维生素D缺乏在全球不同人群和地区普遍存在,已成为全球性的健康问题。迄今为止,尚未评估中国西南云南省人群的维生素D状况。因此,在这项研究中,根据云南省个体血清25-羟维生素D(25(OH)D)浓度,低纬度,中国的高海拔多种族地区。从2012年10月至2017年12月的25(OH)D浓度数据进行回顾性收集,并使用实验室信息系统从52950名医院参与者(年龄,1天-96岁;女性,73.74%)。使用化学发光免疫测定法评估25(OH)D的血清浓度。分析按性别分层,年龄,采样季节,测试年,少数,住宅区,纬度,海拔和气象因素。维生素D状态分类如下:严重缺乏:<10ng/mL;缺乏:<20ng/mL;不足:<30ng/mL;充足性:≥30ng/mL。结果显示,在以医院为基础的队列中,维生素D缺乏症在云南省非常普遍,缺乏和严重缺乏率为65.1%,充足率为5.30%。女性的维生素D水平和充足率明显低于男性(20.13±7.22ng/mLvs.17.56±6.66ng/mL和8.20%vs.4.20%;p<0.01);在春季和冬季(16.93±6.24ng/mL;2.97%和16.38±6.43ng/mL;3.06%,分别)比夏季和秋季(20.23±7.14ng/mL;8.02%和19.10±6.97ng/mL;6.61%[p<0.01],分别);在老年人中(0-6岁:28.29±13.13ng/mL与>60岁:14.88±8.39ng/mL;p<0.01)。在彝族个体中观察到相对较高的维生素D水平,庄,哈尼,戴,苗族和the族,回族和藏族的个体水平低于汉族(p<0.01)。平均日照持续时间,平均气温,最大紫外线值和纬度与维生素D水平显着相关(r分别为-0.53、0.60、0.31、-0.68;p<0.05)。这些结果表明,维生素D的状态受性别的影响,年龄,少数,高海拔和低海拔地区的纬度和一些气象因素。因此,新的公共卫生政策,例如关于阳光照射的建议,食品强化和营养教育,以及实施维生素D补充计划必须考虑缓解云南省维生素D缺乏,中国西南地区。
Vitamin D deficiency is widespread in different populations and regions worldwide and has become a global health issue. The vitamin D status of the population in the Yunnan Province of Southwest
China has not been evaluated to date. Therefore, in this study, we evaluated the vitamin D status according to the serum concentrations of 25-hydroxyvitamin D (25(OH)D) in individuals of Yunnan Province, a low-
latitude, high-altitude and multiracial region in
China. The data on 25(OH)D concentrations from October 2012 to December 2017 were retrospectively collected and assessed using the laboratory information system from 52 950 hospital-based participants (age, 1 day-96 years; females, 73.74%). The serum concentration of 25(OH)D was evaluated using a chemiluminescent immunoassay. The analysis was stratified by sex, age, sampling season, testing year, minority, residential district,
latitude, altitude and meteorological factors. Vitamin D status was classified as follows: severe deficiency: <10 ng/mL; deficiency: <20 ng/mL; insufficiency: <30 ng/mL; and sufficiency: ≥30 ng/mL. The results showed that vitamin D deficiency is highly prevalent in Yunnan Province in a hospital-based cohort, with a deficiency and severe deficiency rate of 65.1% and a sufficiency rate of 5.30%. Significantly lower vitamin D levels and sufficiency rates were observed in females than in males (20.13 ± 7.22 ng/mL vs. 17.56 ± 6.66 ng/mL and 8.20% vs. 4.20%; p < 0.01, respectively); in spring and winter (16.93 ± 6.24 ng/mL; 2.97% and 16.38 ± 6.43 ng/mL; 3.06%, respectively) than in summer and autumn (20.23 ± 7.14 ng/mL; 8.02% and 19.10 ± 6.97 ng/mL; 6.61% [p < 0.01], respectively); and in older individuals (0-6 years: 28.29 ± 13.13 ng/mL vs. >60 years: 14.88 ± 8.39 ng/mL; p < 0.01). Relatively higher vitamin D levels were observed in individuals of Yi, Zhuang, Hani, Dai, Miao and Lisu minorities and lower levels in individuals of Hui and Zang minorities compared with those of the Han nationality (p < 0.01). The mean sunlight duration, mean air temperature, maximum ultraviolet value and latitude were significantly correlated with vitamin D levels (r = -0.53, 0.60, 0.31, -0.68, respectively; p < 0.05). These results suggest that vitamin D status is influenced by sex, age, minority, latitude and some meteorological factors in areas with high and low altitudes. Hence, new public health policies, such as advice on sunshine exposure, food fortification and nutrition education, as well as the implementation of vitamin D supplementation programmes must be considered to alleviate vitamin D deficiency in Yunnan province, Southwest
China.