Jabbar Zulfikar, Aggarwal Pardeep K, Chandel Nirupama, Kohli Harbir S, Gupta Krishan L, Sakhuja Vinay, Jha Vivekanand
Department of Nephrology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Nephrology (Carlton). 2009 Apr;14(3):345-9. doi: 10.1111/j.1440-1797.2008.01082.x. Epub 2009 Jan 21.
Vitamin D is being increasingly recognized as an important player in disease. Hypovitaminosis D is widespread in chronic kidney disease (CKD) populations around the world. The vitamin D status of Indian CKD patients is not known.
Levels of 25(OH) vitamin D and parathyroid hormone (PTH) were measured in adult north Indian male patients with newly diagnosed stage IV-V CKD and matched control subjects drawn from the same population. A total of 100 (34 stage IV and 66 stage V) patients with CKD and 72 controls were studied.
Only 4% control and 1% of CKD subjects had normal (>30 ng/mL) vitamin D levels. Approximately 68% of control and 77% of the CKD population had vitamin D deficiency (<15 ng/ml) whereas the remaining 38% control and 22% CKD patients had insufficient (15-30 ng/mL) vitamin D levels. Levels were lower in CKD subjects compared to their family members, and the CKD patients were significantly more likely to have severe vitamin D deficiency (<5 ng/mL). A strong negative correlation was noted between vitamin D and PTH. No significant correlation was found between vitamin D levels and body mass index, bodyfat percentage, serum albumin or calcium levels.
Vitamin D deficiency is highly prevalent in north Indians, and this is more pronounced in CKD subjects. There is a significant inverse correlation between the vitamin D and PTH levels. The clinical significance of this deficiency and the potential benefits to be derived from vitamin D supplementation in this population merits further studies.
维生素D在疾病中的重要作用日益受到认可。全球慢性肾脏病(CKD)人群中维生素D缺乏症普遍存在。印度CKD患者的维生素D状况尚不清楚。
对新诊断为IV-V期CKD的成年北印度男性患者及来自同一人群的匹配对照者测量25(OH)维生素D和甲状旁腺激素(PTH)水平。共研究了100例(34例IV期和66例V期)CKD患者和72例对照者。
仅4%的对照者和1%的CKD受试者维生素D水平正常(>30 ng/mL)。约68%的对照者和77%的CKD人群存在维生素D缺乏(<15 ng/ml),而其余38%的对照者和22%的CKD患者维生素D水平不足(15-30 ng/mL)。CKD受试者的维生素D水平低于其家庭成员,且CKD患者严重维生素D缺乏(<5 ng/mL)的可能性显著更高。维生素D与PTH之间存在强烈的负相关。未发现维生素D水平与体重指数、体脂百分比、血清白蛋白或钙水平之间存在显著相关性。
维生素D缺乏在北印度人群中非常普遍,在CKD受试者中更为明显。维生素D与PTH水平之间存在显著的负相关。这种缺乏的临床意义以及该人群补充维生素D可能带来的潜在益处值得进一步研究。