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血清25-羟维生素D水平对良性阵发性位置性眩晕成功复位后短期残留头晕风险的影响,按性别和发病年龄分层

Effect of the serum 25-hydroxyvitamin D level on risk for short-term residual dizziness after successful repositioning in benign paroxysmal positional vertigo stratified by sex and onset age.

作者信息

Wu Jing, Jiang Chun-Yan, Bai Ying-Xia, Xu Qian, Sun Xu-Hong, Pan Hui, Shu Liang, Liu Jian-Ren, Chen Wei

机构信息

Department of Neurology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Department of Neurology, Huangpu Branch, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

出版信息

Front Neurol. 2023 Mar 31;14:1144958. doi: 10.3389/fneur.2023.1144958. eCollection 2023.

Abstract

OBJECTIVE

A low serum 25-hydroxyvitamin D (25(OH)D) level is relevant to both the occurrence and recurrence of benign paroxysmal positional vertigo (BPPV). However, whether it also contributes to residual dizziness (RD) after successful repositioning maneuvers is unknown. Therefore, this study aimed to explore the correlation between the serum 25(OH)D level and short-term RD severity in patients with BPPV after successful repositioning maneuvers.

METHODS

In total, 251 patients with BPPV after successful repositioning were enrolled and prospectively followed up for 1 week (W1). Serum 25(OH)D values were detected by chemiluminescence immunoassay at enrollment (W0). In addition, we explored the relationship between 25(OH)D values at baseline and RD severity at W1 in different subgroups stratified by sex and onset age (early-onset, ≤50 years; late-onset, >50 years).

RESULTS

The serum 25(OH)D level of female patients was significantly lower than that of male patients (15.9 ± 6.8 vs. 19.8 ± 6.6 ng/ml, < 0.001). Its level also decreased in early-onset patients compared to late-onset ones (15.3 ± 5.9 vs. 18.0 ± 7.3 ng/ml, = 0.003). In addition, early-onset female patients had lower 25(OH)D values than late-onset female patients (14.0 ± 5.5 vs. 17.1 ± 7.2 ng/ml, = 0.004). However, this difference was not observed between early- and late-onset male patients. Among early-onset female patients, the 25(OH)D values of the moderate-to-severe RD group were lower than those of the minor or no RD group (10.9 ± 3.3 vs. 14.7 ± 5.7 vs. 15.0 ± 5.9 ng/ml, = 0.046). Multivariate analysis found that decreased 25(OH)D values were related to the occurrence of moderate-to-severe RD in early-onset female patients (OR = 0.801; = 0.022). This effect did not exist in late-onset female or male patients with BPPV.

CONCLUSIONS

Age and sex differences in serum 25(OH)D levels exist in patients with BPPV. A decreased 25(OH)D level in early-onset female patients may increase the odds of moderate-to-severe RD 1 week after successful repositioning maneuvers.

摘要

目的

血清25-羟基维生素D(25(OH)D)水平低下与良性阵发性位置性眩晕(BPPV)的发生和复发均相关。然而,其是否也与复位治疗成功后的残余头晕(RD)有关尚不清楚。因此,本研究旨在探讨BPPV患者复位治疗成功后血清25(OH)D水平与短期RD严重程度之间的相关性。

方法

共纳入251例复位治疗成功后的BPPV患者,并对其进行为期1周(W1)的前瞻性随访。在入组时(W0)采用化学发光免疫分析法检测血清25(OH)D值。此外,我们还探讨了按性别和发病年龄分层的不同亚组(早发型,≤50岁;晚发型,>50岁)中基线时的25(OH)D值与W1时RD严重程度之间的关系。

结果

女性患者的血清25(OH)D水平显著低于男性患者(15.9±6.8 vs. 19.8±6.6 ng/ml,<0.001)。早发型患者的血清25(OH)D水平也低于晚发型患者(15.3±5.9 vs. 18.0±7.3 ng/ml,=0.003)。此外,早发型女性患者的25(OH)D值低于晚发型女性患者(14.0±5.5 vs. 17.1±7.2 ng/ml,=0.004)。然而,早发型和晚发型男性患者之间未观察到这种差异。在早发型女性患者中,中重度RD组的25(OH)D值低于轻度或无RD组(10.9±3.3 vs. 14.7±5.7 vs. 15.0±5.9 ng/ml,=0.046)。多因素分析发现,25(OH)D值降低与早发型女性患者中重度RD的发生有关(OR=0.801;=0.022)。这种效应在晚发型女性或男性BPPV患者中不存在。

结论

BPPV患者血清25(OH)D水平存在年龄和性别差异。早发型女性患者25(OH)D水平降低可能会增加复位治疗成功后1周出现中重度RD的几率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f9c5/10102369/ac19acb7e44f/fneur-14-1144958-g0001.jpg

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