Feng M, Lv J, Huang F T, Huang R, Qiu Q, Tang Y, Xu A P
Department of Nephrology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China.
Department of Gastroenterology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China.
Niger J Clin Pract. 2018 Dec;21(12):1639-1644. doi: 10.4103/njcp.njcp_158_18.
We aim to investigate the incidence and associated factors of vitamin D deficiency, a seldom reported factor, in patients with stages 1 and 2 chronic kidney disease (CKD) in southern China.
We conducted a single-center observational study. Hospitalized patients over 14 years old, who were diagnosed with stages 1 and 2 CKD and had their serum 25-hydroxyvitamin D [25 (OH) D] measured, were included. Patients were divided into vitamin D deficient and non-deficient groups depending on the cutoff serum 25 (OH) D value of 37 nmol/L. Clinical and biochemical parameters were evaluated for associated factors of vitamin D deficiency by logistic regression.
A total of 118 patients were included, of which 62 (52.5%) were vitamin D insufficient and 47 (39.8%) were vitamin D deficient. Using multivariate binary logistic regression analysis, high serum level of gamma-glutamyl transpeptidase (GGT) (OR = 5.163; 95%CI, 1.105-24.130; P = 0.037), dyslipidemia (OR = 3.083; 95%CI, 1.029-9.243; P = 0.044), 24-hour urinary protein excretion (UPE) ≥3.5 g/24 hrs (OR = 5.010; 95%CI, 1.316-19.074; P = 0.018), and treatment with glucocorticoids (OR = 2.973; 95%CI, 1.093-8.084; P = 0.033) were independently associated with vitamin D deficiency. In addition, among different types of nephropathy, minimal change disease (MCD) had the highest incidence (85.7%) of vitamin D deficiency.
Poor vitamin D status is common in patients with stages 1 and 2 CKD in southern China. The incidence of vitamin D deficiency is 39.8%. High serum GGT level, dyslipidemia, 24-hour UPE ≥3.5 g/24 hrs, and treatment with glucocorticoids are independent associated factors of vitamin D deficiency.
我们旨在调查维生素D缺乏(一个鲜有报道的因素)在中国南方1期和2期慢性肾脏病(CKD)患者中的发生率及相关因素。
我们进行了一项单中心观察性研究。纳入年龄超过14岁、被诊断为1期和2期CKD且检测了血清25-羟基维生素D [25(OH)D]的住院患者。根据血清25(OH)D值37 nmol/L这一临界值,将患者分为维生素D缺乏组和非缺乏组。通过逻辑回归分析临床和生化参数以找出维生素D缺乏的相关因素。
共纳入118例患者,其中62例(52.5%)维生素D不足,47例(39.8%)维生素D缺乏。采用多因素二元逻辑回归分析,血清γ-谷氨酰转肽酶(GGT)水平升高(OR = 5.163;95%CI,1.105 - 24.130;P = 0.037)、血脂异常(OR = 3.083;95%CI,1.029 - 9.243;P = 0.044)、24小时尿蛋白排泄量(UPE)≥3.5 g/24小时(OR = 5.010;95%CI,1.316 - 19.074;P = 0.018)以及使用糖皮质激素治疗(OR = 2.973;95%CI,1.093 - 8.084;P = 0.033)与维生素D缺乏独立相关。此外,在不同类型的肾病中,微小病变病(MCD)的维生素D缺乏发生率最高(85.7%)。
在中国南方,1期和2期CKD患者中维生素D状态不佳较为常见。维生素D缺乏的发生率为39.8%。血清GGT水平升高、血脂异常、24小时UPE≥3.5 g/24小时以及使用糖皮质激素治疗是维生素D缺乏的独立相关因素。