健康人群和慢性阻塞性肺疾病患者的血清维生素D与血嗜酸性粒细胞计数的关系

Association between vitamin D level and blood eosinophil count in healthy population and patients with chronic obstructive pulmonary disease

目的探讨健康人群和慢性阻塞性肺疾病(COPD)患者血清维生素D缺乏情况及与血嗜酸性粒细胞(EOS)的关系。方法收集南方医科大学南方医院体检中心2017年10月~2021年12月的健康人6163名,男性3781名,女性2382名。根据血清25(OH)D水平分为严重缺乏组(<10 ng/mL)、缺乏组(<20 ng/mL)、不足组(<30 ng/mL)和正常组(≥30 ng/mL)。回顾性纳入2021年4月~2021年6月在我院呼吸科门诊就诊的COPD患者67人为疾病组,并1∶1选取了同期在我院体检中心的67人作为对照组。记录血常规、体质量指数(BMI)等数据。结果健康人群血清25(OH)D(<30 ng/mL)总体缺乏率(包括缺乏和不足)为85.31%,女性缺乏率为89.29%,显著高于男性。6、7、8月份血清25(OH)D水平明显高于12、1、2月份。健康人中血EOS水平在血清25(OH)D严重缺乏组最低,不足组和缺乏组次之,正常组最高(P<0.05)。多重回归分析显示年龄更大、BMI更高及维生素D水平升高均是血EOS升高的危险因素。COPD组(19.66±7.87 ng/mL)血清25(OH)D水平低于健康对照组(26.39±9.28 ng/mL),差异具有统计学意义(P<0.05)。血清25(OH)D水平降低是COPD发生的危险因素。回归分析显示COPD血清25(OH)D水平与血EOS、性别及BMI无明显相关。结论南方地区健康人群和COPD患者血清维生素D水平普遍缺乏,维生素D水平与性别、BMI及血EOS水平关系在健康及疾病状态下不一致。

Objective To investigate the prevalence of vitamin D deficiency and its association with blood eosinophil count in healthy population and patients with chronic obstructive pulmonary disease(COPD).Methods We analyzed the data of a total 6163 healthy individuals undergoing routine physical examination in our hospital between October,2017 and December,2021,who were divided according to their serum 25(OH)D level into severe vitamin D deficiency group(<10 ng/mL),deficiency group(<20 ng/mL),insufficient group(<30 ng/mL)and normal group(≥30 ng/mL).We also retrospectively collected the data of 67 COPD patients admitted in our department from April and June,2021,with 67 healthy individuals undergoing physical examination in the same period as the control group.Routine blood test results,body mass index(BMI)and other parameters were obtained from all the subjects,and logistic regression models were used to investigate the association between 25(OH)D levels and eosinophil count.Results The overall abnormal rate of 25(OH)D level(<30 ng/mL)in the healthy individuals was 85.31%,and the rate was significantly higher in women(89.29%)than in men.Serum 25(OH)D levels in June,July,and August were significantly higher than those in December,January,and February.In the healthy individuals,blood eosinophil counts were the lowest in severe 25(OH)D deficiency group,followed by the deficiency group and insufficient group,and were the highest in the normal group(P<0.05).Multivariable regression analysis showed that an older age,a higher BMI,and elevated vitamin D levels were all risk factors for elevated blood eosinophils in the healthy individuals.The patients with COPD had lower serum 25(OH)D levels than the healthy individuals(19.66±7.87 vs 26.39±9.28 ng/mL)and a significantly higher abnormal rate of serum 25(OH)D(91%vs 71%;P<0.05).A reduced serum 25(OH)D level was a risk factor for COPD.Blood eosinophils,sex and BMI were not significantly correlated with serum 25(OH)D level in patients with COPD.Conclusion Vitamin D deficiency is common in both healthy individuals and COPD patients,and the correlations of vitamin D level with sex,BMI and blood eosinophils differ obviously between healthy individuals and COPD patients.