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目的 探讨社区老年人血清维生素D水平与肌肉衰减症、吞咽障碍等衰弱常见合并症的关系，并分析不同炎症水平的影响。方法 于2020年8—12月，在广东、江苏、内蒙古三地共招募894名65岁及以上社区老年人，通过问卷调查、身体测量、肌肉衰减症评估(握力、步速、体成分)、吞咽障碍评估及血液指标检测[维生素D、血清超敏C反应蛋白(high-sensitivity C-reactive protein, hsCRP)]等方式，采用多元Logistic回归模型等方法，分析维生素D与衰弱常见合并症的关联及炎症水平的交互作用。结果 共有884名老年人完成全部调查，调查人群肌肉衰减症发生率为14.48%,吞咽(疑似)障碍发生率为34.84%。吞咽(疑似)障碍组25-(OH)D2中位数为0.28 ng/mL,25-(OH)D3中位数为24.69 ng/mL,均显著低于非吞咽(疑似)障碍组(0.45 ng/mL,27.18 ng/mL,P<0.01)。25-(OH)D3与hsCRP对吞咽(疑似)障碍的影响存在显著相乘交互作用(P<0.05)。亚组分析显示，在hsCRP<3 mg/L的老年人群中，25-(OH)D3水平与吞咽(疑似)障碍呈显著负相关(OR=0.98,95%CI 0.96～0.99,P<0.05);在hsCRP>3 mg/L的人群中则无显著相关关系。结论 社区老年人血清维生素D水平与吞咽功能显著相关，且该关联受炎症状态影响：在低炎症水平人群中，血清维生素D水平与吞咽障碍风险呈负相关，而在高炎症水平人群中无显著关联。
Abstract：OBJECTIVE To investigate the association between serum vitamin D levels and common frailty-related comorbidities, including sarcopenia and dysphagia, in community-dwelling older people, and to analyze the influence of varying inflammatory conditions.METHODS From August to December 2020, 894 community-dwelling older people aged ≥65 years were recruited from Guangdong, Jiangsu, and Inner Mongolia. Data were collected through questionnaire surveys, physical measurements, sarcopenia assessment(grip strength, gait speed, body composition), dysphagia evaluation, and blood biomarker testing(vitamin D, high-sensitivity C-reactive protein(hsCRP)). Multivariate Logistic regression models were employed to examine the associations between vitamin D and frailty-related comorbidities, as well as the interaction effects of inflammatory levels.RESULTS A total of 884 older people completed the survey. The prevalence of sarcopenia was 14.48%, and the prevalence of dysphagia(including suspected dysphagia) was 34.84%. The median levels of 25-(OH)D2(0.28 ng/mL) and 25-(OH)D3(24.69 ng/mL) in the dysphagia group were significantly lower than those in the non-dysphagia group(0.45 ng/mL and 27.18 ng/mL, respectively; P<0.01). A significant interaction was observed between 25-(OH)D3 and hsCRP in relation to dysphagia(P<0.05). Subgroup analysis revealed that in older people with hsCRP<3 mg/L, 25-(OH)D3 levels were negatively associated with suspected dysphagia(OR=0.98, 95%CI 0.96-0.99, P<0.05), whereas no significant association was found in those with hsCRP>3 mg/L.CONCLUSION Serum vitamin D levels in community-dwelling elderly individuals were significantly associated with swallowing function, and this association was influenced by inflammatory status: in the population with low inflammatory levels, serum vitamin D levels were negatively associated with the risk of dysphagia, while there was no significant association in the population with high inflammatory levels.
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基本信息:
DOI：10.19813/j.cnki.weishengyanjiu.2025.06.006
中图分类号:R592
引用信息:
[1]李程,李裕倩,张婷,等.不同炎症水平下社区老年人血清维生素D水平与衰弱常见合并症关系[J].卫生研究,2025,54(06):915-922.DOI:10.19813/j.cnki.weishengyanjiu.2025.06.006.
基金信息:
中央财政项目-合理膳食与营养健康(No.131031107000150007); 中国老年人膳食营养状况研究(No.150052)
2025-11-14
2025-11-14