Echida Yoshihisa, Mochizuki Toshio, Uchida Keiko, Tsuchiya Ken, Nitta Kosaku
Department of Medicine, Kidney Center, Tokyo Women's Medical University, Japan.
Intern Med. 2012;51(8):845-50. doi: 10.2169/internalmedicine.51.6897. Epub 2012 Apr 15.
We conducted a cohort study to identify the risk factors for vitamin D deficiency in predialyzed patients with chronic kidney disease (CKD).
An observational study of 135 outpatients with stage 3-5 CKD was undertaken. Clinical and biochemical parameters were analyzed in terms of nutritional status, inflammation, and mineral metabolism in relation to serum levels of 25-hydroxyvitamin D [25(OH)D]. Levels of 25(OH)D lower than 15 ng/mL were considered to be deficient.
The 25(OH)D-deficient group had a higher body mass index (24.1±4.2 kg/m(2) vs. 22.5±4.0 kg/m(2), p=0.0322), and had more diabetic patients (27.9% vs. 3.6%, p=0.0003). The multivariate analysis revealed that body mass index (odds ratio=2.758; 95% CI, 1.048-7.721; p=0.0398), the presence of diabetes (odds ratio=7.792; 95% CI, 1.808-55.439; p=0.0043), lower hemoglobin concentration (odds ratio=0.297; 95% CI, 0.099-8.732; p=0.821), higher serum levels of non-HDL cholesterol (odds ratio=3.570; 95% CI, 1.449-9.442; p=0.0053) and triglyceride (odds ratio=2.447; 95% CI, 0.779-1.776; p=0.0258) were the factors associated with low 25(OH)D levels.
Vitamin D deficiency was common among the predialysis CKD patients, and the factors identified as being associated with vitamin D deficiency were diabetes and obesity.
我们开展了一项队列研究，以确定慢性肾脏病（CKD）透析前患者维生素D缺乏的危险因素。
对135例3 - 5期CKD门诊患者进行了一项观察性研究。分析了临床和生化参数，涉及营养状况、炎症以及与血清25 - 羟维生素D [25(OH)D]水平相关的矿物质代谢。25(OH)D水平低于15 ng/mL被认为缺乏。
25(OH)D缺乏组的体重指数较高（24.1±4.2 kg/m²对22.5±4.0 kg/m²，p = 0.0322），且糖尿病患者更多（27.9%对3.6%，p = 0.0003）。多因素分析显示，体重指数（比值比 = 2.758；95%可信区间，1.048 - 7.721；p = 0.0398）、糖尿病的存在（比值比 = 7.792；95%可信区间，1.808 - 5,543.9；p = 0.0043）、较低的血红蛋白浓度（比值比 = 0.297；95%可信区间，0.099 - 0.8732；p = 0.821）、较高的血清非高密度脂蛋白胆固醇水平（比值比 = 3.570；95%可信区间，1.449 - 9.442；p = 0.0053）和甘油三酯（比值比 = 2.447；95%可信区间，0.779 - 1.776；p = 0.0258）是与低25(OH)D水平相关的因素。
维生素D缺乏在透析前CKD患者中很常见，被确定与维生素D缺乏相关的因素是糖尿病和肥胖。
