接受全膝关节置换术患者的维生素 D 缺乏患病率：倾向评分匹配分析。
The Prevalence of Vitamin D Deficiency in Patients Undergoing Total Knee Arthroplasty: A Propensity Score Matching Analysis.
机构信息
Department of Orthopaedic Surgery, Ulsan University Hospital, University of Ulsan College of Medicine, 877 Bangeojinsunhwando-ro, Dong-gu, Ulsan, 44033, Republic of Korea.
Department of Orthopaedic Surgery, Dongcheondongkang Hospital, Ulsan, Republic of Korea.
出版信息
Arch Osteoporos. 2022 Mar 23;17(1):53. doi: 10.1007/s11657-022-01097-7.
PURPOSE
We investigated and compared the serum 25-OH vitamin D [25(OH)D] level and prevalence of vitamin D deficiency (VDD) between patients who underwent total knee arthroplasty (TKA) and healthy participants through a matched analysis.
METHODS
The unmatched case group consisted of 824 patients who underwent TKA and the unmatched control group 2,794 healthy participants examined at our institution. The control group was matched on the various characteristics-sex, age, weight, body mass index (BMI), blood chemistry, and season of sampling-through propensity score matching (PSM). After PSM, 501 and 721 patients were matched in the case and control group, respectively. Levels of blood chemistry including 25(OH)D were examined and VDD was defined as < 20 ng/mL.
RESULTS
The average serum 25(OH)D level was significantly lower in the OA group (15.3 ng/mL) than that in the control group (19.9 ng/mL, p < 0.001). When categorized using a 20 ng/mL cutoff, the VDD prevalence was 75.0% in the OA group and 59.4% in the control group. The prevalence of vitamin D insufficiency was 18.4% in the OA group and 24.5% in the control group. The prevalence of vitamin D sufficiency was 6.8% in the OA group and 15.9% in the control group (p < 0.001).
CONCLUSIONS
The patients who underwent TKA had lower serum 25(OH)D level and higher VDD prevalence compared to the healthy participants who matched using PSM. There were no differences in VDD rates by sex or obesity and the VDD prevalence was more than 70% during all season. Therefore, in patients undergoing TKA, general attention to VDD is required regardless of sex, obesity, and season. Serum 25-OH vitamin D [25(OH)D] level and vitamin D deficiency (VDD) prevalence were compared between patients undergoing total knee arthroplasty and healthy individuals. The differences in serum 25(OH)D level and VDD prevalence were significant between the two groups after propensity score matching.
目的
通过匹配分析，研究并比较了行全膝关节置换术（TKA）患者与健康参与者的血清 25-羟维生素 D [25（OH）D]水平和维生素 D 缺乏症（VDD）的患病率。
方法
未匹配的病例组包括 824 例行 TKA 的患者，未匹配的对照组包括 2794 名在我院检查的健康参与者。通过倾向评分匹配（PSM），对照组在性别、年龄、体重、体重指数（BMI）、血液化学和采样季节等特征方面与病例组进行匹配。PSM 后，病例组和对照组分别匹配了 501 例和 721 例患者。检查了包括 25（OH）D 在内的血液化学水平，将 VDD 定义为<20ng/mL。
结果
OA 组的平均血清 25（OH）D 水平明显低于对照组（15.3ng/mL）（p<0.001）。当使用 20ng/mL 作为截断值进行分类时，OA 组 VDD 患病率为 75.0%，对照组为 59.4%。OA 组维生素 D 不足的患病率为 18.4%，对照组为 24.5%。OA 组维生素 D 充足的患病率为 6.8%，对照组为 15.9%（p<0.001）。
结论
与使用 PSM 匹配的健康参与者相比，行 TKA 的患者血清 25（OH）D 水平较低，VDD 患病率较高。VDD 发生率与性别或肥胖无关，所有季节的 VDD 患病率均超过 70%。因此，在接受 TKA 的患者中，无论性别、肥胖和季节如何，都需要普遍关注 VDD。
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