血清 25-羟维生素 D 浓度与感染之间呈倒 U 型关系：一项横断面研究。

Inverted U-shaped relationship between serum 25-hydroxyvitamin D concentrations and infection: a cross-sectional study.

机构信息

Department of Clinical Laboratory, The Second Affiliated Hospital of Gannan Medical University, Ganzhou, China.

Department of Interventional Radiology, The Second Affiliated Hospital of Gannan Medical University, Ganzhou, China.

出版信息

Front Public Health. 2024 Aug 29;12:1420932. doi: 10.3389/fpubh.2024.1420932. eCollection 2024.

DOI:10.3389/fpubh.2024.1420932

PMID:39267629

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11390550/

Abstract

BACKGROUND

() is a widespread zoonotic parasite transmitted through contaminated food or water. It poses a significant public health threat, especially to pregnant women and immunocompromised individuals. 25-Hydroxyvitamin D [25(OH)D] plays a critical role in regulating both innate and adaptive immune responses, particularly in its anti-infective capacity. However, the relationship between serum 25(OH)D concentrations and infection remains uncertain.

METHODS

We analyzed the data from the National Health and Nutrition Examination Survey (NHANES) spanning 2009-2014 to explore the association between serum 25(OH)D concentrations and infection. Extensive demographic, comorbidity, and dietary data were collected. The status of infection was determined using serum anti-IgG antibodies. Serum 25(OH)D levels were measured using ultra-high performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS). In addition, weighted logistic regression and restricted cubic spline analyses were performed.

RESULTS

Our analysis included 10,157 participants (mean [SE] age, 45.38 [0.39] years; 49.73% female) who met the inclusion criteria. Serum 25(OH)D levels were categorized into quintiles, with the second quintile serving as the reference group. The final model, adjusted for age, sex, race, education level, poverty income ratio, body mass index, smoking status, hypertension, diabetes, chronic kidney disease, depression, physical activity, alcohol intake, seasonal testing, and dietary vitamin D, revealed the following adjusted odds ratios (ORs) for the quintiles: 0.75 (95% confidence interval [CI]: 0.60-0.93) for the first, 0.87 (95% CI: 0.69-1.10) for the third, 0.75 (95% CI: 0.58-0.95) for the fourth, and 0.66 (95% CI: 0.49-0.91) for the fifth. Additionally, a restricted cubic spline analysis revealed an inverted U-shaped relationship between serum 25(OH)D and infection, with an inflection point at approximately 51.29 nmol/L. Odds ratios to the left and right of the inflection point were 1.17 (95% CI: 1.03-1.32) and 0.94 (95% CI, 0.90-0.98) per 10 nmol/L, respectively.

CONCLUSION

Our study uncovers an inverted U-shaped relationship between serum 25(OH)D concentrations and infection, with an inflection point around 51.29 nmol/L.

摘要

背景

（）是一种广泛存在的人畜共患寄生虫，通过受污染的食物或水传播。它对公共卫生构成重大威胁，特别是对孕妇和免疫功能低下者。25-羟维生素 D [25(OH)D]在调节先天和适应性免疫反应方面发挥着关键作用，尤其是在其抗感染能力方面。然而，血清 25(OH)D 浓度与（）感染之间的关系仍不确定。

方法

我们分析了 2009-2014 年全国健康与营养调查（NHANES）的数据，以探讨血清 25(OH)D 浓度与（）感染之间的关联。收集了广泛的人口统计学、合并症和饮食数据。使用血清抗 IgG 抗体确定（）感染状况。使用超高效液相色谱-串联质谱法（UHPLC-MS/MS）测量血清 25(OH)D 水平。此外，进行了加权逻辑回归和限制立方样条分析。

结果

我们的分析包括 10157 名符合纳入标准的参与者（平均[SE]年龄，45.38[0.39]岁；49.73%为女性）。血清 25(OH)D 水平分为五组，第二组为参考组。最终模型，调整年龄、性别、种族、教育水平、贫困收入比、体重指数、吸烟状况、高血压、糖尿病、慢性肾脏病、抑郁、身体活动、饮酒、季节性检测和膳食维生素 D，显示以下五分位数的调整优势比（OR）：第一分位数为 0.75（95%置信区间[CI]：0.60-0.93），第三分位数为 0.87（95%CI：0.69-1.10），第四分位数为 0.75（95%CI：0.58-0.95），第五分位数为 0.66（95%CI：0.49-0.91）。此外，限制立方样条分析显示，血清 25(OH)D 与（）感染之间呈倒 U 型关系，拐点约为 51.29 nmol/L。拐点左侧和右侧的优势比分别为每 10 nmol/L 1.17（95%CI：1.03-1.32）和 0.94（95%CI，0.90-0.98）。