维生素 D 缺乏与中国人 COVID-19 发病率和疾病严重程度相关 [已更正]。
Vitamin D Deficiency Is Associated with COVID-19 Incidence and Disease Severity in Chinese People [corrected].
机构信息
Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
出版信息
J Nutr. 2021 Jan 4;151(1):98-103. doi: 10.1093/jn/nxaa332.
BACKGROUND
Vitamin D might have beneficial potential in influencing the natural history of the coronavirus disease 2019 (COVID-19) due to its immunomodulatory and anti-inflammatory properties.
OBJECTIVE
The aim was to investigate whether vitamin D deficiency is associated with COVID-19 incidence and disease severity in Chinese people.
METHODS
In a cross-sectional study we retrospectively analyzed 335 COVID-19 patients (median: 56.0; IQR: 43.0-64.0 y) who were admitted to the Wuhan Tongji Hospital between 27 February and 21 March 2020. We also included an age- and sex-matched population of 560 individuals (median: 55; IQR: 49.0-60.0 y) who underwent the physical examination program. Their serum 25-hydroxyvitamin D [25(OH)D] concentrations were measured during the same period from 2018-2019. Serum 25(OH)D concentrations were measured for all COVID-19 patients on admission. Severity of COVID-19 was determined based on the level of respiratory involvement. A general linear model with adjustment for covariates was used to compare 25(OH)D concentrations between the COVID-19 and 2018-2019 control groups. Adjusted ORs with 95% CIs for associations between vitamin D status and COVID-19 severity were estimated via multivariable logistic regression.
RESULTS
In the general linear model adjusted for age, sex, comorbidities, and BMI, serum 25(OH)D concentrations were significantly lower among COVID-19 patients than the 2018-2019 controls [ln transformed values of 3.32 ± 0.04 vs. 3.46 ± 0.022 ln (nmol/L), P = 0.014]. Multivariable logistic regression showed that male sex (OR: 2.26; 95% CI: 1.06, 4.82), advanced age (≥65 y) (OR: 4.93; 95% CI: 1.44, 16.9), and vitamin D deficiency (<30 nmol/L) (OR: 2.72; 95% CI: 1.23, 6.01) were significantly associated with COVID-19 severity (all P < 0.05).
CONCLUSIONS
These findings suggested that vitamin D deficiency impacts COVID-19 hospitalization and severity in the Chinese population.
背景
由于维生素 D 具有免疫调节和抗炎特性，因此它可能对影响 2019 年冠状病毒病（COVID-19）的自然病史具有有益的潜力。
目的
本研究旨在调查中国人维生素 D 缺乏是否与 COVID-19 发病率和疾病严重程度相关。
方法
采用回顾性队列研究，分析 2020 年 2 月 27 日至 3 月 21 日期间入住武汉同济医院的 335 例 COVID-19 患者（中位数：56.0；IQR：43.0-64.0 岁）的临床资料。同时纳入了 2018-2019 年期间进行体检的 560 名年龄和性别匹配的个体（中位数：55；IQR：49.0-60.0 岁）。在此期间，检测了他们的血清 25-羟维生素 D [25(OH)D] 浓度。所有 COVID-19 患者入院时均检测血清 25(OH)D 浓度。根据呼吸受累程度确定 COVID-19 的严重程度。采用协方差调整的一般线性模型比较 COVID-19 组和 2018-2019 对照组之间的 25(OH)D 浓度。采用多变量 logistic 回归估计维生素 D 状态与 COVID-19 严重程度之间的关联的调整比值比（OR）及其 95%置信区间（CI）。
结果
在调整年龄、性别、合并症和 BMI 的一般线性模型中，COVID-19 患者的血清 25(OH)D 浓度明显低于 2018-2019 对照组[ln 转换值 3.32±0.04 与 3.46±0.022ln（nmol/L），P=0.014]。多变量 logistic 回归显示，男性（OR：2.26；95%CI：1.06，4.82）、高龄（≥65 岁）（OR：4.93；95%CI：1.44，16.9）和维生素 D 缺乏症（＜30nmol/L）（OR：2.72；95%CI：1.23，6.01）与 COVID-19 严重程度显著相关（均 P＜0.05）。
结论
这些发现表明，维生素 D 缺乏症影响中国人群 COVID-19 的住院和严重程度。
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