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慢性肾脏病患者维生素D缺乏的危险因素

Risk factors for vitamin D deficiency in patients with chronic kidney disease.

作者信息

Echida Yoshihisa, Mochizuki Toshio, Uchida Keiko, Tsuchiya Ken, Nitta Kosaku

机构信息

Department of Medicine, Kidney Center, Tokyo Women's Medical University, Japan.

出版信息

Intern Med. 2012;51(8):845-50. doi: 10.2169/internalmedicine.51.6897. Epub 2012 Apr 15.

Abstract

OBJECTIVE

We conducted a cohort study to identify the risk factors for vitamin D deficiency in predialyzed patients with chronic kidney disease (CKD).

METHODS

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.

RESULTS

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.

CONCLUSION

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.

摘要

目的

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。

方法

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。

结果

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。

结论

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。

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