Henry Ford Hospital, Division of Pulmonary and Critical Care Medicine, Detroit, MI 48202, USA.
Respir Med. 2010 Apr;104(4):564-70. doi: 10.1016/j.rmed.2009.12.004. Epub 2010 Jan 13.
Active vitamin D metabolite, 1, 25-dihydroxyvitamin D, has pleomorphic effects on both innate and acquired immunity. Sarcoid granuloma derived 1, 25-dihydroxyvitamin D leads to hypercalcemia, but the association of 1, 25-dihydroxyvitamin D with the clinical phenotype of the disease is currently unknown.
To determine the relationship between serum 1, 25-dihydroxyvitamin D levels and the degree of sarcoidosis disease chronicity.
Serum 1, 25-dihydroxyvitamin D levels were measured and associated with sarcoidosis activity and phenotypes as assessed by Sarcoidosis Severity Score and Sarcoidosis Clinical Activity Classification respectively.
Fifty nine patients were recruited with 44% having a sub-acute onset, and the chronic disease phenotype. There was no significant difference in serum 1, 25-dihydroxyvitamin D levels by chest radiograph stage (p = 0.092) nor did the levels correlate with the Sarcoidosis Severity Score (r = -0.16; p = 0.216). Serum 1, 25-dihydroxyvitamin D levels were associated with patients requiring repeated regimens of systemic immunosuppressive therapy or >1 year of therapy (SCAC Class 6). Increasing quartiles of serum 1, 25-dihydroxyvitamin D level was associated increased odds of the chronic phenotype (OR 1.82, 95% CI, 1.11, 2.99, p = 0.019). The majority (71%) of the patients with levels >51 pg/mL required chronic immunosuppressive therapy as defined by SCAC class 6.
In patients with sarcoidosis, elevated 1, 25-dihydroxyvitamin D levels are associated with chronic treatment needs.
活性维生素 D 代谢物 1,25-二羟维生素 D 对先天和获得性免疫具有多种影响。结节病肉芽肿衍生的 1,25-二羟维生素 D 导致高钙血症，但目前尚不清楚 1,25-二羟维生素 D 与疾病的临床表型之间的关系。
确定血清 1,25-二羟维生素 D 水平与结节病疾病慢性程度的关系。
测量血清 1,25-二羟维生素 D 水平，并将其与结节病活性和表型分别通过结节病严重程度评分和结节病临床活动分类进行评估。
共招募了 59 例患者，其中 44%为亚急性起病，慢性疾病表型。血清 1,25-二羟维生素 D 水平与胸部 X 线分期无显著差异（p = 0.092），也与结节病严重程度评分无相关性（r = -0.16；p = 0.216）。血清 1,25-二羟维生素 D 水平与需要重复全身免疫抑制治疗或>1 年治疗的患者（SCAC 类 6）相关。血清 1,25-二羟维生素 D 水平的四分位数越高，慢性表型的可能性就越大（OR 1.82，95%CI，1.11，2.99，p = 0.019）。>51pg/mL 水平的患者中，大多数（71%）需要慢性免疫抑制治疗，如 SCAC 类 6 所定义的。
在结节病患者中，升高的 1,25-二羟维生素 D 水平与慢性治疗需求相关。
