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炎症性肠病患者体内较低水平的维生素D与临床疾病活动度及生活质量相关。

LOWER LEVELS OF VITAMIN D CORRELATE WITH CLINICAL DISEASE ACTIVITY AND QUALITY OF LIFE IN INFLAMMATORY BOWEL DISEASE.

作者信息

Castro Francisca Dias De, Magalhães Joana, Carvalho Pedro Boal, Moreira Maria João, Mota Paula, Cotter José

机构信息

Departamento de Gastroenterologia, Centro Hospitalar do Alto Ave, Guimarães, Portugal.

Departamento de Patologia Clínica, Centro Hospitalar do Alto Ave, Guimarães, Portugal.

出版信息

Arq Gastroenterol. 2015 Dec;52(4):260-5. doi: 10.1590/S0004-28032015000400003.

Abstract

BACKGROUND

Inflammatory bowel disease, comprising Crohn's disease and ulcerative colitis, is a group of debilitating conditions associated with deregulated mucosal immune response. Vitamin D has been implicated in immune response and gastrointestinal function.

OBJECTIVES

To investigate the correlation between serum vitamin D levels and disease activity and quality of life in patients with inflammatory bowel disease.

METHODS

This cross-sectional study enrolled ambulatory patients with inflammatory bowel disease and assessed clinical disease activity and quality of life (Short Inflammatory Bowel Disease Questionnaire [SIBDQ]). Vitamin D levels were determined via serum 25-hydroxyvitamin D measurement; deficiency was defined as values <20 ng/mL. Statistical analysis was performed with SPSS vs 20.0.

RESULTS

A total of 76 patients were enrolled, 19 with ulcerative colitis (25%) and 57 with Crohn's disease (75%). Overall, mean serum 25-hydroxyvitamin D levels were low (26.0±10.0 ng/mL), while those in patients with Crohn's disease were significantly lower than ulcerative colitis (24.6±8.0 vs 30.0±12.5 ng/mL; P=0.032). Vitamin D deficiency was found in 30% of patients. Patients who were in clinical remission were found to have higher levels of vitamin D than those who were not in remission (28.0±10.3 vs 21.6±6.0 ng/mL, P=0.001). Inflammatory bowel disease patients with SIBDQ scores <50 were found to have significantly lower mean vitamin D levels compared with patients who had SIBDQ scores ≥50 (23.4±6.9 vs 27.9±10.8 ng/mL, P=0.041).

CONCLUSIONS

A high proportion of patients with inflammatory bowel disease were vitamin D deficient, particularly patients with Crohn's disease. Both clinical disease activity and quality of life correlated significantly with lower levels of vitamin D, illustrating a clear need for supplementation in patients with inflammatory bowel disease.

摘要

背景

炎症性肠病包括克罗恩病和溃疡性结肠炎,是一组与黏膜免疫反应失调相关的使人衰弱的病症。维生素D与免疫反应和胃肠功能有关。

目的

研究炎症性肠病患者血清维生素D水平与疾病活动度及生活质量之间的相关性。

方法

这项横断面研究纳入了炎症性肠病门诊患者,评估了临床疾病活动度和生活质量(简短炎症性肠病问卷[SIBDQ])。通过测定血清25-羟维生素D来确定维生素D水平;维生素D缺乏定义为水平<20 ng/mL。使用SPSS 20.0进行统计分析。

结果

共纳入76例患者,其中19例为溃疡性结肠炎(25%),57例为克罗恩病(75%)。总体而言,血清25-羟维生素D平均水平较低(26.0±10.0 ng/mL),而克罗恩病患者的水平显著低于溃疡性结肠炎患者(24.6±8.0 vs 30.0±12.5 ng/mL;P=0.032)。30%的患者存在维生素D缺乏。临床缓解的患者维生素D水平高于未缓解的患者(28.0±10.3 vs 21.6±6.0 ng/mL,P=0.001)。SIBDQ评分<50的炎症性肠病患者的平均维生素D水平显著低于SIBDQ评分≥50的患者(23.4±6.9 vs 27.9±10.8 ng/mL,P=0.041)。

结论

很大一部分炎症性肠病患者存在维生素D缺乏,尤其是克罗恩病患者。临床疾病活动度和生活质量均与较低的维生素D水平显著相关,这表明炎症性肠病患者显然需要补充维生素D。

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