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维生素 D 水平在评估克罗恩病活动度及其与营养状况和炎症的关系。

Vitamin D levels in the assessment of Crohn's disease activity and their relation to nutritional status and inflammation.

机构信息

Department of Nutrition, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China.

Department of Clinical Medicine, The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China.

出版信息

J Hum Nutr Diet. 2023 Aug;36(4):1159-1169. doi: 10.1111/jhn.13139. Epub 2023 Feb 13.

Abstract

BACKGROUND

Crohn's disease (CD) is frequently associated with malnutrition, inflammation and a deficiency of vitamin D (VD) with the relationships between these symptoms being poorly defined. VD is a modulator of the immune system and is associated with the onset of CD and disease activity. The level of serum VD may have potential in the assessment of CD activity. This study aimed to evaluate the relationships between VD, nutritional status and inflammation, and to identify more accurate VD thresholds.

METHODS

The study included 76 outpatients with CD diagnosed between October 2018 and October 2020 and 76 healthy volunteers. Levels of serum 25(OH)D and nutritional indicators, as well as biochemical and disease activity assessments, were conducted.

RESULTS

Patients with CD and healthy participants were found to differ significantly in their 25(OH)D levels as well in levels of nutritional and inflammatory indicators. The optimal VD cut-off value was found to be 46.81 nmol/L for CD development and 35.32 nmol/L for disease activity. Levels of 25(OH)D were correlated with both nutritional status and inflammation.

CONCLUSIONS

The VD level is likely to be a useful additional tool in the evaluation of CD patients and predicting the disease activity and clinical response. The VD level may relate both to the nutritional status and levels of inflammation in CD patients, and disease progression.

摘要

背景

克罗恩病(CD)常伴有营养不良、炎症和维生素 D(VD)缺乏,这些症状之间的关系尚未明确。VD 是免疫系统的调节剂,与 CD 的发病和疾病活动有关。血清 VD 水平可能对评估 CD 活动具有潜在价值。本研究旨在评估 VD、营养状况和炎症之间的关系,并确定更准确的 VD 阈值。

方法

该研究纳入了 2018 年 10 月至 2020 年 10 月期间诊断为 CD 的 76 例门诊患者和 76 名健康志愿者。检测了血清 25(OH)D 水平和营养指标以及生化和疾病活动评估。

结果

CD 患者与健康参与者的血清 25(OH)D 水平以及营养和炎症指标水平存在显著差异。发现 VD 最佳截断值为 46.81 nmol/L 时用于 CD 发病,为 35.32 nmol/L 时用于疾病活动。25(OH)D 水平与营养状况和炎症水平均相关。

结论

VD 水平可能是评估 CD 患者和预测疾病活动和临床反应的有用附加工具。VD 水平可能与 CD 患者的营养状况和炎症水平以及疾病进展有关。

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