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重型β地中海贫血患儿25-羟基维生素D与血脂谱的相关性

Correlation between 25-Hydroxyvitamin D and Lipid Profile among Children with Beta Thalassemia Major.

作者信息

Nasir Christian, Rosdiana Nelly, Lubis Aridamuriany Dwiputri

机构信息

Department of Child Health, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia.

出版信息

Open Access Maced J Med Sci. 2018 Oct 5;6(10):1790-1794. doi: 10.3889/oamjms.2018.388. eCollection 2018 Oct 25.

Abstract

BACKGROUND

Beta thalassemia major is associated with lipid profile abnormalities, presented as a lower level of total cholesterol (TC), low-density lipoproteins (LDL), high-density lipoprotein (HDL), and higher triglyceride level; increasing risk for cardiovascular complications. The previous studies indicated that Vitamin D give a positive impact on the lipid profile in healthy children population. However, its role needs to be determined in a high-risk group of children with beta-thalassemia major.

AIM

To determine the correlation between vitamin D (25-OHD) and lipid profile among children with beta-thalassemia major.

METHODS

A cross-sectional study was conducted in a general tertiary hospital in Medan, Sumatera Utara, Indonesia from January to March 2018. Subjects were children aged below 18-year-old with beta-thalassemia major. The measurement of vitamin D (25-OHD) level and 10-12 hour overnight fasting serum lipid profile including total cholesterol, triglyceride, HDL, and LDL were performed. The analysis was done using Pearson's correlation and Fisher test. P value < 0.05 was considered significant.

RESULTS

Forty-five subjects were enrolled in this study, with serum ferritin level ranged from 1017 to 13372 ng/mL. The prevalence of vitamin D deficiency (a 25-OHD level less than 20 ng/mL) in this study was 40%, with mean value at 20.6 (SD 5.3) ng/mL. The markers for cardiovascular risk were observed to be elevated, both in Atherogenic Index Plasma (0.32 ± 0.25) and TC: HDL ratio (4.2 ± 1.5). Statistical analysis revealed that Vitamin D had positive correlation with total cholesterol (r = 0.302, p = 0.044) and HDL (r = 0.297, p = 0.048). There was no significant correlation between both vitamin D and triglyceride (p = 0.305), or vitamin D and LDL (p = 0.727).

CONCLUSION

Vitamin D correlated positively with total cholesterol and HDL in children with beta-thalassemia major. Positive correlation to HDL indicated a beneficial effect of vitamin D to reduce the risk of cardiovascular complication.

摘要

背景

重型β地中海贫血与脂质谱异常有关,表现为总胆固醇(TC)、低密度脂蛋白(LDL)水平降低,高密度脂蛋白(HDL)水平降低,甘油三酯水平升高;心血管并发症风险增加。先前的研究表明,维生素D对健康儿童群体的脂质谱有积极影响。然而,其在重型β地中海贫血高危儿童群体中的作用尚需确定。

目的

确定重型β地中海贫血患儿维生素D(25-OHD)与脂质谱之间的相关性。

方法

2018年1月至3月在印度尼西亚北苏门答腊棉兰的一家综合三级医院进行了一项横断面研究。研究对象为18岁以下的重型β地中海贫血患儿。检测维生素D(25-OHD)水平以及禁食10 - 12小时后的血清脂质谱,包括总胆固醇、甘油三酯、HDL和LDL。采用Pearson相关性分析和Fisher检验进行分析。P值<0.05被认为具有统计学意义。

结果

本研究共纳入45名受试者,血清铁蛋白水平在1017至13372 ng/mL之间。本研究中维生素D缺乏(25-OHD水平低于20 ng/mL)的患病率为40%,平均值为20.6(标准差5.3)ng/mL。观察到心血管风险标志物升高,动脉粥样硬化指数血浆(0.32±0.25)和TC:HDL比值(4.2±1.5)均升高。统计分析显示,维生素D与总胆固醇(r = 0.302,p = 0.044)和HDL(r = 0.297,p = 0.048)呈正相关。维生素D与甘油三酯(p = 0.305)或维生素D与LDL(p = 0.727)之间无显著相关性。

结论

重型β地中海贫血患儿维生素D与总胆固醇和HDL呈正相关。与HDL的正相关表明维生素D对降低心血管并发症风险具有有益作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/98d9/6236037/aff0819f66eb/OAMJMS-6-1790-g001.jpg

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