维生素D及年龄对子宫肌瘤发生的预测价值

Predictive value of vitamin D combined with age for the occurrence of uterine fibroids

目的 评估子宫肌瘤(UFs)患者中维生素D和年龄的临床意义。方法 选取2017年12月至2018年7月期间南充市中心医院的子宫肌瘤患者133例(实验组),来源于体检中心的健康人员65例(对照组),采用电化学发光法检测血清维生素D水平。统计学比较实验组与对照组的临床特征,并采用单因素和多因素logistic回归分析方法对可能导致患者发生子宫肌瘤的因素进行分析,运用MedCalc 16.2医学统计软件绘制ROC曲线确定血清维生素D与年龄预测子宫肌瘤发生的最佳临界水平。结果 实验组血清维生素D水平(12.13±0.46) nmol/L低于对照组(15.91±0.64) nmol/L (P=0.01)。多因素分析提示年龄(OR=24.28;95%CI8.74~67.45;P=0.01)、维生素D (OR=6.54;95%CI 2.66~16.07;P=0.01)是预测子宫肌瘤发生的独立危险因素。运用MedCalc 16.2医学统计软件绘制出ROC曲线分析血清维生素D预测子宫肌瘤发生的最佳临界值为13.01 nmol/L (AUC 0.72;敏感性63.91%;特异性73.4%;95%CI 0.65~0.78;P=0.000);年龄预测子宫肌瘤发生的最佳临界值为38岁(AUC 0.82;敏感性86.47%;特异性71.19%;P=0.000);维生素D联合年龄预测子宫肌瘤发生的AUC值为0.84。结论 血清维生素D的缺乏和年龄可能是预测子宫肌瘤发生的重要因素之一。

Objective To evaluate the clinical significance of vitamin D and age in patients with uterine fibroids(UFs).Methods 133 patients with uterine fibroids admitted to the Nanchong Central Hospital from December 2017 to July 2018 were enrolled as the experimental,65 healthy women from the physical examination center at the same period were selected as control group,electrochemiluminescence assay was used to detect the serum vitamin D level in the two groups.The clinical characteristics of the two groups were statistically compared,univariate and multivariate Logistic regression analysis methods were used to analyze the factors that may lead to the occurrence of uterine fibroids.MedCalc 16.2 medical statistical software was used to draw ROC curves to determine serum vitamin D predicting the best critical level of uterine fibroids with age and Vitamin D.Results The serum vitamin D level of the experimental group was lower than that of the control group[(12.13±0.46)nmol/L vs(15.91±0.64)nmol/L,P=0.01].Multivariate Logistic regression analysis suggested that age(OR=24.28,95%CI 8.74~67.45,P=0.01),vitamin D(OR=6.54,95%CI 2.66~16.07,P=0.01)were independent risk factors of predicting uterine fibroids.ROC curve analysis showed that the optimal cut-off value of serum vitamin D level was 13.01 nmol/L(AUC 0.72;sensitivity 63.91%;specificity 73.4%;95%CI 0.65~0.78,P=0.000);the optimal cut⁃off value of age was 38 years old(AUC 0.82,sensitivity 86.47%;specificity 71.19%,P=0.000);the AUC value of vitamin D combined with age to predict the occurrence of uterine fibroids is 0.84.Conclusions The lack of serum vitamin D or combined age may be one of the important factors for predicting the occurrence of uterine fibroids.