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炎症性肠病患儿的维生素 D:一项随机对照临床试验。

Vitamin D in Children With Inflammatory Bowel Disease: A Randomized Controlled Clinical Trial.

机构信息

Pediatric Department.

Tropical Medicine Department.

出版信息

J Clin Gastroenterol. 2021 Oct 1;55(9):815-820. doi: 10.1097/MCG.0000000000001443.

Abstract

BACKGROUND

Vitamin D has anti-inflammatory and immune regulatory functions.

GOALS

The authors investigated the effect of vitamin D supplementation in children with inflammatory bowel disease (IBD) and hypovitaminosis D on disease activity, quality of life (QOL), inflammatory markers, and cytokines.

STUDY

This randomized double-blinded controlled clinical trial included 120 children with IBD and hypovitaminosis D; 22 of them were excluded later. Patients were randomized to receive either oral vitamin D3 in a dose of 2000 IU/day or placebo for 6 months. The primary outcome was to evaluate the effect of vitamin D supplementation on the IBD activity score. The secondary outcomes were to assess the QOL, inflammatory markers, cytokines, the safety of vitamin D, and to correlate serum vitamin D level with various clinical and laboratory variables.

RESULTS

Vitamin D supplementation significantly decreased the IBD activity score in the vitamin D group compared with the placebo group. Moreover, QOL significantly improved after vitamin D supplementation. Inflammatory markers, for example, erythrocyte sedimentation rate, C-reactive protein, and fecal calprotectin and interleukin-2 IL-12, IL-17, IL-23, and tumor necrosis factor-alpha significantly decreased in the vitamin D group. However, IL-10 significantly increased after vitamin D supplementation. Vitamin D was significantly inversely correlated with the activity score, QOL score, levels of all inflammatory markers, the frequency of hospitalization, and emergency department visits.

CONCLUSION

Vitamin D supplementation may have a beneficial effect in children with IBD.

摘要

背景

维生素 D 具有抗炎和免疫调节功能。

目的

作者研究了补充维生素 D 对炎症性肠病(IBD)和维生素 D 缺乏儿童的疾病活动、生活质量(QOL)、炎症标志物和细胞因子的影响。

研究

这是一项随机双盲对照临床试验,纳入了 120 例 IBD 和维生素 D 缺乏的儿童;其中 22 例后来被排除。患者被随机分为口服维生素 D3 组(剂量为 2000IU/天)或安慰剂组,疗程为 6 个月。主要结局是评估维生素 D 补充对 IBD 活动评分的影响。次要结局是评估 QOL、炎症标志物、细胞因子、维生素 D 的安全性,并将血清维生素 D 水平与各种临床和实验室变量相关联。

结果

与安慰剂组相比,维生素 D 补充组的 IBD 活动评分显著降低。此外,维生素 D 补充后 QOL 显著改善。炎症标志物,如红细胞沉降率、C 反应蛋白和粪便钙卫蛋白以及白细胞介素-2(IL-2)、IL-12、IL-17、IL-23 和肿瘤坏死因子-α(TNF-α),在维生素 D 组显著降低。然而,IL-10 在维生素 D 补充后显著增加。维生素 D 与活动评分、QOL 评分、所有炎症标志物水平、住院频率和急诊科就诊次数呈显著负相关。

结论

维生素 D 补充可能对 IBD 儿童有益。

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