Papanikolaou Ilias C, Tabila Brian, Tabila Kristina, Borok Zea, Sharma Om, Gould Michael K
Division of Pulmonary, Critical Care and Sleep Medicine, Keck School of Medicine, University of Southern California, USA.
Department of Pulmonary Medicine, Corfu General Hospital, Greece.
Sarcoidosis Vasc Diffuse Lung Dis. 2018;35(2):154-159. doi: 10.36141/svdld.v35i2.6199. Epub 2018 Apr 28.
Hypercalcemia, a common feature in sarcoidosis, is due to the excessive production of active Vitamin D metabolite, 1,25(OH)D. Levels of 25(OH) Vitamin D however may not be appropriate. To assess Vitamin D status and its clinical associations in sarcoidosis patients compared to a general respiratory diseases out-patient clinic population, serving as controls. 64 sarcoidosis cases and 53 control cases with other than sarcoidosis respiratory diseases, matched for age and sex were included in the study. Serum 25(OH)D, 1,25(OH)D, calcium, angiotensin converting enzyme (ACE) were measured. 25(OH) Vitamin D was described as deficient when <20 ng/ml and insufficient when <30 ng/ml. Clinical parameters were recorded for sarcoidosis cases. Overall 41/64 sarcoidosis cases (64%) had low 25(OH) D, 7/64 (11%) had high 1,25(OH)D and 2/64 had hypercalcaemia (3%). Sarcoidosis subjects likely exhibited deficient (39%) or normal 25(OH)D levels (36%) in comparison to controls (p=0.018). 25(OH) Vitamin D deficiency in sarcoidosis was associated with race and radiological stage I disease, with regression analysis identifying African-American race as the only significant risk factor (p=0.03). An inverse correlation between ACE and 25(OH)D levels was found (p=0.052). 1,25(OH)D was significantly elevated in sarcoidosis compared to controls. Among sarcoidosis patients, those with insufficient 25(OH)D levels exhibited higher calcium levels in serum. 25(OH) Vitamin D deficiency is prevalent in sarcoidosis, particularly in African-Americans and likely those with active disease. However, concomitant 1,25(OH)D elevation and associated hypercalcaemia make Vitamin D supplementation dangerous in sarcoidosis. .
高钙血症是结节病的常见特征，其原因是活性维生素D代谢产物1,25(OH)D生成过多。然而，25(OH)维生素D的水平可能并不合适。为了评估结节病患者与作为对照的普通呼吸道疾病门诊患者相比的维生素D状态及其临床关联，本研究纳入了64例结节病患者和53例患有除结节病外的其他呼吸道疾病、年龄和性别相匹配的对照病例。检测了血清25(OH)D、1,25(OH)D、钙、血管紧张素转换酶(ACE)。当25(OH)维生素D<20 ng/ml时被描述为缺乏，<30 ng/ml时为不足。记录了结节病患者的临床参数。总体而言，64例结节病患者中有41例(64%)25(OH)D水平低，7例(11%)1,25(OH)D水平高，2例(3%)有高钙血症。与对照组相比，结节病患者可能表现出缺乏(39%)或正常(36%)的25(OH)D水平(p = 0.018)。结节病患者的25(OH)维生素D缺乏与种族和放射学I期疾病相关，回归分析确定非裔美国人种族是唯一的显著危险因素(p = 0.03)。发现ACE与25(OH)D水平呈负相关(p = 0.052)。与对照组相比，结节病患者的1,25(OH)D显著升高。在结节病患者中，25(OH)D水平不足的患者血清钙水平较高。25(OH)维生素D缺乏在结节病中很普遍，尤其是在非裔美国人以及可能患有活动性疾病的患者中。然而，1,25(OH)D同时升高及相关的高钙血症使得在结节病中补充维生素D很危险。
