探讨慢性阻塞性肺疾病患者血清中1α,25-二羟维生素D水平及其影响因素

摘要

Objective 1α,25-dihydroxyvitamin D [1α,25(OH)2D3] is the main performer of biological functions of vitamin D signal.It has been suggested that the serum 1α,25(OH)2D3levels were affected by its precursor levels, 25 -hydroxylvitamin D [25 (OH)D], and the status of microenvironmental inflammatory .Our study aimed to analyze the serum 1α,25(OH)2D3levels and their in-fluencing factors in patients with chronic obstructive pulmonary disease ( COPD) .Methods After recruiting 124 COPD patients and 188 healthy controls, we examined the serum levels of 1α,25(OH)2D3 and 25(OH)D using enzyme-linked immunosorbent assay (ELISA). The laboratory data, such as C-reaction protein (CRP), white blood cells (WBC), hemoglobin (Hb) and albumin (Alb), were col-lected during the corresponding time.Results Average serum levels of 1α,25(OH)2D3 and 25(OH)Din COPD patients were lower than those in the controls (28.33 ±5.87 vs 30.58 ±6.48pg/ml, t=3.108, P=0.002;25.73 ±5.44 vs 27.14 ±5.89ng/ml, t=2.128, P=0.034, respectively).In the stratified analysis for the course of disease in COPD patients , average serum levels of 1α,25(OH)2D3 and 25(OH)Din patients with acute exacerbation were shown to be significantly lower than in those with stable phase (27.04 ±4.67 vs 29.17 ±5.01pg/ml, t=2.377, P=0.019;24.31 ±4.22 vs 26.66 ±4.56ng/ml, t=2.888, P=0.005, respectively).Subsequently, the Spearman rank correlation analysis was performed to evaluate the correlative factors influencing the serum levels of 1α,25(OH)2D3 in patients with COPD.The variables included serum levels of 25(OH)D and inflammatory related indicators,such as CRP, WBC, Hb and Alb.In result, serum levels of 1α,25(OH)2D3 in COPD patients were shown to be positively related with serum levels of 25(OH)D and CRP (r=0.291, P=0.002;r=0.352, P=0.004, respectively), and negatively correlated with Alb (r=-0.346, P=0.000), whereas not linked to WBC and Hb (P>0.05).Conclusion Serum 1α,25(OH)2D3levels in patients with COPD were closely related with the levels of 25(OH)D, CRP and Alb, and may influence the course of disease .%目的 1α, 25-二羟维生素D [1α,25(OH)2D3]是维生素D信号生物学功能的主要执行者,其血清水平不仅受其前体25-羟维生素D[25(OH)D]水平的调控,还受体内炎性状态的影响. 本研究旨在分析慢性阻塞性肺疾病(COPD)患者中血清1α,25(OH)2D3 水平及其影响因素.方法 收集124例COPD患者和188名健康对照者,采用酶联免疫吸附法检测血清1α, 25(OH)2D3 及25(OH)D水平,同期收集COPD患者血清C反应蛋白(CRP)、白细胞计数(WBC)、血红蛋白量(Hb)及白蛋白(Alb)等实验室资料.结果 经两独立样本t检验,与对照组相比,COPD组中血清1α,25(OH)2D3 和25(OH)D平均水平明显降低,分别为:28.33 ±5.87 vs 30.58 ±6.48pg/ml, t=3.108, P=0.002;25.73 ±5.44 vs 27.14 ±5.89ng/ml, t=2.128, P=0.034.根据患者病程分层分析,与稳定期COPD相比,急性加重期患者中血清1α,25(OH)2D3 和25(OH)D平均水平亦显著降低,分别为:27.04 ±4.67 vs 29.17 ±5.01pg/ml, t=2.377, P=0.019;24.31 ±4.22 vs 26.66 ±4.56ng/ml, t=2.888, P=0.005. 采用Spearman相关分析法检验COPD组中血清1α,25(OH)2D3 水平的相关影响因素,纳入的变量包括血清25(OH)D水平及CRP、WBC、Hb、Alb等血清学指标. 结果显示COPD组中血清1α,25(OH)2D3 水平与25(OH)D和CRP呈正相关(r=0.291, P=0.002;r=0.352, P=0.004),与Alb呈负相关(r=-0.346, P=0.001),而与WBC和Hb无关(P>0.05).结论 COPD患者中血清1α,25(OH)2D3 水平与血清25(OH)D、CRP和Alb水平密切相关,并可能影响患者的病程.