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1型发作性睡病中的维生素D缺乏:重新评估

Vitamin D deficiency in type 1 narcolepsy: a reappraisal.

作者信息

Dauvilliers Yves, Evangelista Elisa, Lopez Regis, Barateau Lucie, Scholz Sabine, Crastes de Paulet Barbara, Carlander Bertrand, Jaussent Isabelle

机构信息

Department of Neurology, National Reference Network for Narcolepsy, CHU Montpellier, Hôpital Gui-de-Chauliac, France; INSERM U1061, University of Montpellier 1, Montpellier, France.

Department of Neurology, National Reference Network for Narcolepsy, CHU Montpellier, Hôpital Gui-de-Chauliac, France.

出版信息

Sleep Med. 2017 Jan;29:1-6. doi: 10.1016/j.sleep.2016.05.008. Epub 2016 Sep 29.

Abstract

OBJECTIVES

Narcolepsy type 1 (NT1) is considered to be an immune-mediated disease in which environmental factors, such as vitamin D, might play a major role. The association between NT1 and vitamin D deficiency has previously been reported. The aim of this case-control study was to reassess vitamin D levels in a large clinic-based adult and paediatric population of patients with NT1 by considering several potential confounding factors.

METHODS

The serum level of 25-hydroxyvitamin D (25OHD) was measured in 174 Caucasian patients with NT1 and 174 controls. Demographic and clinical features, body mass index (BMI), Pandemrix® vaccination, age, and season at the time of blood sampling were recorded. Between-group comparisons were made using univariate and multivariate logistic regression analyses. When appropriate, interaction terms were tested using the Wald Chi-squared test.

RESULTS

Age, BMI, and season of blood sampling were different between groups. Conversely, the 25OHD level and fraction of subjects with vitamin D deficiency (serum level <75 nmol/L: 46.6% of patients vs 48.3% of controls; <50 nmol/L: 20.7% vs 17.2%) did not differ between patients with NT1 and controls. Overall, vitamin D deficiency was more frequent in men, obese subjects, and in samples collected in winter, without any association with NT1. In the patients group, no significant association was found between vitamin D deficiency, NT1 duration and severity, treatment, and Pandemrix® vaccination.

CONCLUSIONS

Vitamin D levels were not associated with NT1 in a large case-control population when potential demographic and clinical confounding factors were taken into account.

摘要

目的

1型发作性睡病(NT1)被认为是一种免疫介导的疾病,其中环境因素,如维生素D,可能起主要作用。先前已有NT1与维生素D缺乏之间关联的报道。本病例对照研究的目的是通过考虑几个潜在的混杂因素,重新评估一大群以临床为基础的成年和儿科NT1患者的维生素D水平。

方法

测量了174例白种人NT1患者和174例对照者的血清25-羟维生素D(25OHD)水平。记录了人口统计学和临床特征、体重指数(BMI)、Pandemrix®疫苗接种情况、年龄以及采血时的季节。采用单因素和多因素逻辑回归分析进行组间比较。在适当情况下,使用Wald卡方检验对交互项进行检验。

结果

两组之间的年龄、BMI和采血季节不同。相反,NT1患者和对照者之间的25OHD水平以及维生素D缺乏受试者的比例(血清水平<75 nmol/L:患者为46.6%,对照者为48.3%;<50 nmol/L:20.7%对17.2%)没有差异。总体而言,维生素D缺乏在男性、肥胖受试者以及冬季采集的样本中更为常见,与NT1无任何关联。在患者组中,未发现维生素D缺乏、NT1病程和严重程度、治疗以及Pandemrix®疫苗接种之间存在显著关联。

结论

在考虑潜在的人口统计学和临床混杂因素时,一大例对照人群中维生素D水平与NT1无关。

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