新生血管性与非新生血管性年龄相关性黄斑变性中的维生素D缺乏
Vitamin D deficiency in neovascular versus nonneovascular age-related macular degeneration.
作者信息
Itty Sujit, Day Shelley, Lyles Kenneth W, Stinnett Sandra S, Vajzovic Lejla M, Mruthyunjaya Prithvi
机构信息
*Department of Ophthalmology, Duke University Medical Center; †Department of Ophthalmology, Stanford Medical Center; ‡Department of Medicine, Duke University Medical Center; §Geriatric Research Education and Clinical Centers, Veterans Affairs Medical Center, Durham, North Carolina; ¶The Carolinas Center for Medical Excellence, Cary, North Carolina; and **Division of Biostatistics, Duke University Medical Center.
出版信息
Retina. 2014 Sep;34(9):1779-86. doi: 10.1097/IAE.0000000000000178.
PURPOSE
To compare 25-hydroxyvitamin D (25OHD) levels in patients with neovascular age-related macular degeneration (NVAMD) with patients with nonneovascular age-related macular degeneration and control patients.
METHODS
Medical records of all patients diagnosed with age-related macular degeneration and tested for serum 25OHD level at a single medical center were reviewed. Control patients were selected from patients diagnosed with pseudophakia but without age-related macular degeneration. The lowest 25OHD level available for each patient was recorded.
RESULTS
Two hundred sixteen patients with nonneovascular age-related macular degeneration, 146 with NVAMD, and 100 non-age-related macular degeneration control patients were included. The levels of 25OHD (mean ± SD) were significantly lower in NVAMD patients (26.1 ± 14.4 ng/mL) versus nonneovascular age-related macular degeneration (31.5 ± 18.2 ng/mL, P = 0.003) and control (29.4 ± 10.1 ng/mL, P = 0.049) patients. The prevalence of vitamin D insufficiency (<30 ng/mL 25OHD), deficiency (<20 ng/mL), and severe deficiency (<10 ng/mL) were highest in the NVAMD group. The highest quintile of 25OHD was associated with a 0.35 (95% confidence interval, 0.18-0.68) odds ratio for NVAMD.
CONCLUSION
This is the largest study to compare 25OHD levels in patients with the different clinical forms of age-related macular degeneration. Mean 25OHD levels were lower and vitamin D deficiency was more prevalent in NVAMD patients. These associations suggest that further research is necessary regarding vitamin D deficiency as a potentially modifiable risk factor for the development of NVAMD.
目的
比较新生血管性年龄相关性黄斑变性（NVAMD）患者、非新生血管性年龄相关性黄斑变性患者和对照患者的25-羟基维生素D（25OHD）水平。
方法
回顾了在单一医疗中心诊断为年龄相关性黄斑变性并检测血清25OHD水平的所有患者的病历。对照患者选自诊断为人工晶状体眼但无年龄相关性黄斑变性的患者。记录每位患者可用的最低25OHD水平。
结果
纳入了216例非新生血管性年龄相关性黄斑变性患者、146例NVAMD患者和100例非年龄相关性黄斑变性对照患者。与非新生血管性年龄相关性黄斑变性患者（31.5±18.2 ng/mL，P = 0.003）和对照患者（29.4±10.1 ng/mL，P = 0.049）相比，NVAMD患者的25OHD水平（均值±标准差）显著更低。NVAMD组维生素D不足（<30 ng/mL 25OHD）、缺乏（<20 ng/mL）和严重缺乏（<10 ng/mL）的患病率最高。25OHD最高五分位数与NVAMD的比值比为0.35（95%置信区间，0.18 - 0.68）。
结论
这是比较不同临床类型年龄相关性黄斑变性患者25OHD水平的最大规模研究。NVAMD患者的平均25OHD水平较低，维生素D缺乏更为普遍。这些关联表明，有必要进一步研究维生素D缺乏作为NVAMD发生发展的潜在可改变风险因素。
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