A predictive model of vitamin D insufficiency in older community people: From the Sao Paulo Aging & Health Study (SPAH)

作者：Lopes Jaqueline B; Fernandes Georgea H; Takayama Liliam; Figueiredo Camille P; Pereira Rosa M R^*

来源：Maturitas, 2014, 78(4): 335-340.

DOI：10.1016/j.maturitas.2014.05.023

• Predictive risk factors
• 25-Hydroxyvitamin D
• Older
• Prevalence
• Season
• Diabetes

Objective: To evaluate the prevalence of 25-hydroxyvitamin D insufficiency (25OHD < 20 ng/mL) and to develop a predictive model for this status.
Methods: This is a cross-sectional study including 908 community-dwelling older subjects, 18% (158) of which were randomly selected to be a "test" sample, with the remaining (750) composing a "development" sample. A radioimmunoassay technique was used to measure 25OHD levels. Anthropometrical data, information about lifestyle habits and co-morbidities were obtained. Multiple logistic regression models were created. An Index Risk of Vitamin D Insufficiency (IRVDI) was designed and subsequently validated. The performance of this tool was assessed through ROC analysis.
Results: The prevalence of 25OHD <20 ng/mL was of 58.0% (CI 95% 51.6-64.6). The clinical independent factors for 25OHD <20 ng/mL were female gender (OR=2.16; 95%CI 1.13-4.13; p=0.020), diabetes (OR=1.84; 95%CI 1.23-2.74; p=0.003) and season (winter/spring) (OR=3.63, 95%CI 2.62-4.88; p < 0.001). After statistical adjustments, the IRVDI was able to identify older people at risk for vitamin D insufficiency with a sensitivity of 55.9%, specificity 72.3% and ROC area of 0.685 (p < 0.001).
Conclusions: Our results suggest that vitamin D insufficiency is common among Brazilian community-dwelling elderly. Female gender, diabetes and the season (winter/spring) were the important parameters that predicted this status. The clinical use of these parameters can be help to design and target appropriate public health interventions. The IRVDI is a convenient tool for the selection of older people at risk for vitamin D insufficiency.

• 出版日期2014-8