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严重维生素D缺乏会增加中国系统性红斑狼疮患者出现中度至重度疾病活动的风险。

Severe vitamin D deficiency increases the risk for moderate to severe disease activity in Chinese patients with SLE.

作者信息

Gao C-C, Liu S-Y, Wu Z-Z, Li T-F, Gao G-M, Liu Z-S, Zheng Z-H

机构信息

The First Affiliated Hospital of Zhengzhou University, Rheumatology, Zhengzhou, Henan province, People's Republic of China.

The First Affiliated Hospital of Zhengzhou University, Rheumatology, Zhengzhou, Henan province, People's Republic of China

出版信息

Lupus. 2016 Oct;25(11):1224-9. doi: 10.1177/0961203316635289. Epub 2016 Feb 25.

Abstract

OBJECTIVE

We aimed to investigate the prevalence of vitamin D deficiency in Chinese lupus patients and to assess the association between vitamin D levels and disease severity.

METHODS

Serum levels of 25OHD3 in 121 patients with systemic lupus erythematosus (SLE) and 150 healthy controls were measured by electrochemiluminescence immunoassay. Data regarding demographics and clinical parameters were collected. Disease activity of SLE was evaluated according to the SLE Disease Activity Index (SLEDAI) score and irreversible organ damage by the Systemic Lupus International Collaborating Clinic/American College of Rheumatology, SLICC/ACR Damage Index (SDI). The multivariate logistic regression model was used to investigate the association between the degree of vitamin D deficiency and SLEDAI or SDI scores.

RESULTS

The prevalence of vitamin D insufficiency (25OHD3 <30 ng/ml) and severe deficiency (25OHD3 <10 ng/ml) in SLE patients was 62.81% and 34.71%, respectively. Logistic regression analysis indicated that the cut-off point of 25OHD3 concentration was 10 ng/ml where its level was correlated with increased SLEDAI (OR 6.420, p = 0.006), but not with the SDI. In addition, hydroxychloroquine treatment lowered the SLEDAI increased by the severe 25OHD3 deficiency (OR 0.280, p = 0.008). Moreover, long disease duration (OR 1.014, p = 0.008) predicted moderate to severe organ damage.

CONCLUSIONS

Vitamin D deficiency is highly prevalent in patients with SLE. Severe deficiency increases the risk for moderate to severe disease activity, but not for organ damage.

摘要

目的

我们旨在调查中国狼疮患者维生素D缺乏的患病率,并评估维生素D水平与疾病严重程度之间的关联。

方法

采用电化学发光免疫分析法检测121例系统性红斑狼疮(SLE)患者和150例健康对照者的血清25OHD3水平。收集人口统计学和临床参数数据。根据SLE疾病活动指数(SLEDAI)评分评估SLE的疾病活动度,并根据系统性红斑狼疮国际协作诊所/美国风湿病学会(SLICC/ACR)损伤指数(SDI)评估不可逆器官损伤。采用多因素逻辑回归模型研究维生素D缺乏程度与SLEDAI或SDI评分之间的关联。

结果

SLE患者维生素D不足(25OHD3<30 ng/ml)和严重缺乏(25OHD3<10 ng/ml)的患病率分别为62.81%和34.71%。逻辑回归分析表明,25OHD3浓度的截断点为10 ng/ml,此时其水平与SLEDAI升高相关(比值比6.420,p = 0.006),但与SDI无关。此外,羟氯喹治疗降低了严重25OHD3缺乏导致的SLEDAI升高(比值比0.280,p = 0.008)。此外,病程长(比值比1.014,p = 0.008)预示着中度至重度器官损伤。

结论

SLE患者中维生素D缺乏非常普遍。严重缺乏会增加中度至重度疾病活动的风险,但不会增加器官损伤的风险。

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