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特发性炎性肌病患者血清维生素 D 水平低。

Low serum levels of vitamin D in idiopathic inflammatory myopathies.

机构信息

Rheumatology Unit, Danderyd's Hospital, Karolinska Institutet, Stockholm 18288, Sweden.

出版信息

Ann Rheum Dis. 2013 Apr;72(4):512-6. doi: 10.1136/annrheumdis-2012-201849. Epub 2012 Sep 19.

Abstract

OBJECTIVES

To evaluate serum levels of 25(OH) vitamin D in patients with idiopathic inflammatory myopathies (IIM) (polymyositis (PM), dermatomyosistis (DM), inclusion body myositis (IBM) and juvenile DM (JDM)) and to compare these with healthy controls.

METHODS

Serum samples from 149 patients with IIM and 290 healthy controls matched for gender and the month of blood sampling were analysed for 25(OH) vitamin D. ORs for vitamin D classes with 95% CI were calculated using a matched (conditional) logistic regression model. Groups were compared by the Kruskal-Wallis test and p values <0.05 were considered significant.

RESULTS

Patients with IIM had significantly lower serum levels of 25(OH) vitamin D than healthy controls (median 39 (10-168) nmol/l vs 68 (19-197) nmol/l; p=0.0001). There was no significant difference in vitamin D levels between the myositis subgroups. When vitamin D levels were subclassified into deficient (<50 nmol/l), insufficient (50-74 nmol/l) and normal (≥75 nmol/l), most of the patients with PM (68%), DM (65%) and IBM (53%) had deficient levels compared with only 60 (21%) healthy individuals. In patients with IIM the OR for deficient versus normal was 17.7 (95% CI 8.1 to 38.6) and the OR for insufficient versus normal was 2.4 (95% CI 1.2 to 4.7).

CONCLUSIONS

Low serum levels of vitamin D were found in most patients with IIM and may confer a risk factor for developing adult myositis, similar to some other autoimmune diseases.

摘要

目的

评估特发性炎性肌病(IIM)(多发性肌炎(PM)、皮肌炎(DM)、包涵体肌炎(IBM)和青少年皮肌炎(JDM))患者血清 25(OH)维生素 D 水平,并将其与健康对照组进行比较。

方法

分析了 149 例 IIM 患者和 290 例性别和采血月份匹配的健康对照者的血清样本,以检测 25(OH)维生素 D。采用匹配(条件)logistic 回归模型计算维生素 D 各等级的比值比(OR)及其 95%置信区间(CI)。采用 Kruskal-Wallis 检验比较各组间差异,P 值<0.05 为差异有统计学意义。

结果

与健康对照组相比,IIM 患者的血清 25(OH)维生素 D 水平显著降低(中位数 39(10-168)nmol/L vs. 68(19-197)nmol/L;P=0.0001)。各组间肌炎亚组间维生素 D 水平无显著差异。将维生素 D 水平进一步细分为缺乏(<50 nmol/L)、不足(50-74 nmol/L)和正常(≥75 nmol/L),结果发现 PM(68%)、DM(65%)和 IBM(53%)患者大部分处于缺乏水平,而仅有 60(21%)名健康个体处于缺乏水平。与正常组相比,IIM 患者维生素 D 缺乏组的 OR 值为 17.7(95%CI 8.1-38.6),不足组的 OR 值为 2.4(95%CI 1.2-4.7)。

结论

大多数 IIM 患者血清维生素 D 水平较低,这可能成为发生成人肌炎的危险因素,与其他一些自身免疫性疾病类似。

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