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维生素D缺乏及可改变的风险因素在克罗恩病患者中的作用。

The role of vitamin D deficiency and modifiable risk factors in patients with Crohn's disease.

作者信息

Feng Xiaoyue, Yin Qin, Kang Ying, Jiang Kang, Xu Mengqing, Wang Fangyu

机构信息

Division of Gastroenterology and Hepatology, Nanjing Jinling Hospital, Jinling School of Clinical Medicine, Nanjing Medical University, Nanjing, Jiangsu, China.

Orthopedics Department, Wuxi 9th People's Hospital Affiliated to Soochow University, Wuxi, Jiangsu, China.

出版信息

Front Immunol. 2025 Jul 30;16:1616924. doi: 10.3389/fimmu.2025.1616924. eCollection 2025.

Abstract

BACKGROUNDS

Vitamin D insufficiency is usually seen in Crohn's disease (CD). Our study aims to determine the risk factors for vitamin D insufficiency in CD patients.

METHODS

Between May 2021 and December 2023, we enrolled 102 CD patients and 100 healthy people in our hospital who were eligible for the study. Changes in vitamin D levels were also analyzed. CD patients were divided into active and clinical remission, and further changes in micronutrient and vitamin D levels were analyzed. Lastly, risk factor analysis was conducted using univariate, multivariate, and LASSO regression analysis models.

RESULTS

The average age of CD patients was 38.91 ± 3.31 years, whereas the average age of the healthy people was 38.64 ± 2.26 years. Vitamin D levels were significantly lower in CD patients than in healthy controls (19.62 ± 2.68 vs. 22.68 ± 4.61), especially for patients with active CD. In 11 patients treated with vedolizumab, compared to the pre-treatment Vedolizumab group, vitamin D levels improved more dramatically post-Vedolizumab therapy. According to univariate analysis, Age (OR: 0.95, 95% CI 0.26-1.33, p=0.01), sex (OR: 0.26, 95% CI 0.25-0.99, p=0.03), recent biologics (OR: 0.54, 95% CI 0.44-1.25, p=0.02), iron (OR: 0.89, 95% CI 0.72-1.62, p=0.02), and total 25-OH vitamin D (OR: 1.25, 95% CI 1.02-1.99, p=0.02) did significantly differ between patients with and without vitamin D deficiency. After controlling for several variables, multivariate analysis revealed that a lower odds ratio was linked to increasing age at diagnosis (OR: 0.12, 95% CI 0.03-0.85, p=0.02), sex (OR: 0.58, 95% CI 0.44-0.95, p=0.01), iron (OR: 0.44, 95% CI 0.11-0.62, p=0.01), and 25-OH vitamin D total (OR: 0.48, 95% CI 0.25-0.95, p=0.03). In addition, Age, time since illness onset, and 25-OH vitamin D were found to be helpful indicators for CD patients using LASSO regression.

CONCLUSION

According to this study, vitamin D insufficiency was often linked to CD patients with active status and pre-treatment Vedolizumab. Furthermore, Age, time since illness onset, and 25-OH vitamin D were found to be significant risk factors for CD.

摘要

背景

维生素D缺乏在克罗恩病(CD)患者中较为常见。本研究旨在确定CD患者维生素D缺乏的危险因素。

方法

2021年5月至2023年12月期间,我们纳入了我院102例符合研究条件的CD患者和100名健康人。分析维生素D水平的变化。将CD患者分为活动期和临床缓解期,并进一步分析微量营养素和维生素D水平的变化。最后,使用单因素、多因素和LASSO回归分析模型进行危险因素分析。

结果

CD患者的平均年龄为38.91±3.31岁,而健康人的平均年龄为38.64±2.26岁。CD患者的维生素D水平显著低于健康对照组(19.62±2.68 vs. 22.68±4.61),尤其是活动期CD患者。在11例接受维多珠单抗治疗的患者中,与治疗前的维多珠单抗组相比,维多珠单抗治疗后维生素D水平改善更为显著。单因素分析显示,年龄(OR:0.95,95%CI 0.26-1.33,p=0.01)、性别(OR:0.26,95%CI 0.25-0.99,p=0.03)、近期生物制剂使用情况(OR:0.54,95%CI 0.44-1.25,p=0.02)、铁(OR:0.89,95%CI 0.72-1.62,p=0.02)和总25-羟基维生素D(OR:1.25,95%CI 1.02-1.99,p=0.02)在维生素D缺乏和非缺乏患者之间存在显著差异。在控制了多个变量后,多因素分析显示,诊断时年龄增加(OR:0.12,95%CI 0.03-0.85,p=0.02)、性别(OR:0.58,95%CI 0.44-0.95,p=0.01)、铁(OR:0.44,95%CI 0.11-0.62,p=0.01)和总25-羟基维生素D(OR:0.48(,95%CI 0.25-0.95,p=0.03)与较低的比值比相关。此外,使用LASSO回归发现年龄、发病时间和25-羟基维生素D是CD患者的有用指标。

结论

根据本研究,维生素D缺乏常与活动期CD患者和治疗前的维多珠单抗治疗有关。此外,年龄、发病时间和25-羟基维生素D被发现是CD的重要危险因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0908/12343588/1d435b7b8a7b/fimmu-16-1616924-g001.jpg

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