Loh Zhong Yi, Yap Chun Wei, Vathsala Anantharaman, How Priscilla
Department of Pharmacy, Faculty of Science , National University of Singapore , Singapore.
Department of Medicine, Division of Nephrology , National University Hospital, Singapore , Singapore.
Clin Kidney J. 2012 Aug;5(4):303-8. doi: 10.1093/ckj/sfs074.
Vitamin D deficiency is common in patients with chronic kidney disease (CKD) and can cause skeletal and extraskeletal complications. The purpose of this study is to determine the clinical and demographic risk factors for vitamin D deficiency in multiethnic CKD patients in Singapore, a sun-rich country, so that patients at risk can be identified and treated early.
Pre-dialysis CKD patients from the National University Hospital (NUH), Singapore, Outpatient Renal Clinic who had their serum 25-hydroxyvitamin D [25(OH)D] levels measured between January 2008 and October 2010 were included. Their clinical and demographic parameters were collected from hospital databases and medical charts. Logistic regression was used to identify potential predictors for vitamin D deficiency in these patients. Two models, Mt30 and Mt16, were built using threshold serum 25(OH)D levels of ≤30 and <16 ng/mL, respectively.
Of the 219 patients included, 82.7 and 25.6% had serum 25(OH)D levels ≤30 and <16 ng/mL, respectively. Predictors identified for vitamin D deficiency include absence of vitamin D supplementation, type 2 diabetes mellitus (DM), non-cancer diagnosis, younger age, Malay race, treatment with calcitriol and higher serum bicarbonate (CO2) levels. Common predictors for the two models were lack of vitamin D supplementation and DM. The areas under the receiver-operating characteristic (ROC) curve for the validation sets were 0.697 and 0.687 for the Mt30 and Mt16 models, respectively.
Vitamin D deficiency is common among multiethnic CKD patients in Singapore. Risk factors identified in this study include absence of vitamin D supplementation, DM, non-cancer diagnosis, young age, Malay race, calcitriol treatment and higher serum CO2. The knowledge of these risk factors is useful for predicting vitamin D deficiency in CKD patients in Singapore.
维生素D缺乏在慢性肾脏病（CKD）患者中很常见，可导致骨骼和骨骼外并发症。本研究的目的是确定新加坡这个阳光充足国家中多民族CKD患者维生素D缺乏的临床和人口统计学风险因素，以便识别有风险的患者并尽早进行治疗。
纳入2008年1月至2010年10月期间在新加坡国立大学医院（NUH）门诊肾脏科测量血清25-羟基维生素D [25(OH)D]水平的透析前CKD患者。从医院数据库和病历中收集他们的临床和人口统计学参数。采用逻辑回归确定这些患者维生素D缺乏的潜在预测因素。分别使用血清25(OH)D水平阈值≤30和<16 ng/mL建立了两个模型，即Mt30和Mt16。
纳入的219例患者中，血清25(OH)D水平≤30和<16 ng/mL的患者分别占82.7%和25.6%。确定的维生素D缺乏预测因素包括未补充维生素D、2型糖尿病（DM）、非癌症诊断、年龄较小、马来族、使用骨化三醇治疗以及血清碳酸氢盐（CO2）水平较高。两个模型的常见预测因素是未补充维生素D和DM。Mt30和Mt16模型验证集的受试者工作特征（ROC）曲线下面积分别为0.697和0.687。
维生素D缺乏在新加坡多民族CKD患者中很常见。本研究确定的风险因素包括未补充维生素D、DM、非癌症诊断、年轻、马来族、骨化三醇治疗和血清CO2水平较高。了解这些风险因素有助于预测新加坡CKD患者的维生素D缺乏情况。
