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D-vítamínhagur og árstíðabundnar sveiflur í ýmsum aldurshópum kvenna á Íslandi

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Authors
Gunnar Sigurðsson
Leifur Franzson
Hólmfríður Þorgeirsdóttir,
Laufey Steingrímsdóttir
Issue Date
1999-05-01

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Other Titles
Vitamin D intake and serum 25-OH-vitamin D concentration in different age groups of Icelandic women
Citation
Læknablaðið 1999, 85(5):398-405
Abstract
Objective: The aim of this study was to evaluate the vitamin D intake and serum concentrations of 25-OH-vitamin D (25-OH-D) in different age groups of Icelandic women. The seasonal variation of 25-OH-D and its relationship with parathyroid hormone (PTH) level was evaluated but some studies have indicated that subclinical vitamin D deficiency may lead to osteoporosis because of secondary elevations of parathyroid hormone levels and subsequent bone mineral release. Material and methods: 25-OH-D was measured (RIA, Incstar) in serum from the following age groups of women; 12-15 years (n=325), 16, 18 and 20 years (n=247), 25 years (n=86), 34-48 years (n=107) and in 70 years old (n=308). PTH (IRMA, Nichols) was measured only in the 70 years old. vitamin D intake was assessed by a standardized food frequency questionnaire. The seasonal variation of 25-OH-D was evaluated in the age group 12-15 years and 70 years old. Results: In the different age groups the 25-OH-D concentration was positively correlated to vitamin D intake (r=0.2-0.54; p<0.05). The mean concentration of 25-OH-D in 12-15 years old was 34.6±22 nmol/L compared to 53.9120 nmol/L in the 70 years old, p<0.01. The levels of the other age groups were in between. A marked seasonal variation in 25-OH-D was obser¬ved in the 12-15 years old with low vitamin D intake whereas only a slight seasonal variation was noted in the 70 years old with a mean vitamin D intake of 15 ug/day. Conclusions: The vitamin D status amongst 70 years old women in Iceland is good because of common intake of codliveroil and vitamin D supplements (83%). The desirable level for 25-OH-D in this age group seems to be around 50 nmol/L and this level is achieved by the intake of 15-20 ug/day (600-800 units) of vitamin D. Vitamin D deficiency is however common amongst 12-15 years old during late winter. Low serum 25-OH-D levels are also common amongst the other age groups studied during late winter. From the results it seems reasonable to recommend that foods like milk should be fortified with vitamin D in Iceland, especially during winter time.
Markmið: Markmið rannsóknarinnar var að meta neyslu D-vítamíns og bera saman við 25-OH-vitamin D þéttni í sermi (25-OH-D) í ýmsum hópum kvenna á aldursbilinu 12-70 ára. Ennfremur vildum við kanna tengsl 25-OH-D við magn kalkhormóns í sermi (parathyroid hormone, PTH), en ýmislegt bendir til að vægur skortur á D-vítamíni valdi beinbynningu, vegna lægri þéttni kalsíums í blóði sem leiði til aukinnar framleiðslu kalkhormóns og þar með til aukinnar losunar steinefna úr beinum. Efniviður og aðferðir: 25-OH-D var mælt í eftirfarandi hópum kvenna, sem valdir voru með slembiúrtökum: 12-15 ára stúlkum (n=325), 16, 18 og 20 ára stúlkum (n=247), 25 ára stúlkum (n=86), 34-48 ára konum (n=107) og 70 ára konum (n=308). Kalkhormón var eingöngu mælt í 70 ára konum. Ennfremur voru gerðar mataræðiskannanir í öllum hópum nema hjá 12-15 ára stúlkum þar sem stuðst var við fyrri könnun Manneldisráðs. Árstíðabundnar sveiflur á 25-OH-D voru kannaðar hjá 12-15 ára stúlkum og 70 ára konum með því að dreifa sýnatökunum í jafnstóra hópa á tímabilinu frá September 1997 til júní 1998. Niðurstöður: Þéttni 25-OH-D var í réttu hlutfalli við D-vítamíninntökuna (r=0,3-0,54). Meðalþéttni 25-OH-D (september-maí) var 34,6±22 nmól/L í 12-15 ára stúlkum, 43,9+20 hjá 16-20 ára stúlkum (febrúar-apríl), 50,1±24 hjá 25 ára stúlkum (nóvember-desember), en 36,6+16 hjá 34-48 ára konum (febrúar-apríl) og 53,9±20 nmól/L hjá 70 ára konum (september-júní). Marktækar árstíðabundnar sveiflur voru á 25-OH-D meðal 12-15 ára stúlkna en minni hjá 70 ára konum. í 12-15 ára hópnum náði 25-OH-D lágmarki í marsmánuði en í maímánuði í 70 ára konunum. Marktæk neikvæð fylgni fannst milli þéttni 25-OH-D og ln-PTH í 70 ára hórjnum (r=-0,2; p<0,01). Ályktanir: D-vítamínbúskapur 70 ára kvenna er almennt góður, en að sama skapi er honum ábótavant meðal 12-15 ára stúlkna, einkum síðla vetrar þegar lítil D-vítamínframleiðsla er í húð. Verulega lág gildi sáust nær eingöngu í hópi 12-15 ára stúlkna. D-vítamínbúskapur meðal eldri stúlkna og miðaldra kvenna virtist þama mitt á milli. Æskileg neðri mörk 25-OH-D fyrir 70 ára konur virðast vera um 50 nmól/L, en það svarar til inntöku að minnsta kosti 15-20 ug (600-800 eininga) af D-vítamíni á dag. Til að tryggja nægilega þéttni D-vítamíns í blóði síðla vetrar meðal allra aldurshópa virðist eðlilegt að D-vítamínbæta mjólkurafurðir að vetrarlagi.
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