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探讨新诊断多发性硬化症患者维生素 D 与骨密度的关系。

Investigation of the relationship between vitamin D and bone mineral density in newly diagnosed multiple sclerosis.

机构信息

Deparment of Biochemistry, Faculty of Medicine, Recep Tayyip Erdogan University, Rize, 53100, Turkey.

出版信息

Acta Neurol Belg. 2013 Mar;113(1):43-7. doi: 10.1007/s13760-012-0123-0. Epub 2012 Aug 16.

DOI:10.1007/s13760-012-0123-0
PMID:22895896
Abstract

The aim of this study was to investigate the relationship between vitamin D and bone mineral density in newly diagnosed multiple sclerosis (MS) and to compare results with data from healthy controls. A total of 60 subjects, including 30 patients with MS, newly diagnosed and untreated (18 females, 12 males, at 18-40 years of age) and 30 healthy controls (20 female, 10 male) were enrolled in this study. Bone mineral density (BMD) of the lumbar spine and left femoral neck region were measured by dual-energy X-ray absorptiometry (DEXA). Serum levels of 25-hydroxyvitamin D (25OHD) were measured by chemiluminescence microparticle immunoassay (CMIA) on the Architect-i2000(®) (Abbott) system. 25OHD levels of MS patients were significantly lower than in controls. 25OHD levels were 27.2 ± 14.1 ng/ml in MS patients and 42.6 ± 8.8 ng/ml in controls (p = 0.001). Twenty-six (86.6 %) of our patients had a reduced BMD in lumbar spine or femoral neck region; of these 24 patients (80 %) had osteopenia and 2 patients (6.6 %) had osteoporosis. Interestingly, there was no significant correlation between 25OHD and BMD in lumbar spine and femoral neck region (r = 0.454, p = 0,074; r = 0.636, p = 0.082). Interestingly, a significant reduction of bone density in female MS patients was observed. In our study, 25OHD deficiency and lower BMD appeared in newly diagnosed multiple sclerosis. This is compatible with shared etiologic or pathogenic factors in MS and osteopenia/osteoporosis, and calls for an active approach to optimize bone health in early stages of MS.

摘要

本研究旨在探讨新诊断多发性硬化症(MS)患者维生素 D 与骨密度之间的关系,并将结果与健康对照组数据进行比较。共纳入 60 例受试者,包括 30 例新诊断且未经治疗的 MS 患者(18 名女性,12 名男性,年龄 18-40 岁)和 30 例健康对照组(20 名女性,10 名男性)。采用双能 X 线吸收法(DEXA)测量腰椎和左侧股骨颈区的骨密度(BMD)。采用化学发光微粒子免疫分析法(CMIA)在 Architect-i2000(®)(雅培)系统上检测血清 25-羟维生素 D(25OHD)水平。MS 患者的 25OHD 水平明显低于对照组。MS 患者的 25OHD 水平为 27.2±14.1ng/ml,对照组为 42.6±8.8ng/ml(p=0.001)。我们的 26 例(86.6%)患者腰椎或股骨颈区域的 BMD 降低;其中 24 例(80%)患者存在骨质疏松症,2 例(6.6%)患者存在骨质疏松症。有趣的是,25OHD 与腰椎和股骨颈区域的 BMD 之间无显著相关性(r=0.454,p=0.074;r=0.636,p=0.082)。有趣的是,女性 MS 患者的骨密度明显降低。在本研究中,新诊断的多发性硬化症患者存在 25OHD 缺乏和较低的 BMD。这与 MS 和骨质疏松症中存在共同的病因或发病机制一致,需要在 MS 早期积极采取措施优化骨骼健康。

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