维生素D受体（VDR）和维生素D结合蛋白（VDBP）基因多态性与脓毒症易感性及预后的关系
Relationship of VDR and VDBP gene polymorphisms with sepsis susceptibility and prognosis.
作者信息
Lian Chan, Ying Kangtai, Shao Haiyan, Gu Haiting, Mao Wenwei
机构信息
Department of Respiratory Medicine, The First People's Hospital of Wenling City, Wenling, Zhejiang, China.
出版信息
Front Genet. 2025 Apr 25;16:1590750. doi: 10.3389/fgene.2025.1590750. eCollection 2025.
OBJECTIVE
This research focused on the association of vitamin D receptor (VDR) and vitamin D binding protein (VDBP) gene polymorphisms with sepsis susceptibility and prognosis.
METHODS
110 septic patients were selected as the sepsis group, and another 100 patients with common infections who did not develop sepsis as the control group. 28 days death of patients in the sepsis group were counted. Within 24 h of admission, patients were scored by Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) and Sequential Organ Failure Assessment (SOFA). Serum lactate (Lac), C-reactive protein (CRP), procalcitoninogen (PCT) and vitamin D levels were evaluated. All patient DNAs were extracted. The polymorphisms of VDR and VDBP genes and vitamin D genes and VDBP locus were tested and compared in both groups; and the receiver operating characteristic (ROC) curves were plotted to calculate the area under the area under the curve (AUC) and assess the diagnostic value of each indicator for sepsis. Patients in the sepsis group were categorized into a death group and a survival group, the above indicators were compared in the two groups and the factors affecting the prognosis of sepsis patients were analyzed.
RESULTS
Compared to the control group, the sepsis group exhibited higher APACHE II scores, SOFA scores, serum Lac, CRP, PCT levels, VDR locus and VDBP locus frequencies, and lower vitamin D levels ( < 0.05). The ROC curve analysis showed that the AUC for the diagnosis of sepsis using the at the VDBP gene locus was 0.579 (95% CI: 0.501-0.656) (sensitivity: 52.70%; specificity: 63.00%, < 0.05). APACHE II and SOFA scores and serum levels of Lac, CRP, and PCT in the death group were raised and vitamin D levels were diminished than those in the survival group ( < 0.05). Raised APACHE II and SOFA scores were independent risk factors affecting sepsis prognosis.
CONCLUSION
The f allele at the VDR locus and the at the VDBP locus significantly raise the risk of sepsis in patients.
目的
本研究聚焦于维生素D受体（VDR）和维生素D结合蛋白（VDBP）基因多态性与脓毒症易感性及预后的关联。
方法
选取110例脓毒症患者作为脓毒症组，另选100例未发生脓毒症的普通感染患者作为对照组。统计脓毒症组患者的28天死亡率。入院24小时内，采用急性生理与慢性健康状况评分系统Ⅱ（APACHEⅡ）和序贯器官衰竭评估（SOFA）对患者进行评分。评估血清乳酸（Lac）、C反应蛋白（CRP）、降钙素原（PCT）和维生素D水平。提取所有患者的DNA。检测并比较两组患者VDR和VDBP基因及维生素D基因和VDBP位点的多态性；绘制受试者工作特征（ROC）曲线以计算曲线下面积（AUC），并评估各指标对脓毒症的诊断价值。将脓毒症组患者分为死亡组和存活组，比较两组上述指标，并分析影响脓毒症患者预后的因素。
结果
与对照组相比，脓毒症组患者的APACHEⅡ评分、SOFA评分、血清Lac、CRP、PCT水平、VDR位点和VDBP位点频率更高，而维生素D水平更低（P<0.05）。ROC曲线分析显示，利用VDBP基因位点诊断脓毒症的AUC为0.579（95%CI：0.501-0.656）（敏感性：52.70%；特异性：63.00%，P<0.05）。死亡组患者的APACHEⅡ和SOFA评分以及血清Lac、CRP和PCT水平高于存活组，而维生素D水平低于存活组（P<0.05）。升高的APACHEⅡ和SOFA评分是影响脓毒症预后的独立危险因素。
结论
VDR位点的f等位基因和VDBP位点的[具体突变类型]显著增加患者发生脓毒症的风险。
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