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[维生素D与儿童及青年成人囊性纤维化患者的慢性肺部定植]

[VITAMIN D AND CHRONIC LUNG COLONIZATION IN PEDIATRIC AND YOUNG ADULTS CYSTIC FIBROSIS PATIENTS].

作者信息

González Jiménez David, Muñoz Codoceo Rosana, Garriga García María, Molina Arias Manuel, Alvarez Beltran Marina, García Romero Ruth, Martínez Costa Cecilia, Meavilla Olivas Silvia María, Peña Quintana Luis, Gallego Gutierrez Silvia, Marugan de Miguelsanz Jose Manuel, Suarez Cortina Lucrecia, Castejón Ponce Esperanza Natividad, Leis Trabazo Rosaura, Martín Cruz Fayna, Díaz Martín Juan Jose, Bousoño García Carlos

机构信息

Gastroenterología y Nutrición Pediátrica. Hospital Universitario Central de Asturias, Oviedo..

Gastroenterología y nutrición pediátrica. Hospital Infantil Universitario Niño Jesús, Madrid..

出版信息

Nutr Hosp. 2015 Oct 1;32(4):1629-35. doi: 10.3305/nh.2015.32.4.9503.

Abstract

INTRODUCTION AND OBJECTIVES

evaluate vitamin D status and its association with chronic lung colonisation in Cystic Fibrosis patients.

MATERIAL AND METHODS

descriptive cross-sectional multicenter study. From November 2012 to April 2014, at 12 national hospitals, 377 patients with Cystic Fibrosis were included. Vitamin D levels < 30 ng/ml were classified as insufficient. Chronic colonisation was considered if they had at least two positive cultures in the past year.

RESULTS

the median age was 8.9 years (2 months to 20 years). 65% had insufficient levels of vitamin D. There was an inverse correlation between age and vitamin D levels (r = -0.20 p < 0.001). Those diagnosed by screening, were younger and had higher levels of vitamin D. There was an inverse correlation between the number of colonisations and vitamin D levels (r = -0.16 p = 0.0015). Adjusting for age, pancreatic status and diagnosis by screening, colonization by S. aureus in 6 years, increased the risk of insufficient levels of vitamin D: OR 3.17 (95% CI 1.32 to 7.61) (p = 0.010) and OR 3.77 (95% CI 1.37 to 10 , 37) (p = 0.010), respectively.

CONCLUSIONS

despite adequate supplementation, more than half of our patients did not achieve optimal levels of vitamin D. Regardless of age, diagnosis by screening or pancreatic status, chronic colonization by Pseudomonas sp. in children and adolescents and S. Aureus in infants and preschoolars increases the risk of developing vitamin D deficiency in these patients.

摘要

引言与目的

评估囊性纤维化患者的维生素D状态及其与慢性肺部定植的关联。

材料与方法

描述性横断面多中心研究。2012年11月至2014年4月,在12家国立医院纳入了377例囊性纤维化患者。维生素D水平<30 ng/ml被分类为不足。如果患者在过去一年中至少有两次培养阳性,则认为存在慢性定植。

结果

中位年龄为8.9岁(2个月至20岁)。65%的患者维生素D水平不足。年龄与维生素D水平呈负相关(r = -0.20,p < 0.001)。通过筛查确诊的患者更年轻且维生素D水平更高。定植次数与维生素D水平呈负相关(r = -0.16,p = 0.0015)。在调整年龄、胰腺状态和筛查诊断后,6岁时金黄色葡萄球菌定植增加了维生素D水平不足的风险:比值比分别为3.17(95%置信区间1.32至7.61)(p = 0.010)和3.77(95%置信区间1.37至10.37)(p = 0.010)。

结论

尽管进行了充分补充,但超过一半的患者未达到最佳维生素D水平。无论年龄、筛查诊断或胰腺状态如何,儿童和青少年中的假单胞菌属慢性定植以及婴儿和学龄前儿童中的金黄色葡萄球菌定植都会增加这些患者发生维生素D缺乏的风险。

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