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维生素D状态和肥胖对肾移植患者C反应蛋白的影响。

Impact of vitamin D status and obesity on C-reactive protein in kidney-transplant patients.

作者信息

Ewers Bettina, Gasbjerg Ane, Zerahn Bo, Marckmann Peter

机构信息

Department of Nephrology, Copenhagen University Hospital Herlev, Denmark.

出版信息

J Ren Nutr. 2008 May;18(3):294-300. doi: 10.1053/j.jrn.2007.11.004.

Abstract

OBJECTIVE

We examined whether vitamin D status and obesity are associated with low-grade systemic inflammation, as assessed by serum concentrations of C-reactive protein (CRP) in an adult population of kidney-transplant patients.

DESIGN

This was a single-center, cross-sectional study.

SETTING AND PATIENTS

Data were collected between December 2005 and April 2006 from 161 adult (aged >18 years) kidney-transplant patients (mean age, 53.1 years; SD, 11.5 years; females/males, 78/83), with a median kidney-graft age of 7.0 years and serum CRP levels < or =10 mg/L.

METHODS

Vitamin D status was assessed by serum concentrations of 25-hydroxyvitamin D (25-OHD) and 1,25-dihydroxyvitamin D (1,25(OH)(2)D). The presence of low-grade systemic inflammation was assessed by serum CRP. Selected lifestyle factors and anthropometric variables were determined in a subgroup of patients (n = 90). Bivariate correlation and multiple regression analyses were performed.

RESULTS

Hypovitaminosis D (ie, S-25-OHD < or =75 nmol/L) was present in 73% of females, and 89% of males. The median level of serum CRP was 1.7 mg/L. Vitamin D status was not significantly associated with serum CRP. In the patient subgroup, indices of obesity (body mass index, body weight, and fat mass) correlated positively, and lean body mass correlated negatively, with serum CRP. Only fat mass remained significantly associated with serum CRP in multiple regression analysis.

CONCLUSIONS

No impact of vitamin D status on low-grade systemic inflammation was found. Fat mass correlated positively with CRP, suggesting that obesity may increase the risk of cardiovascular disease and chronic allograft rejection in kidney-transplant patients.

摘要

目的

我们通过检测成年肾移植患者血清C反应蛋白(CRP)浓度,来研究维生素D状态和肥胖与低度全身炎症是否相关。

设计

这是一项单中心横断面研究。

地点和患者

2005年12月至2006年4月期间收集了161例成年(年龄>18岁)肾移植患者的数据(平均年龄53.1岁;标准差11.5岁;女性/男性,78/83),肾移植中位年龄为7.0岁,血清CRP水平≤10mg/L。

方法

通过血清25-羟基维生素D(25-OHD)和1,25-二羟基维生素D(1,25(OH)₂D)浓度评估维生素D状态。通过血清CRP评估低度全身炎症的存在。在一部分患者(n = 90)中确定了选定的生活方式因素和人体测量变量。进行了双变量相关性和多元回归分析。

结果

73%的女性和89%的男性存在维生素D缺乏(即S-25-OHD≤75nmol/L)。血清CRP的中位水平为1.7mg/L。维生素D状态与血清CRP无显著相关性。在患者亚组中,肥胖指标(体重指数、体重和脂肪量)与血清CRP呈正相关,瘦体重与血清CRP呈负相关。在多元回归分析中,只有脂肪量仍与血清CRP显著相关。

结论

未发现维生素D状态对低度全身炎症有影响。脂肪量与CRP呈正相关,表明肥胖可能增加肾移植患者心血管疾病和慢性移植物排斥反应的风险。

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