Maraj Małgorzata, Hetwer Paulina, Dumnicka Paulina, Ceranowicz Piotr, Mazur-Laskowska Małgorzata, Ząbek-Adamska Anna, Warzecha Zygmunt, Kuśnierz-Cabala Beata, Kuźniewski Marek
Jagiellonian University Medical College, Faculty of Medicine, Department of Physiology, Grzegórzecka 16 St., 31-531 Kraków, Poland.
Jagiellonian University Medical College, Faculty of Medicine, Dietetics, Anny St. 12, 31-008 Kraków, Poland.
J Clin Med. 2020 Mar 16;9(3):807. doi: 10.3390/jcm9030807.
End-stage renal disease (ESRD) patients are vulnerable to vitamin D deficiency due to impaired renal hydroxylation, low dietary intake and inadequate sun exposure. Vitamin D plays a role in innate and adaptive immunity and its seasonal variation has been linked to mortality. ESRD is associated with inadequate removal of pro-inflammatory cytokines regulating acute phase protein (APP) synthesis. Our aim was to look for associations between lifestyle factors, diet, and vitamin D seasonal variation and their relationship with selected APPs and calcium-phosphate metabolism. The study included 59 ESRD patients treated with maintenance hemodialysis. A 24-hour dietary recall was conducted in the post-summer (November 2018, PS) and post-winter (February/March 2019, PW) period, and blood was collected for the measurements of serum total vitamin D, α-acid glycoprotein (AGP), C-reactive protein (CRP), albumin, prealbumin (PRE), parathormone, calcium and phosphate. A self-constructed questionnaire gathered information on vitamin D supplementation, sun exposure and physical activity. Higher caloric intake was observed PW compared PS. Less than 15% of participants met the dietary recommendations for energy, protein, fiber, vitamin D and magnesium intake. Vitamin D supplementation was associated with higher serum vitamin D regardless of season. AGP, PRE, albumin, and vitamin D presented seasonal changes (higher values PS). In patients with serum vitamin D below 25 ng/mL, vitamin D seasonal change correlated with CRP and prealbumin change. Phosphate and Ca × P correlated positively with AGP. A low vitamin D serum level could impact the inflammatory process; however, more studies are needed to confirm the relationship.
终末期肾病（ESRD）患者由于肾脏羟化功能受损、饮食摄入不足和阳光照射不充分，易患维生素D缺乏症。维生素D在先天性和适应性免疫中发挥作用，其季节性变化与死亡率相关。ESRD与调节急性期蛋白（APP）合成的促炎细胞因子清除不足有关。我们的目的是寻找生活方式因素、饮食和维生素D季节性变化之间的关联，以及它们与选定的APP和钙磷代谢的关系。该研究纳入了59例接受维持性血液透析治疗的ESRD患者。在夏末（2018年11月，PS）和冬末（2019年2月/3月，PW）期间进行了24小时饮食回顾，并采集血液测量血清总维生素D、α-酸性糖蛋白（AGP）、C反应蛋白（CRP）、白蛋白、前白蛋白（PRE）、甲状旁腺激素、钙和磷。通过一份自行编制的问卷收集了有关维生素D补充、阳光照射和体育活动的信息。与PS相比，PW时观察到热量摄入更高。不到15%的参与者达到了能量、蛋白质、纤维、维生素D和镁摄入的饮食建议。无论季节如何，维生素D补充与较高的血清维生素D相关。AGP、PRE、白蛋白和维生素D呈现季节性变化（PS时值更高）。血清维生素D低于25 ng/mL的患者中，维生素D季节性变化与CRP和前白蛋白变化相关。磷酸盐和钙磷乘积与AGP呈正相关。低血清维生素D水平可能会影响炎症过程；然而，需要更多研究来证实这种关系。
