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维生素 D 状态与印度 IgA 肾病患者疾病严重程度和结局的关联。

Association of vitamin D status with disease severity and outcome in Indian patients with IgA nephropathy.

机构信息

All India Institute of Medical Sciences, New Delhi, India.

Department of Nephrology, All India Institute of Medical Sciences, New Delhi, India.

出版信息

BMC Nephrol. 2023 Jan 17;24(1):15. doi: 10.1186/s12882-023-03061-0.

Abstract

BACKGROUND

Vitamin D deficiency has been examined as a risk factor for severity and progression of kidney disease due to its immunomodulatory effects. There is paucity of data about its impact in IgA nephropathy (IgAN).

METHODS

In a retrospective cohort study, 25 (OH) vitamin D assay was performed in bio-banked baseline serum samples collected during kidney biopsy of 105 adult patients with primary IgAN diagnosed between 2015 and 2019. A level of < 10 ng/mL was defined as Vitamin D deficiency.

RESULTS

Mean age of patients was 34 ± 10.6 years, 69.5% were males. Mean baseline 25(OH) Vitamin D levels was 15.9 ± 11.9 ng/mL and 41(39%) patients had vitamin D deficiency. Serum albumin level was lower in vitamin D deficient patients compared to those who had higher vitamin D levels (3.7 ± 0.9 vs 4.1 ± 0.7 g/dl, p = 0.018)but there was no significant difference in baseline proteinuria and eGFR. Crescentic lesions were more frequent in vitamin D deficient group (19.5% vs 6.3%, p = 0.022). At median follow up of 21.5 months (6 - 56 months), there was no difference in remission (68.3% vs 65.6%, p = 0.777) and disease progression (12.5% vs 9.4%, p = 0.614) in those with and without Vitamin D deficiency respectively. On multivariate cox proportional hazard analysis, vitamin D deficiency was not a significant risk factor for renal survival (HR-1.79, 95% confidence interval:0.50-6.34, p = 0.368).

CONCLUSION

There was no association between vitamin D deficiency and disease profile as well as renal outcome in Indian patients with IgAN.

摘要

背景

由于维生素 D 具有免疫调节作用,因此人们研究了其缺乏是否会成为导致肾病严重程度和进展的一个风险因素。然而,关于其在 IgA 肾病(IgAN)中的影响的数据却很少。

方法

在一项回顾性队列研究中,对 2015 年至 2019 年间在肾脏活检时采集的 105 名原发性 IgAN 成年患者的生物库基线血清样本进行了 25(OH)维生素 D 检测。将血清水平<10ng/ml 定义为维生素 D 缺乏。

结果

患者的平均年龄为 34±10.6 岁,69.5%为男性。平均基线 25(OH) 维生素 D 水平为 15.9±11.9ng/ml,41(39%)名患者存在维生素 D 缺乏。与维生素 D 水平较高的患者相比,维生素 D 缺乏患者的血清白蛋白水平更低(3.7±0.9 与 4.1±0.7g/dl,p=0.018),但两组间基线蛋白尿和 eGFR 无显著差异。维生素 D 缺乏组新月体病变更为常见(19.5%比 6.3%,p=0.022)。在中位随访 21.5 个月(6-56 个月)时,维生素 D 缺乏组和不缺乏组的缓解率(分别为 68.3%和 65.6%,p=0.777)和疾病进展率(分别为 12.5%和 9.4%,p=0.614)均无差异。多变量 Cox 比例风险分析显示,维生素 D 缺乏不是肾脏生存的显著危险因素(HR-1.79,95%置信区间:0.50-6.34,p=0.368)。

结论

在印度 IgAN 患者中,维生素 D 缺乏与疾病特征及肾脏预后均无关联。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/521a/9843909/06dcca07756e/12882_2023_3061_Fig1_HTML.jpg

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