摘要
目的探讨特发性膜性肾病(IMN)患者25-羟维生素D_3[25-(OH) D_3]水平及其与血脂的关系。方法检测109例初诊IMN患者治疗前的血清25-(OH) D_3及血脂水平,根据25-(OH) D_3水平将患者分为缺乏[25-(OH) D_3<25 nmol/L]组和不足[25-(OH) D_3≥25 nmol/L]组,分析25-(OH) D_3及其与血脂水平的关系。所有患者均补充维生素D,监测随访期间血清TC变化情况。结果入院时,109例IMN患者的25-(OH) D_3中位水平为12. 27(6. 79,24. 91) nmol/L,其中≥25 nmol/L共27例,<25 nmol/L共82例; 77. 98%(85/109)的患者合并高脂血症,以TC升高为主;不足组IMN患者TC、TG、LDL-C水平均高于缺乏组患者(均P <0. 05); IMN患者25-(OH) D_3水平与TC、TG、LDL-C水平均呈负相关(均P <0. 05)。随访期间,不足组的TC水平总体呈下降趋势(P <0. 05),但缺乏组中各时间点TC水平差异无统计学意义(P> 0. 05)。随访0、1、2个月时不足组的TC水平仍高于缺乏组(均P <0. 05),但3~6个月时两组差异无统计学意义(P> 0. 05)。结论 IMN患者普遍存在25-(OH) D_3水平低下,25-(OH) D_3缺乏可能在IMN肾病血脂代谢紊乱的发生中起一定作用。补充维生素D或利于降低IMN患者血脂水平,从而控制病情。
Objective To investigate 25-hydroxyvitamin D3[25-( OH) D3]level and its relation with blood lipid in patients with idiopathic membranous nephropathy( IMN). Methods Serum 25-( OH) D3 and blood lipid levels were detected in 109 patients initially diagnosed as IMN before treatment,the patients were divided into deficiency group[25-( OH) D3< 25 nmol/L] and insufficiency group[25-( OH) D3≥25 nmol/L]according to their 25-( OH) D3 level,the relationship between 25-( OH) D3 level and blood lipid level was analyzed. All the patients were given vitamin D supplement,and changes in their serum TC were monitored during follow-up. Results Median 25-( OH) D3 level was12. 27( 6. 79,24. 91) nmol/L in 109 IMN patients on admission,including 27 with 25-( OH) D3≥25 nmol/L and 82 with25-( OH) D3< 25 nmol/L. About 77. 98%( 85/109) of the patients suffered from complication of hyperlipoidemia,the majority of them experienced elevated TG;IMN patients in the insufficiency group had higher levels of TC,TG and LDL-C compared with those in the deficiency group( all P < 0. 05). Among IMN patients,25-( OH) D3 level negatively correlated with TC,TG or LDL-C level( all P < 0. 05). During follow-up,TC level showed an overall decline in the insufficiency group( P < 0. 05),but in the deficiency group,no statistically significant difference was found in TC levels at various time points( P > 0. 05). TC levels at 0,1 and 2 months of follow-up remained higher in the insufficiency group compared with those in the deficiency group( all P < 0. 05),but no statistically significant difference was found between the two groups at 3-6 months of follow-up( P > 0. 05). Conclusion Decline of 25-( OH) D3 level is common in IMN patients,and 25-( OH) D3 deficiency probably plays a certain role in the development of blood-lipid metabolic disorder in IMN. Vitamin D supplement might be beneficial to decreasing blood lipid level of IMN patients,thus controlling the disease.
作者
冯陆怀
邹凡
黄钰
李筝绮
刘慧珍
黄姗姗
邓颖
梁钟娥
杨桢华
FENG Lu-huai;ZOU Fan;HUANG Yu;LI Zheng-qi;LIU Hui-zhen;HUANG Shan-shan;DENG Ying;LIANG Zhong-er;YANG Zhen-hua(Graduate School,Guangxi Medical University,Nanning 530021,China;The 923th Hospital of the Joint Logistics Support Force of the Chinese People′s Liberation Army,Nanning 530021,China;Wuzhou People′s Hospital,Wuzhou 543000,China;Department of Nephrology,the First Affiliated Hospital of Guangxi Medical University,Nanning 530021,China)
出处
《广西医学》
CAS
2019年第6期694-697,共4页
Guangxi Medical Journal
基金
广西壮族自治区卫生厅科技研究计划课题(桂卫Z2011322)
关键词
特发性膜性肾病
25羟维生素D3
血脂
Idiopathic membranous nephropathy
25-hydroxyvitamin D3
Blood lipid