强化运动、维生素D和钙剂补充对社区绝经后女性生活质量的影响

摘要

Objective To examine the effects of intensive exercise and calcium supplementation combined with vitamin D on quality of life in postmenopausal women.Methods Six hundred and fourteen postmenopausal women with risk factors of osteoporosis were randomized to four groups:group A (control group),group B (regular Tai chi movement),group C (elemental calcium 600 mg/d+VitD3 800 IU/d),and group D { elemental calcium 600 mg/d+ 1,25dihydroxy-vitamin D[1,25(OH)2D] 0.25 μg/d}.Quality of life was assessed by SF-36 questionnaire at baseline,one year and two years after intervention.Results Physical functioning (PF),general health (GH),and vitality (VT) improved at the 12th month visit in group A (P=0.007,0.029,and 0.037,respectively).The above indexes showed no difference at the 24th month follow-up (All P＞0.05),while role-physical (RP) and role-emotional (RE) declined significantly compared with baseline (All P =0.000).In group B,VT increased at the 1st year visit (P =0.041) while no statistical difference was seen at the 2nd year follow-up.At one year visit,all indices did not change in group C and group D (All P＞0.05).Two years after intervention,RP and mental health (MH) decreased significantly in group C (P =0.043,0.001,respectively).Moreover,RP,MH plus RE was all descended statistically compared to baseline as well (P =0.049,0.000,0.001,respectively).Conclusion Calcium supplementation combined with either cholecalciferol or calcitriol did not improve quality of life in this group of postmenopausal women,while intensive exercise might help to sustain life quality of postmenopausal women in our study.%目的 观察强化运动、不同种类维生素D制剂联合钙剂补充对绝经后女性生活质量的影响.方法 614名具有骨质疏松高危因素的绝经后女性纳入本研究,采用数字表法随机分为4组:A组为对照组,B组为强化运动组,C组予元素钙600 mg/d+普通维生素D 800 IU/d,D组予元素钙600 mg/d+1,25双羟维生素D[1,25dihydroxy-vitamin D,1,25(0H)2D] 0.25μg/d.随访2年,在基线、随访1年及2年时分别采用生活质量评价量表(short form 36 health state survey questionhaire,SF-36)评分对受试者生活质量进行评估.结果 A组随访1年时生理功能、总体健康及活力较基线改善(P分别为0.007、0.029、0.037),上述指标在2年随访时与基线比较差异无统计学意义(P＞0.05);2年随访时生理职能及情感职能较基线显著下降(P均＜0.001).B组随访1年时活力与基线比较改善(P=0.041),2年时各项评分与基线比较差异均无统计学意义(P＞0.05).C、D组随访1年SF-36各项评分与基线比较差异均无统计学意义(P＞0.05);2年时C组生理职能、精神健康较基线下降(P=0.043、0.001),D组生理职能、情感职能及精神健康较基线显著下降(P分别为0.049、0.000、0.001).结论 本研究未观察到钙剂联合普通维生素D或活性维生素D显著改善绝经后女性生活质量,强化运动或许有助于维持绝经后女性生活质量.