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慢性自身免疫性萎缩性胃炎患者维生素D缺乏的相关性:一项前瞻性研究。

Relevance of vitamin D deficiency in patients with chronic autoimmune atrophic gastritis: a prospective study.

作者信息

Massironi Sara, Cavalcoli Federica, Zilli Alessandra, Del Gobbo Alessandro, Ciafardini Clorinda, Bernasconi Susanna, Felicetta Irene, Conte Dario, Peracchi Maddalena

机构信息

Gastroenterology and Endoscopy Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.

Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy.

出版信息

BMC Gastroenterol. 2018 Nov 8;18(1):172. doi: 10.1186/s12876-018-0901-0.

Abstract

BACKGROUND

Chronic autoimmune atrophic gastritis (CAAG) is an autoimmune disease characterized by hypo/achlorhydria. A role of CAAG in the pathogenesis of nutritional deficiencies has been reported, therefore we hypothesized a possible association between CAAG and 25-OH-Vitamin D [25(OH)D] deficiency. Aim of the present study is to evaluate the prevalence of 25(OH)D deficiency in CAAG patients.

METHODS

87 CAAG patients (71 females; mean age 63.5 ± 12.8 years) followed at our Centre from January 2012 to July 2015 were consecutively evaluated. 25(OH)D, vitamin B, parathormone, and calcium were measured in all the CAAG patients. The results were compared with a control group of 1232 healthy subjects.

RESULTS

In the CAAG group the mean 25(OH)D levels were significantly lower than in the control group (18.8 vs. 27.0 ng/ml, p < 0.0001). 25(OH)D levels < 20 ng/ml was observed in 57 patients, while levels < 12.5 ng/ml in 27 patients. A significant correlation between vitamin B values at diagnosis and 25(OH)D levels was observed (r = 0.25, p = 0.01). Interestingly, the CAAG patients with moderate/severe gastric atrophy had lower 25(OH)D values as compared to those with mild atrophy (11.8 vs. 20 ng/ml; p = 0.0047). Moreover, the 25(OH)D levels were significantly lower in CAAG patients with gastric carcinoid as compared to those without gastric carcinoid (11.8 vs. 19.8 ng/ml; p = 0,0041).

CONCLUSION

Data from the present study showed a significant reduction of 25(OH)D levels in CAAG patients and a possible impairment of vitamin D absorption in CAAG may be postulated. Any implication to the genesis of gastric carcinoids remains to be elucidated.

摘要

背景

慢性自身免疫性萎缩性胃炎(CAAG)是一种以胃酸过少/无胃酸为特征的自身免疫性疾病。已有报道称CAAG在营养缺乏的发病机制中起作用,因此我们推测CAAG与25-羟基维生素D[25(OH)D]缺乏之间可能存在关联。本研究的目的是评估CAAG患者中25(OH)D缺乏的患病率。

方法

对2012年1月至2015年7月在我们中心随访的87例CAAG患者(71例女性;平均年龄63.5±12.8岁)进行连续评估。对所有CAAG患者测量25(OH)D、维生素B、甲状旁腺激素和钙。将结果与1232名健康受试者的对照组进行比较。

结果

CAAG组的平均25(OH)D水平显著低于对照组(18.8对27.0 ng/ml,p<0.0001)。57例患者的25(OH)D水平<20 ng/ml,27例患者的水平<12.5 ng/ml。观察到诊断时维生素B值与25(OH)D水平之间存在显著相关性(r=0.25,p=0.01)。有趣的是,与轻度萎缩患者相比,中度/重度胃萎缩的CAAG患者的25(OH)D值更低(11.8对20 ng/ml;p=0.0047)。此外,与无胃类癌的CAAG患者相比,有胃类癌的CAAG患者的25(OH)D水平显著更低(11.8对19.8 ng/ml;p=0.0041)。

结论

本研究数据显示CAAG患者的25(OH)D水平显著降低,可能推测CAAG患者维生素D吸收存在障碍。胃类癌发生的任何影响仍有待阐明。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2521/6225568/474e0999bab0/12876_2018_901_Fig1_HTML.jpg

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