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维生素D对一家三级护理中心收治的克罗恩病患者住院率的影响。

Impact of vitamin D on the hospitalization rate of Crohn's disease patients seen at a tertiary care center.

作者信息

Venkata Krishna V R, Arora Sumant S, Xie Feng-Long, Malik Talha A

机构信息

Krishna VR Venkata, Sumant S Arora, Department of Internal Medicine, University of Alabama at Birmingham Montgomery Health Center, Montgomery, AL 36116, United States.

出版信息

World J Gastroenterol. 2017 Apr 14;23(14):2539-2544. doi: 10.3748/wjg.v23.i14.2539.

Abstract

AIM

To study the association between vitamin D level and hospitalization rate in Crohn's disease (CD) patients.

METHODS

We designed a retrospective cohort study using adult patients (> 19 years) with CD followed for at least one year at our inflammatory bowel disease center. Vitamin D levels were divided into: low mean vitamin D level (< 30 ng/mL) appropriate mean vitamin D level (30-100 ng/mL). Generalized Poisson Regression Models (GPR) for Rate Data were used to estimate partially adjusted and fully adjusted incidence rate ratios (IRR) of hospitalization among CD patients. We also examined IRRs for vitamin D level as a continuous variable.

RESULTS

Of the 880 CD patients, 196 patients with vitamin D level during the observation period were included. Partially adjusted model demonstrated that CD patients with a low mean vitamin D level were almost twice more likely to be admitted (IRR = 1.76, 95%CI: 1.38-2.24) compared to those with an appropriate vitamin D level. The fully adjusted model confirmed this association (IRR = 1.44, 95%CI: 1.11-1.87). Partially adjusted model with vitamin D level as a continuous variable demonstrated, higher mean vitamin D level was associated with a 3% lower likelihood of admission with every unit (ng/mL) rise in mean vitamin D level (IRR = 0.97, 95%CI: 0.96-0.98). The fully adjusted model confirmed this association (IRR = 0.98, 95%CI: 0.97-0.99).

CONCLUSION

Normal or adequate vitamin D stores may be protective in the clinical course of CD. However, this role needs to be further characterized and understood.

摘要

目的

研究克罗恩病(CD)患者维生素D水平与住院率之间的关联。

方法

我们设计了一项回顾性队列研究,纳入在我们炎症性肠病中心随访至少一年的成年CD患者(>19岁)。维生素D水平分为:低平均维生素D水平(<30 ng/mL)、适当平均维生素D水平(30 - 100 ng/mL)。使用针对率数据的广义泊松回归模型(GPR)来估计CD患者住院的部分调整和完全调整发病率比(IRR)。我们还将维生素D水平作为连续变量检查IRR。

结果

在880例CD患者中,纳入了196例在观察期内有维生素D水平记录的患者。部分调整模型显示,与维生素D水平适当的患者相比,平均维生素D水平低的CD患者入院可能性几乎高出两倍(IRR = 1.76,95%CI:1.38 - 2.24)。完全调整模型证实了这种关联(IRR = 1.44,95%CI:1.11 - 1.87)。将维生素D水平作为连续变量的部分调整模型显示,平均维生素D水平每升高一个单位(ng/mL),入院可能性降低3%(IRR = 0.97,95%CI:0.96 - 0.98)。完全调整模型证实了这种关联(IRR = 0.98,95%CI:0.97 - 0.99)。

结论

正常或充足的维生素D储备可能在CD临床病程中具有保护作用。然而这一作用需要进一步明确和理解。

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Optimal vitamin D levels in Crohn's disease: a review.克罗恩病的最佳维生素 D 水平:综述。
Proc Nutr Soc. 2015 Feb;74(1):56-66. doi: 10.1017/S0029665114001591. Epub 2014 Dec 11.
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The vitamin D status in inflammatory bowel disease.炎症性肠病中的维生素D状况。
PLoS One. 2014 Jul 3;9(7):e101583. doi: 10.1371/journal.pone.0101583. eCollection 2014.
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Review article: vitamin D and inflammatory bowel diseases.综述文章:维生素 D 与炎症性肠病。
Aliment Pharmacol Ther. 2014 Jan;39(2):125-36. doi: 10.1111/apt.12553. Epub 2013 Nov 17.

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