Impact of vitamin D and hypolactasia on bone mineral density: a population-based study in Estonia
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2010-05-19T10:13:27Z
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Abstract
Osteoporoos on oluline rahvatervise probleem kogu maailmas ja luude haprusest tingitud murrud põhjustavad elukvaliteedi märkimisväärset langust ning suremuse tõusu. Luutihedust ja selle mõjureid kompleksselt käsitlevad rahvastikupõhised uuringud Eestis puudusid.
Uuringus osales 367 juhuslikkuse printsiibil valitud 25-70 aastast Eesti elanikku.
Luude mineraalne tihedus on eestlastel sarnane standardses (NHANES III) andmebaasis avaldatud noorte täiskasvanute luutiheduse väärtustega.
Tulemuste rakendamisel osteoporoosi diagnoosimisel 264 järjestikusel osteoporoosi kabinetti pöördunul, selgusid mõningad lahknevused võrreldes rutiinselt kasutatava standartandmebaasiga.
D-vitamiini sisaldus seerumis oli iseseisvaks luude mineraalset tihedust määravaks teguriks. Määratud keskmine D vitamiini tase oli aastaringselt madal ja seda mõjutasid oluliselt inimeste päevitamisharjumused, mis erinesid sõltuvalt uuritavate kehakaalust ja vanusest.
Luutihedust mõjutas ka rõõsa piima tarbimine. Uuritavate piima tarbimist vähendas pigem tunnetuslik piima talumatus kui geenianalüüsi alusel kindlaks tehtud ensüümi laktaas madal aktiivsus. Rõõska piima subjektiivselt mitte taluvatel inimestel oli ka kõrgem luu ainevahetuse indikaatorite tase ning madalam luude mineraalne tihedus.
Uuring selgitas erinevate osteoporoosi riskifaktorite mõju luu mineraalsele tihedusele Eesti täiskasvanud elanikel. Töö tulemused on aluseks edasisteks uuringuteks antud valdkonnas ja võimaldavad preventiivsete meetmete paremat planeerimist Eestis.
Osteoporosis is a major public health problem around the world due to the increased mortality and decreased quality of life in those affected by the disease. Comprehensive population based studies looking at the various risk factors for osteoporosis in Estonia were missing. 367 randomly selected individuals aged 25-70 years participated in the study. We found that the normative range for bone mineral density in Estonia is similar to that reported in the standard (NHANES III) database. Diagnosing osteoporosis using the local database in 264 consecutive subjects (age 21-88) at our osteoporosis, however showed some classification discrepancies. Vitamin D was a significant independent determinant of bone mineral density. The prevalence of vitamin D insufficiency and deficiency was high throughout the year. Sun-bathing habits significantly influenced vitamin D levels and reduced sun-exposure constitutes a risk factor for hypovitaminosis in the overweight and the elderly. Milk consumption was also a significant determinant of bone mineral density. Self-perceived lactose intolerance rather than hypolactasia influenced milk product consumption subjects who considered themselves milk intolerant consumed significantly less milk, had higher bone markers and lower bone mineral density. Our study determined the role of several important risk factors for low bone mineral density in the general population. This study forms a basis for future studies in this field and facilitates the planning of osteoporosis prevention in Estonia.
Osteoporosis is a major public health problem around the world due to the increased mortality and decreased quality of life in those affected by the disease. Comprehensive population based studies looking at the various risk factors for osteoporosis in Estonia were missing. 367 randomly selected individuals aged 25-70 years participated in the study. We found that the normative range for bone mineral density in Estonia is similar to that reported in the standard (NHANES III) database. Diagnosing osteoporosis using the local database in 264 consecutive subjects (age 21-88) at our osteoporosis, however showed some classification discrepancies. Vitamin D was a significant independent determinant of bone mineral density. The prevalence of vitamin D insufficiency and deficiency was high throughout the year. Sun-bathing habits significantly influenced vitamin D levels and reduced sun-exposure constitutes a risk factor for hypovitaminosis in the overweight and the elderly. Milk consumption was also a significant determinant of bone mineral density. Self-perceived lactose intolerance rather than hypolactasia influenced milk product consumption subjects who considered themselves milk intolerant consumed significantly less milk, had higher bone markers and lower bone mineral density. Our study determined the role of several important risk factors for low bone mineral density in the general population. This study forms a basis for future studies in this field and facilitates the planning of osteoporosis prevention in Estonia.
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