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维生素 D 和骨骼肌质量对弥漫性大 B 细胞淋巴瘤患者预后的影响。

Effect of Vitamin D and Skeletal Muscle Mass on Prognosis of Patients with Diffuse Large B-Cell Lymphoma.

机构信息

Department of Hematology and Infectious Disease, Gifu University Hospital, Gifu 501-1194, Japan.

Department of Hematology, Gifu Municipal Hospital, Gifu 500-8513, Japan.

出版信息

Nutrients. 2024 Aug 11;16(16):2653. doi: 10.3390/nu16162653.

DOI:10.3390/nu16162653
PMID:39203790
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11357194/
Abstract

This study investigated the prognostic impact of vitamin D deficiency and reduced skeletal muscle mass in diffuse large B-cell lymphoma (DLBCL) patients. A retrospective analysis of 186 newly diagnosed DLBCL patients from 2012 to 2022 was conducted, measuring serum 25-hydroxyvitamin D [25(OH)D] levels and the skeletal muscle index (SMI). Decreased vitamin D levels were linked to more severe DLBCL disease, with a median 25(OH)D concentration of 13 (4.0-27) ng/mL. Males in the group with a low SMI had a considerably lower 25(OH)D concentration. The optimal threshold of 25(OH)D levels for overall survival (OS) was 9.6 ng/mL, with lower values associated with a higher likelihood of recurrence and mortality. Multivariable analysis showed hazard ratios for OS of 1.4 [95% CI 0.77-2.5] for a low SMI and 3.2 [95% CI 1.8-5.8] for low 25(OH)D concentration. The combination of a low SMI and low vitamin D concentration resulted in the worst prognosis. Thus, low levels of vitamin D associated with disease progression significantly impact DLBCL prognosis, which can be further stratified by the SMI, providing valuable insights for patient management and potential therapeutic interventions.

摘要

本研究旨在探讨维生素 D 缺乏和骨骼肌减少对弥漫性大 B 细胞淋巴瘤(DLBCL)患者的预后影响。对 2012 年至 2022 年间新诊断的 186 例 DLBCL 患者进行了回顾性分析,测量了血清 25-羟维生素 D [25(OH)D] 水平和骨骼肌指数(SMI)。维生素 D 水平降低与更严重的 DLBCL 疾病相关,中位 25(OH)D 浓度为 13(4.0-27)ng/mL。低 SMI 组男性的 25(OH)D 浓度明显较低。总生存(OS)的最佳 25(OH)D 水平阈值为 9.6ng/mL,较低的值与更高的复发和死亡率相关。多变量分析显示,低 SMI 的 OS 风险比为 1.4(95%CI 0.77-2.5),低 25(OH)D 浓度的 OS 风险比为 3.2(95%CI 1.8-5.8)。低 SMI 和低维生素 D 浓度的组合导致预后最差。因此,与疾病进展相关的低维生素 D 水平显著影响 DLBCL 的预后,可进一步根据 SMI 进行分层,为患者管理和潜在的治疗干预提供有价值的见解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/030f/11357194/92f911f390f9/nutrients-16-02653-g006.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/030f/11357194/b22e3bfac933/nutrients-16-02653-g003.jpg
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A Systematic Review Assessing the Impact of Vitamin D Levels on Adult Patients with Lymphoid Malignancies.一项评估维生素 D 水平对成人淋巴恶性肿瘤患者影响的系统评价。
Curr Oncol. 2023 Apr 20;30(4):4351-4364. doi: 10.3390/curroncol30040331.
3
Determination of a Serum 25-Hydroxyvitamin D Reference Ranges in Japanese Adults Using Fully Automated Liquid Chromatography-Tandem Mass Spectrometry.
采用全自动液相色谱-串联质谱法测定日本成年人血清 25-羟维生素 D 的参考范围。
J Nutr. 2023 Apr;153(4):1253-1264. doi: 10.1016/j.tjnut.2023.01.036. Epub 2023 Feb 3.
4
Prognostic Value of Sarcopenia in Patients With Diffuse Large B-Cell Lymphoma Treated With R-CHOP: A Systematic Review and Meta-Analysis.R-CHOP方案治疗的弥漫性大B细胞淋巴瘤患者中肌肉减少症的预后价值:一项系统评价和荟萃分析
Front Nutr. 2022 Feb 25;9:816883. doi: 10.3389/fnut.2022.816883. eCollection 2022.
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