血清维生素D及其受体水平与多发性子宫肌瘤的相关性

Correlation of serum vitamin D and its receptor levels with multiple uterine fibroids

目的探讨血清维生素D(VD)及维生素D受体(VDR)水平在多发性子宫肌瘤中的变化及与疾病发生的相关性。方法选取2017年9月至2020年9月儋州市人民医院收治的82例子宫肌瘤患者为研究对象,根据肌瘤数目分为单发组(n=36)和多发组(n=46),同时选择同期于医院进行体检的38例健康女性作为健康对照组(n=38),比较三组研究对象血清VD和VDR水平以及多发性子宫肌瘤患者不同病理特征之间VD和VDR水平差异,进一步对多发性子宫肌瘤发生的影响因素进行单因素和Logistic回归分析。结果单发组、多发组和健康对照组血清VD、VDR水平比较差异有统计学意义(F值分别为72.321、24.518,P<0.01),每两组间比较结果显示多发肌瘤组血清VD、VDR水平均显著低于单发肌瘤组和健康对照组(t值分别为6.474、7.896、10.325、12.098,P<0.05),单发肌瘤组血清VD、VDR水平均显著低于健康对照组(t值分别为5.309、7.328,P<0.05)。多发性子宫肌瘤患者不同肌瘤位置之间血清VD、VDR水平比较差异均无统计学意义(F值分别为0.046、0.131,P>0.05),而不同肌瘤直径、不同肌瘤体积之间血清VD、VDR水平比较差异有统计学意义(F值分别为5.021、6.562、5.059、6.881,P<0.05),随着肌瘤直径和体积增加,患者血清VD、VDR水平逐渐降低。多发性子宫肌瘤与健康对照组年龄构成、BMI、吸烟情况、孕次、产次、口服避孕药比较差异均有统计学意义(χ^(2)值分别为4.055~21.397,P<0.05)。Logistic回归分析结果显示VD、VDR、口服避孕药与多发性子宫肌瘤发生有关(OR值分别为3.729、4.180、3.288,P<0.05)。结论多发性子宫肌瘤患者血清VD及VDR水平显著降低,VD及VDR缺乏为多发性子宫肌瘤发生的危险因素,需要临床医生重视。

Objective To investigate the changes of serum vitamin D(VD)and vitamin D receptor(VDR)levels in multiple uterine fibroids and their correlations with the occurrence of disease.Methods Eighty-two patients with uterine fibroids who were admitted to Danzhou People′s Hospital from September 2017 to September 2020 were selected as the study subjects.According to the number of fibroids,they were divided into the single group(n=36)and the multiple group(n=46).At the same time,38 healthy women who underwent physical examination in the hospital during the same period were selected as the healthy control group(n=38).The serum VD and VDR levels of the three groups and the differences of VD and VDR levels among the patients with multiple uterine fibroids of different pathological features were compared,and the influencing factors of the occurrence of multiple uterine fibroids were further analyzed by univariate and Logistic regression analysis.Results There were statistically significant differences in serum VD and VDR levels in the single,multiple and healthy control groups(F=72.321 and 24.518,respectively,P<0.01).Results of comparison between each two groups showed that serum VD and VDR levels in the multiple fibroids group were significantly lower than those in the single fibroids group and healthy control group(t=6.474,7.896,10.325 and 12.098,respectively,P<0.05).The serum VD and VDR levels in the single fibroid group were significantly lower than those in the healthy control group(t=5.309 and 7.328,respectively,P<0.05).There was no significant difference in serum VD and VDR levels between different fibroid locations in patients with multiple uterine fibroids(F=0.046 and 0.131,respectively,P>0.05).However,there were statistically significant differences in serum VD and VDR levels among different fibroid diameter and fibroid volume(F=5.021,6.562,5.059 and 6.881,respectively,P<0.05).With the increase of fibroid diameter and volume,serum VD and VDR levels in patients gradually decreased.There were significant differences in age composition,BMI,smoking status,gravidity,parity and oral contraceptives between the multiple uterine fibroids and the healthy control group(χ^(2)=4.055-21.397,respectively,P<0.05).Logistic regression analysis results showed that VD,VDR and oral contraceptives were related to the occurrence of multiple uterine fibroids(OR=3.729,4.180 and 3.288,respectively,P<0.05).Conclusion The levels of serum VD and VDR were significantly decreased in patients with multiple uterine fibroids.VD and VDR deficiencies were risk factors for the occurrence of multiple uterine fibroids,which should be paid attention by clinicians.