975例肿瘤患者血清9种维生素水平及维生素缺乏影响因素研究

A Survey of Serum Levels for Nine Vitamins and Risk Factors for Vitamin Deficiency in 975 Cases of Canc⁃er Patients

目的 维生素水平异常与肿瘤发生、发展及治疗预后不良有关。本研究旨在了解肿瘤患者血清维生素水平及影响因素,为该群体维生素水平的个体化监测及维生素补充提供依据。方法 回顾性分析2019~2022年北京大学肿瘤医院血清维生素检测的患者数据,维生素浓度采用电化学方法测定,利用SPSS25.0统计分析,描述不同肿瘤患者的9种维生素浓度分布情况,分析维生素异常的相关因素。结果 本研究共纳入975例肿瘤患者,进行维生素A、D_(3)、E检测975次,维生素B_(2)检测822次,维生素B_(9)、B_(12)检测820次,维生素B6检测819次及维生素C、B_(1)检测821次。结果表明,肿瘤患者维生素D_(3)、A、B_(9)及C缺乏率高,分别为73.8%、46.4%、18.9%、10.7%。其他类型维生素缺乏率均低于5%。少数肿瘤患者维生素水平超过正常值。Logistic回归结果表明,女性患者维生素D_(3)、A缺乏率高;BMI过低会增加维生素A、C缺乏的风险;季节是维生素D_(3)、A、B_(9)、C缺乏的共同影响因素;手术与肿瘤转移均会增加维生素A、C缺乏的风险。结论 肿瘤患者血清维生素D_(3)、A、B_(9)、C缺乏严重,需加强监测。本研究将为肿瘤患者血清维生素水平精准监测与补充提供依据。

OBJECTIVE To illustrate vitamin nutritional status of cancer patients and monitor serum vitamin levels.METHODS Electrochemical method was used to measure the concentrations of nine vitamins in human serum.These data were ana⁃lyzed using SPSS 25.0 statistical software to determine the deviation between the measured values and normal values,and to investigate the causes of abnormalities for serum vitamin levels.RESULTS A total of 975 cancer patients were evaluable for this analysis,with 975 cases of vitamin A,D_(3),and E,822 cases of vitamin B_(2),820 cases of vitamin B_(9)and B_(12),819 cases of vitamin B6,821 cases of vitamin C and B_(1).The deficiency rates were 73.8%,46.4%,18.9%and 10.7%for vitamin D_(3),A,B_(9)and C,while deficiency rates of other vitamins were less than 5%.A few cancer patients have vitamin levels that were above the upper limit.Logistic regres⁃sion showed that female patients were more likely to develop vitamin D_(3)and A deficiency.Statistically significant correlation was found between the seasons and the vitamin deficiency.Underweight increased the risk of vitamin A and C deficiency.Operation and cancer metastasis were correlated with vitamin A,C deficiency,respectively.CONCLUSION Cancer patients have substantial deficiency in serum vitamin D_(3),A,B_(9)and C.This study provides scientific rationality for identifying cancer patients with high risk of vitamin defi⁃ciency and will facilitate rational monitoring of serum vitamin levels and prudent vitamin therapy.