维持性血液透析患者血清维生素 D 水平与健康相关生活质量的关系。

Relationship between Serum Vitamin D Levels and Health-Related Quality of Life in Maintenance Hemodialysis Patients.

机构信息

Department of Nephrology, Faculty of Medicine, Erzincan University, Erzincan, Turkey,

Department of Internal Medicine, Faculty of Medicine, Erzincan, Turkey.

出版信息

Blood Purif. 2019;48(1):67-75. doi: 10.1159/000497242. Epub 2019 Feb 21.

DOI:10.1159/000497242

PMID:30799428

Abstract

OBJECTIVES

Aim of the study was investigating the effect of serum vitamin D levels on health-related quality of life in hemodialysis patients.

METHOD

One-hundred and twenty-three maintenance hemodialysis patients were enrolled in this cross-sectional study. Patients divided into 2 groups according to serum vitamin D levels. A serum 25-hydroxyvitamin D (25[OH] D) level of < 20 ng/mL was identified as vitamin D deficiency (n = 78), and a serum level of ≥20 ng/mL was identified as normal (n = 45). Kidney Disease Quality of Life 36 (KDQOL-36) survey was used for quality of life measurement. Scores of the all of 5 subscales of KDQOL-36 were calculated. Multiple linear regression analyses were used to define independent risk factors affecting the survey.

RESULTS

Mean age of patients was 62 and 56% of patients were male. Mean 25(OH) D levels were 11.86 and 29.57 ng/mL, respectively, in 2 groups. There was statistically significant difference between age and Kt/V levels between 2 groups (p = 0.008 and p = 0.041). Age and gender were found as significant predictors of vitamin D deficiency (p = 0.026 and p = 0.021). In symptom and problem list subscale, gender and comorbidity were detected as independent risk factors (p = 0.050 and p = 0.032). Comorbidity was the only independent risk factor for effect of kidney disease subscale (p < 0.001). Independent risk factors associated with burden of kidney disease subscale were comorbidity and serum 25 (OH) D levels (p = 0.003 and p = 0.023). Serum 25(OH) D, gender, and comorbidity were independently associated with physical component summary (PCS) subscale (p < 0.001, p = 0.008, and p = 0.011). The only independently associated factor with mental component summary (MCS) was serum 25(OH) D (p < 0.001).

CONCLUSION

We first showed the relationship between serum vitamin D levels and KDQOL-36 in hemodialysis patients. Lower serum vitamin D levels were negatively associated with burden of kidney disease, PCS, and MCS subscales.

摘要

目的

本研究旨在探讨血清维生素 D 水平对血液透析患者健康相关生活质量的影响。

方法

本横断面研究纳入了 123 名维持性血液透析患者。根据血清维生素 D 水平将患者分为 2 组。血清 25-羟维生素 D（25[OH] D）水平<20ng/ml 定义为维生素 D 缺乏（n=78），血清水平≥20ng/ml 定义为正常（n=45）。采用肾脏病生活质量量表 36（KDQOL-36）对生活质量进行测量。计算所有 5 个 KDQOL-36 亚量表的得分。采用多元线性回归分析定义影响调查的独立危险因素。

结果

患者的平均年龄为 62 岁，56%为男性。两组的平均 25（OH）D 水平分别为 11.86 和 29.57ng/ml，两组间年龄和 Kt/V 水平存在统计学差异（p=0.008 和 p=0.041）。年龄和性别是维生素 D 缺乏的显著预测因素（p=0.026 和 p=0.021）。在症状和问题列表亚量表中，性别和合并症是独立的危险因素（p=0.050 和 p=0.032）。合并症是肾脏病亚量表的唯一独立危险因素（p<0.001）。与肾脏病负担亚量表相关的独立危险因素是合并症和血清 25（OH）D 水平（p=0.003 和 p=0.023）。血清 25（OH）D、性别和合并症与身体成分综合评分（PCS）亚量表独立相关（p<0.001、p=0.008 和 p=0.011）。与心理成分综合评分（MCS）唯一相关的独立因素是血清 25（OH）D（p<0.001）。