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维生素D状态预测老年人的体能状况及其衰退情况
Vitamin D Status Predicts Physical Performance and Its Decline in Older Persons
Wicherts IS, van Schoor NM, Boeke AJP  2009/5/27 10:50:39 
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J Clin Endocrinol Metab, 2007,
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Abstract
Context:
Vitamin D deficiency is common among older people and can cause mineralization defects, bone loss, and muscle weakness.

Objective:
The aim of this study was to investigate the association of serum 25-hydroxyvitamin D (25-OHD) concentration with current physical performance and its decline over 3yr among elderly.

Design:
The study consisted of a cross-sectional and longitudinal design (3-yr follow-up) within the Longitudinal Aging Study Amsterdam.

Setting:
An age- and sex-stratified random sample of the Dutch older population was used.

Other Participants:
Subjects included 1234 men and women (aged 65yr and older) for cross-sectional analysis and 979 (79%) persons for longitudinal analysis.

Main Outcome Measure(s):
Physical performance (sum score of the walking test, chair stands, and tandem stand) and decline in physical performance were measured.

Results:
Serum 25-OHD was associated with physical performance after adjustment for age, gender, chronic diseases, degree of urbanization, body mass index, and alcohol consumption. Compared with individuals with serum 25-OHD levels above 30ng/ml, physical performance was poorer in participants with serum 25-OHD less than 10ng/ml [regression coefficient (B)=−1.69; 95% confidence interval (CI)=−2.28; −1.10], and with serum 25-OHD of 10–20ng/ml (B=−0.46; 95% CI=−0.90; −0.03). After adjustment for confounding variables, participants with 25-OHD less than 10ng/ml and 25-OHD between 10 and 20ng/ml had significantly higher odds ratios (OR) for 3-yr decline in physical performance (OR=2.21; 95% CI=1.00–4.87; and OR=2.01; 95% CI=1.06–3.81), compared with participants with 25-OHD of at least 30ng/ml. The results were consistent for each individual performance test.

Conclusions:
Serum 25-OHD concentrations below 20ng/ml are associated with poorer physical performance and a greater decline in physical performance in older men and women. Because almost 50% of the population had serum 25-OHD below 20ng/ml, public health strategies should be aimed at this group
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