Department of Nutrition, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, 510080, China.
The Second School of Clinical Medicine, Southern Medical University, Guangzhou, 510080, China.
Curr Med Sci. 2023 Jun;43(3):496-504. doi: 10.1007/s11596-023-2741-6. Epub 2023 May 30.
Vitamin D (VD) deficiency was reported to contribute to the progression of Crohn's disease (CD) and affect the prognosis of CD patients. This study investigated the role of serum VD, body mass index (BMI), and tumor necrosis factor alpha (TNF-α) in the diagnosis of Crohn's disease.
CD patients (n=76) and healthy subjects (n=76) were enrolled between May 2019 and December 2020. The serum 25-hydroxyvitamin D [25(OH)D] levels, BMI, and TNF-α levels, together with other biochemical parameters, were assessed before treatment. The diagnostic efficacy of the single and joint detection of serum 25(OH)D, BMI, and TNF-α was determined using receiver operating characteristic (ROC) curves.
The levels of 25(OH) D, BMI, and nutritional indicators, including hemoglobin, total protein, albumin, and high-density lipoprotein cholesterol, were much lower, and the TNF-α levels were much higher in the CD patients than in the healthy subjects (P<0.05 for all). The areas under the ROC curve for the single detection of 25(OH)D, BMI, and TNF-α were 0.887, 0.896, and 0.838, respectively, with the optimal cutoff values being 20.64 ng/mL, 19.77 kg/m, and 6.85 fmol/mL, respectively. The diagnostic efficacy of the joint detection of 25(OH)D, BMI, and TNF-α was the highest, with an area under the ROC curve of 0.988 (95%CI: 0.968-1.000).
The joint detection of 25(OH)D, TNF-α, and BMI showed high sensitivity, specificity, and accuracy in CD diagnosis; thus, it would be effective for the diagnosis of CD in clinical practice.
维生素 D(VD)缺乏被报道与克罗恩病(CD)的进展有关,并影响 CD 患者的预后。本研究旨在探讨血清 VD、体重指数(BMI)和肿瘤坏死因子-α(TNF-α)在 CD 诊断中的作用。
本研究纳入了 2019 年 5 月至 2020 年 12 月期间的 76 例 CD 患者和 76 例健康对照者。在治疗前评估了血清 25-羟维生素 D [25(OH)D]水平、BMI 和 TNF-α水平以及其他生化参数。使用受试者工作特征(ROC)曲线确定血清 25(OH)D、BMI 和 TNF-α 的单一和联合检测的诊断效能。
CD 患者的 25(OH)D 水平、BMI 以及包括血红蛋白、总蛋白、白蛋白和高密度脂蛋白胆固醇在内的营养指标均显著低于健康对照者,而 TNF-α水平显著高于健康对照者(均 P<0.05)。25(OH)D、BMI 和 TNF-α 的单项检测的 ROC 曲线下面积分别为 0.887、0.896 和 0.838,最佳截断值分别为 20.64ng/mL、19.77kg/m2 和 6.85fmol/mL。25(OH)D、BMI 和 TNF-α 联合检测的诊断效能最高,ROC 曲线下面积为 0.988(95%CI:0.968-1.000)。
25(OH)D、TNF-α 和 BMI 的联合检测在 CD 诊断中具有较高的灵敏度、特异性和准确性;因此,在临床实践中对 CD 的诊断具有有效性。