~39岁年龄组PVDD最高,为29.6 %;单身人群PVDD为37.2 %,高于非单身人群的22.2 %,差异均有统计学意义(均P<0.05)。多因素对数二项分布回归分析结果显示,河南省成人VDD与性别、婚姻状态、职业、文化程度、检查季节有关,以男性为参照,女性校正现患比(APR)及其95 % CI为2.04(1.56 ~ 2.68);以非单身为参照,单身人群APR(95 % CI)为1.29(1.01 ~ 1.64);以农林牧渔水业为参照,农林牧渔水业以外行业、无工作/家务、退休的人群APR(95 % CI)分别为1.81(1.27~2.58)、1.56(1.05~2.30)、1.76(1.22~2.54);以小学及以下文化程度为参照,初中、高中/中专/技校、大专及以上人群APR(95 % CI)分别为1.33(0.99~1.80)、1.44(1.03~2.03)、1.78(1.32~2.40);以秋季为参照,冬季APR(95 % CI)为1.44(1.14~1.82)。 结论 河南省成年人秋冬季PVDD较高;女性、单身、较高文化程度、农林牧渔水业以外行业、冬季增加了VDD患病风险。 Abstract:Objective To examine the status of vitamin D deficiency (VDD) during the autumn and winter among adults in Henan province and to provide references for reducing adverse health effect of VDD. Methods Using multistage cluster random sampling, we conducted a survey among 8 455 urban and rural residents aged 18 years and above in 14 districts/counties of Henan province from October 2018 through February 2019. The participants′ serum 25(OH)D2 and 25(OH)D3 were determined with high-performance liquid chromatography-tandem mass spectrometry. Complex sampling weighting adjustment was adopted to estimate the prevalence of VDD (PVDD) among the participants. Results The estimated PVDD for all participants was 24.2% (95% confidence interval [95% CI]: 19.5% – 29.6%); the PVDD for the males was significantly lower than that for the females (16.0% vs. 32.0%, P < 0.05); the age-specific PVDD was highest (29.6%) for the participants aged 18 – 39 years; and the unmarried participants had significantly higher PVDD compared to those married (37.2% vs. 22.2%, P < 0.05). Multivariate log binomial regression analysis showed that in comparison with control groups, the adjusted prevalence ratio (APR) of VDD was significantly higher in following subgroups: females (vs. males: 2.04, 95% CI: 1.56 – 2.68), the unmarried (vs. the married: 1.29, 95% CI: 1.01 – 1.64), being employed in industries other than agriculture/forestry/animal husbandry/fishery/aquaculture (vs. being employed in the industries listed above or the unemployed: 1.81, 95% CI: 1.27 – 2.58; vs. the employed/housekeepers: 1.56, 95% CI: 1.05 – 2.30; vs. retirees: 1.76, 95% CI: 1.22 – 2.54), with higher education attainment (vs. primary school and below: 1.33 [95% CI: 0.99 – 1.80] for those with junior high school attainment, 1.44 [95% CI: 1.03 – 2.03] for senior high /technical secondary / technical school, and 1.78 [95% CI: 1.32 – 2.40] for college and above), being surveyed in winter season (vs. in autumn season: 1.44, 95% CI: 1.14 – 1.82 ). Conclusion The prevalence of vitamin D deficiency is high during the autumn and winter season among adults in Henan province and the prevalence was mainly influenced by gender, marital status, education attainment, occupation, and season. -
Key words:
- vitamin D /
- deficiency /
- prevalence /
- adults
1) (王国杰为本文并列第一作者) -
表 1 河南省不同人口学特征成年人维生素D缺乏患病率
特征 调查人数 患病人数 患病率(%) a 95 % CI χ2 值 校正F 值 P 值 性别 男性 3652 531 16.0 11.9~21.2 294.62 41.19 < 0.001 女性 4803 1417 32.0 25.7~38.9 年龄(岁) 18~39 1292 427 29.6 22.5~37.8 113.64 6.64 0.005 40~64 4867 1053 20.0 15.7~25.3 65~104 2296 468 18.2 10.8~29.1 民族 其他民族 113 36 36.9 26.8~48.4 6.59 7.32 0.014 汉族 8342 1912 24.1 19.4~29.5 婚姻状态 非单身 7813 1770 22.2 17.8~27.2 112.04 12.71 0.002 单身 642 178 37.2 27.8~47.7 职业 农林牧渔水业 2580 318 15.5 10.0~23.4 306.73 9.95 < 0.001 农林牧渔水以外行业 2122 643 34.7 27.3~42.9 无工作/家务 2641 629 26.2 22.4~30.3 退休 1112 358 31.3 17.8~48.8 文化程度 小学及以下 3238 557 16.2 10.9~23.3 252.11 10.59 < 0.001 初中 3131 712 23.9 19.2~29.3 高中/中专/技校 1496 423 27.4 22.2~33.3 大专及以上 590 256 42.3 29.0~56.9 居住社区类型 城镇 4634 1369 31.8 23.1~42.1 175.93 7.51 0.013 农村 3821 579 19.2 15.3~23.7 检查季节 秋季(10 — 11月) 3704 686 20.1 14.2~27.8 54.08 2.51 0.129 冬季(12月 — 次年2月) 4751 1262 27.1 21.2~33.9 合计 8455 1948 24.2 19.5~29.6 注:a患病率采用加权调整方法估算。 表 2 河南省成年居民人口学特征与维生素D缺乏关联性多因素分析
人口学特征 参照组 PR 95 % CI $S_{\bar x}$ t 值 P 值 性别 女性 男性 2.04 1.56~2.68 0.265 5.50 < 0.001 年龄(岁) 40~64 18~39 0.96 0.68~1.35 0.159 – 0.26 0.799 65~104 18~39 0.88 0.56~1.38 0.190 – 0.58 0.566 民族 汉族 其他民族 0.77 0.54~1.10 0.133 – 1.51 0.146 婚姻状态 单身 非单身 1.29 1.01~1.64 0.149 2.17 0.042 职业 农林牧渔水以外行业 农林牧渔水业 1.81 1.27~2.58 0.308 3.49 0.002 无工作/家务 农林牧渔水业 1.56 1.05~2.30 0.291 2.37 0.028 退休 农林牧渔水业 1.76 1.22~2.54 0.311 3.19 0.005 文化程度 初中 小学及以下 1.33 0.99~1.80 0.192 2.00 0.059 高中/中专/技校 小学及以下 1.44 1.03~2.03 0.235 2.25 0.036 大专及以上 小学及以下 1.78 1.32~2.40 0.255 4.01 0.001 居住社区类型 农村 城镇 0.82 0.63~1.06 0.103 – 1.6 0.125 调查季节 冬季(12月 — 次年2月) 秋季(10 — 11月) 1.44 1.14~1.82 0.162 3.22 0.004 常数项 0.10 0.04~0.24 0.043 – 5.28 < 0.001 -
[1] 赵洺良, 王明刚, 刘振玉, 等. 维生素D类药物及其类似物的研发进展[J]. 中国骨质疏松杂志, 2021, 27(6): 914 – 921. doi: 10.3969/j.issn.1006-7108.2021.06.026 [2] 何雪冬, 王芳, 廖顺琪, 等. 中国成人血清25羟维生素D水平与骨密度相关性的Meta分析[J]. 中国骨质疏松杂志, 2021, 27(6): 808 – 812. doi: 10.3969/j.issn.1006-7108.2021.06.006 [3] Roth DE, Abrams SA, Aloia J, et al. Global prevalence and disease burden of vitamin D deficiency: a roadmap for action in low - and middle - income countries[J]. Annals of the New York Academy of Sciences, 2018, 1430(1): 44 – 79. doi: 10.1111/nyas.13968 [4] 李红霞, 魏锦秀, 谢晓敏. 不同糖耐量人群血浆25羟维生素D水平比较[J]. 中国糖尿病杂志, 2021, 29(5): 362 – 366. doi: 10.3969/j.issn.1006-6187.2021.05.008 [5] 罗梦莹, 邹德玲. 维生素D对冠心病的发生及病变程度的影响[J]. 临床心血管病杂志, 2021, 37(6): 537 – 541. [6] 宋琼, 胡柳, 万政策, 等. 成年体检人群血清25羟维生素D与高血压的相关性研究[J]. 华中科技大学学报(医学版), 2021, 50(2): 185 – 188, 224. [7] 康美尼, 许士光. 维生素D缺乏与骨骼外健康的研究进展[J]. 医学综述, 2020, 26(17): 3354 – 3358. doi: 10.3969/j.issn.1006-2084.2020.17.006 [8] 江巍, 高凤荣. 维生素D缺乏相关性疾病研究进展[J]. 中国骨质疏松杂志, 2014, 20(3): 331 – 337. doi: 10.3969/j.issn.1006-7108.2014.03.026 [9] 夏诗幻, 于微, 江松, 等. 维生素D改善2型糖尿病相关机制研究进展[J]. 中国公共卫生, 2016, 32(9): 1267 – 1270. doi: 10.11847/zgggws2016-32-09-36 [10] 栾德春, 高倩, 崔玉丰, 等. 富含维生素D食物及户外活动与认知功能关系[J]. 中国公共卫生, 2020, 36(1): 78 – 81. doi: 10.11847/zgggws1124922 [11] Palacios C, Gonzalez L. Is vitamin D deficiency a major global public health problem?[J]. The Journal of Steroid Biochemistry and Molecular Biology, 2014, 144: 138 – 145. doi: 10.1016/j.jsbmb.2013.11.003 [12] Holick MF, Binkley NC, Bischoff-Ferrari HA, et al. Evaluation, treatment, and prevention of vitamin D deficiency: an endocrine society clinical practice guideline[J]. The Journal of Clinical Endocrinology and Metabolism, 2011, 96(7): 1911 – 1930. doi: 10.1210/jc.2011-0385 [13] Matyjaszek-Matuszek B, Lenart-Lipińska M, Woźniakowska E. Clinical implications of vitamin D deficiency[J]. Przegląd Menopauzalny, 2015, 14(2): 75 – 81. doi: 10.5114/pm.2015.52149 [14] 廖祥鹏, 张增利, 张红红, 等. 维生素D与成年人骨骼健康应用指南(2014年标准版)[J]. 中国骨质疏松杂志, 2014, 20(9): 1011 – 1030. doi: 10.3969/j.issn.1006-7108.2014.09.002 [15] 叶荣, 郜艳晖, 杨翌, 等. log - binomial模型估计的患病比及其应用[J]. 中华流行病学杂志, 2010, 31(5): 576 – 578. doi: 10.3760/cma.j.issn.0254-6450.2010.05.024 [16] Williamson T, Eliasziw M, Fick GH. Log - binomial models: explor-ing failed convergence[J]. Emerging Themes in Epidemiology, 2013, 10: 14. doi: 10.1186/1742-7622-10-14 [17] 田美娜, 陈磊, 宋立江, 等. 河北省部分城乡居民维生素D营养状况分析[J]. 河北医药, 2016, 38(4): 606 – 608. [18] Parva NR, Tadepalli S, Singh P, et al. Prevalence of vitamin D deficiency and associated risk factors in the US population (2011-2012)[J]. Cureus, 2018, 10(6): e2741. [19] 张巧, 彭年春, 徐淑静, 等. 贵阳城区成人维生素D营养状况调查[J]. 中华内分泌代谢杂志, 2011, 27(8): 659 – 663. doi: 10.3760/cma.j.issn.1000-6699.2011.08.012 [20] 赵振平, 王丽敏, 李镒冲, 等. 2013年中国慢性病及其危险因素监测系统省级代表性评价[J]. 中华预防医学杂志, 2018, 52(2): 165 – 169. doi: 10.3760/cma.j.issn.0253-9624.2018.02.009 [21] 谢荣, 陆娣, 倪君君. 血清维生素D检测方法研究进展[J]. 检验医学与临床, 2019, 16(6): 849 – 853. doi: 10.3969/j.issn.1672-9455.2019.06.040 [22] 童小平. 25-羟基维生素D检测方法综述[J]. 预防医学, 2018, 30(3): 278 – 280,283. [23] Almetwazi MS, Noor AO, Almasri DM, et al. The association of vitamin D deficiency and glucose control among diabetic patients[J]. Saudi Pharmaceutical Journal, 2017, 25(8): 1179 – 1183. doi: 10.1016/j.jsps.2017.09.001
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