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目的调查广州地区青年男性维生素D、PTH状态及其与区域骨密度之间的关系。方法随机选取2011年5月-2012年8月在广州军区广州总医院门诊部体检的60名广州青年男性志愿受试者,年龄18～44岁。评估血清25(OH)D、PTH水平,并分析血清25(OH)D、PTH与骨转换指标和区域骨密度(BMD)的相关性。结果 46.7%的青年男性血清25(OH)D水平>30 ng/mL,53.3%低于30 ng/mL,5%低于20 ng/mL。血清25(OH)D水平与年龄分布无统计学差异(P>0.05)。双变量分析显示血清25(OH)D水平与PTH负相关(r=-0.264,P=0.042),与β-Crosslaps负相关(r=-0.257,P=0.047)。血清25(OH)D水平、PTH与L1-4以及单个腰椎L1、L2、L3、L4的BMD无相关性。股骨大转子BMD与血清25(OH)D正相关(r=0.271,P=0.040),校正年龄、BMI和骨生化指标后,正相关性更加明显(r=0.319,P=0.020)。多元线性回归分析显示BMI、ALP与全腰、L1、L3、L4椎BMD相关,BMI、PINP与L2椎BMD相关,BMI、25(OH)D与全髋、大转子BMD相关。结论青年男性广泛存在血清25(OH)D不足状态,血清25(OH)D水平与股骨大转子BMD明显正相关,适当补充维生素D和钙剂,对维持大转子区域的骨量至关重要。
Objective To investigate the status of vitamin D and PTH in young males in Guangzhou and their relationship with regional bone mineral density. Methods A total of 60 young male volunteers from Guangzhou, Guangzhou, from May 2011 to August 2012 in the outpatient department of Guangzhou General Hospital of Guangzhou Military Region were randomly selected and aged 18-44 years. Serum 25 (OH) D, PTH levels were assessed and the association of serum 25 (OH) D, PTH with bone turnover index and regional bone mineral density (BMD) was analyzed. Results Serum levels of 25 (OH) D in 46.7% of young men were> 30 ng / mL, with 53.3% below 30 ng / mL and 5% below 20 ng / mL. Serum 25 (OH) D levels and age distribution was not statistically different (P> 0.05). Bivariate analysis showed a negative correlation between serum 25 (OH) D level and PTH (r = -0.264, P = 0.042) and a negative correlation with β-Crosslaps (r = -0.257, P = 0.047). There was no correlation between serum 25 (OH) D level, PTH and L1-4 and BMD of L1, L2, L3, L4 in single lumbar vertebra. BMD of femoral greater trochanter was positively correlated with serum 25 (OH) D (r = 0.271, P = 0.040). Correlation of age, BMI and bone biochemical parameters was more significant (r = 0.319, P = 0.020). Multivariate linear regression analysis showed that BMI and ALP were related to total BMD, L1, L3 and L4 vertebral BMD. BMI and PINP were correlated with L2 BMD. BMI and 25 (OH) D were correlated with total hip and greater trochanter BMD. Conclusions The serum 25 (OH) D deficiency exists widely in young males. Serum 25 (OH) D levels are positively correlated with BMD of femoral gyrus. Adequate vitamin D and calcium supplementation are crucial for maintaining the amount of bone in the greater trochanter.