Zittermann Armin, Kuhn Joachim, Dreier Jens, Knabbe Cornelius, Prokop Sylvana, Gummert Jan F, Börgermann Jochen
Clinic for Thoracic and Cardiovascular Surgery, Heart and Diabetes Center North Rhine-Westphalia, Ruhr University Bochum, Bad Oeynhausen, Germany.
Institute for Laboratory and Transfusion Medicine, Heart and Diabetes Center North Rhine-Westphalia, Ruhr University Bochum, Bad Oeynhausen, Germany.
Int J Lab Hematol. 2014 Feb;36(1):29-36. doi: 10.1111/ijlh.12112. Epub 2013 May 28.
There is emerging data that vitamin D plays a role in erythropoiesis. Low 25-hydroxyvitamin D (25OHD) levels may therefore be a risk factor for anemia in patients scheduled for cardiac surgery.
We investigated 4428 consecutive cardiac surgical patients to determine an association between anemia (hemoglobin concentration <12.5 g/dL, 27.1% of the study cohort) and circulating 25OHD.
In patients with severe vitamin D deficiency (25OHD < 12.5 nm), mean hemoglobin concentrations were 0.80 g/dL lower compared with patients with adequate 25OHD levels (50.0-100 nm). Hemoglobin levels were not significantly different at 25OHD levels above 100 nm compared with 50.0-100 nm. In multivariable-adjusted logistic regression analyses, the odds ratios for anemia of the groups with severe and moderate vitamin D deficiency (12.5-29.9 nm) were 1.70 (95% CI:1.09-2.63) and 1.41 (95% CI:1.02-1.96), respectively, compared with patients who had circulating 25OHD levels of 75-100 nm. Prevalence of deficient circulating 25OHD levels was highest in anemia of chronic kidney disease.
This cross-sectional study demonstrates an independent association between vitamin D status and anemia risk with optimal 25OHD levels of 75-100 nm. Randomized controlled trials are needed to clarify whether this association is causal.
有新数据表明维生素D在红细胞生成中起作用。因此，对于计划进行心脏手术的患者，25-羟维生素D（25OHD）水平低可能是贫血的一个危险因素。
我们调查了4428例连续的心脏手术患者，以确定贫血（血红蛋白浓度<12.5 g/dL，占研究队列的27.1%）与循环25OHD之间的关联。
在严重维生素D缺乏（25OHD<12.5 nmol/L）的患者中，与25OHD水平充足（50.0 - 100 nmol/L）的患者相比，平均血红蛋白浓度低0.80 g/dL。25OHD水平高于100 nmol/L时的血红蛋白水平与50.0 - 100 nmol/L时相比无显著差异。在多变量调整的逻辑回归分析中，与循环25OHD水平为75 - 100 nmol/L的患者相比，严重和中度维生素D缺乏（12.5 - 29.9 nmol/L）组贫血的比值比分别为1.70（95%CI：1.09 - 2.63）和1.41（95%CI：1.02 - 1.96）。循环25OHD水平缺乏在慢性肾脏病贫血中最为常见。
这项横断面研究表明维生素D状态与贫血风险之间存在独立关联，最佳25OHD水平为75 - 100 nmol/L。需要进行随机对照试验以阐明这种关联是否具有因果关系。
