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维生素D在溃疡性结肠炎已治疗患者和难治性患者中的作用:一项病例对照研究。

The role of vitamin D in treated and refractory ulcerative colitis patients: a case-control study.

作者信息

Ahmadi Amjad, Shokoohizadeh Leili, Sheikhesmaili Farshad, Nikkhoo Bahram, Mohammadi Asadollah, Mirzaei Mohammadali Khan, Alikhani Mohammad Yousef, Yousefimashouf Rasoul

机构信息

Infectious Disease Research Center, Avicenna Institute of Clinical Sciences, Avicenna Health Research Institute, Hamadan University of Medical Sciences, Hamadan, Iran.

Department of Microbiology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran.

出版信息

BMC Gastroenterol. 2024 Dec 18;24(1):454. doi: 10.1186/s12876-024-03558-4.

Abstract

BACKGROUND

Ulcerative colitis is a form of chronic inflammatory bowel disease (IBD) marked by ongoing inflammation of the mucosal lining that extends from the rectum to the upper part of the colon. Vitamin D regulates immune responses in several autoimmune and inflammatory diseases, including ulcerative colitis. Therefore, the study aims to investigate the role of vitamin D in the pathogenesis and treatment of ulcerative colitis.

METHODS

This case-control study included 94 participants who were divided into four groups. Group 1: people with ulcerative colitis who responded to treatment (n = 24). Group 2: family members of patients who responded to treatment and did not have the disease (n = 24). Group 3: People with ulcerative colitis who are resistant to treatment (n = 23). Group 4: family members of treatment-resistant patients who does not have the disease (n = 23). Groups 1 and 3 were considered as patient groups (n = 47) and groups 2 and 4 as control groups (n = 47). Blood samples were taken and analyzed for complete blood count (CBC), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and serum vitamin D levels.

RESULTS

The mean age of treatment-responsive patients (group 1) was 45.88 ± 18.51 years, while treatment-resistant patients (group 3) averaged 41.30 ± 13.01 (P = 0.33) years. Serum Vitamin D levels were 24.96 ± 9.66 ng/mL in group 1 and 27.70 ± 12.28 ng/mL in group 3, showing no significant correlation with ulcerative colitis (P = 0.41). All groups had a BMI within the normal range, and mean CRP levels varied significantly across groups. Hemoglobin was significantly lower in group 3 compared to group 1 (P = 0.029), but ESR results showed no significant relationship with ulcerative colitis. Vitamin D levels were highest in patients with lower BMI, and no significant relationships were found between Vitamin D and other risk factors, although extensive colitis was associated with higher Vitamin D levels compared to distal colitis.

CONCLUSION

In this study, there was no significant association between ulcerative colitis and serum levels of vitamin D. However, the small number of patients may limit the conclusions that can be drawn regarding the role of vitamin D in the treatment of ulcerative colitis. Future studies should aim for larger cohorts to provide more definitive insights into this important issue.

摘要

背景

溃疡性结肠炎是一种慢性炎症性肠病(IBD),其特征是从直肠延伸至结肠上部的黏膜持续发炎。维生素D在包括溃疡性结肠炎在内的多种自身免疫性和炎症性疾病中调节免疫反应。因此,本研究旨在探讨维生素D在溃疡性结肠炎发病机制和治疗中的作用。

方法

本病例对照研究纳入了94名参与者,分为四组。第一组:对治疗有反应的溃疡性结肠炎患者(n = 24)。第二组:对治疗有反应且未患该病的患者家属(n = 24)。第三组:对治疗耐药的溃疡性结肠炎患者(n = 23)。第四组:未患该病的治疗耐药患者家属(n = 23)。第一组和第三组被视为患者组(n = 47),第二组和第四组为对照组(n = 47)。采集血样并分析全血细胞计数(CBC)、红细胞沉降率(ESR)、C反应蛋白(CRP)和血清维生素D水平。

结果

对治疗有反应的患者(第一组)平均年龄为45.88±18.51岁,而对治疗耐药的患者(第三组)平均年龄为41.30±13.01岁(P = 0.33)。第一组血清维生素D水平为24.96±9.66 ng/mL,第三组为27.70±12.28 ng/mL,与溃疡性结肠炎无显著相关性(P = 0.41)。所有组的体重指数均在正常范围内,且各组间平均CRP水平差异显著。与第一组相比,第三组血红蛋白显著降低(P = 0.029),但ESR结果显示与溃疡性结肠炎无显著关系。体重指数较低的患者维生素D水平最高,维生素D与其他危险因素之间未发现显著关系,尽管广泛性结肠炎与远端结肠炎相比维生素D水平较高。

结论

在本研究中,溃疡性结肠炎与血清维生素D水平之间无显著关联。然而,患者数量较少可能会限制关于维生素D在溃疡性结肠炎治疗中作用的结论。未来的研究应以更大的队列研究为目标,以便对这一重要问题提供更明确的见解。

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本文引用的文献

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Ulcerative colitis: an update.溃疡性结肠炎:最新进展。
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Epidemiology and Pathogenesis of Ulcerative Colitis.溃疡性结肠炎的流行病学和发病机制。
Gastroenterol Clin North Am. 2020 Dec;49(4):643-654. doi: 10.1016/j.gtc.2020.07.005. Epub 2020 Sep 25.
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Mucosal vitamin D signaling in inflammatory bowel disease.黏膜维生素 D 信号在炎症性肠病中的作用。
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The role of vitamin D in inflammatory bowel disease: a guide for clinical practice.维生素 D 在炎症性肠病中的作用:临床实践指南。
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