维生素D水平在中老年特发性膜性肾病中的临床意义

Clinical value of vitamin D levels in middle-aged and elderly patients with idiopathic membranous nephropathy

目的 探讨维生素D水平在中老年特发性膜性肾病(IMN)中的临床意义。方法 选择广西壮族自治区民族医院2021年6月至2022年6月收治的100例中老年IMN患者为观察组,另选取同期100例健康体检者为对照组。观察组分别根据病理分期、24 h尿蛋白(24 h UP)水平及清蛋白(ALB)水平进行分组。比较各组间血清25-羟基维生素D[25(OH)D]、胱抑素C(CysC)、肌酐(Cr)、尿素氮(BUN)、β_(2)-微球蛋白(β_(2)-MG)、ALB及24 h UP的水平。结果 观察组血清25(OH)D和ALB水平显著低于对照组,Cr、CysC、β_(2)-MG水平显著高于对照组,差异均有统计学意义(P<0.05),但两组BUN水平比较,差异无统计学意义(P>0.05)。在不同病理分期患者中,Ⅰ期组25(OH)D水平显著高于Ⅱ期组和Ⅲ~Ⅳ期组,Ⅱ期组25(OH)D水平显著高于Ⅲ~Ⅳ期组,差异均有统计学意义(P<0.05);而不同病理分期患者的Cr、BUN、CysC、β_(2)-MG、24 h UP及ALB水平比较,差异均无统计学意义(P>0.05)。24 h UP<3.5 g/24 h组25(OH)D水平显著高于24 h UP≥3.5 g/24 h组(P<0.05)。ALB<25 g/L组25(OH)D水平显著低于ALB≥25 g/L组(P<0.05)。在中老年IMN患者中,25(OH)D水平与CysC、β_(2)-MG、24 h UP水平呈负相关(r=-0.398、-0.387、-0.382,P<0.05),与ALB水平呈正相关(r=0.463,P<0.05)。结论 中老年IMN患者维生素D水平普遍偏低,维生素D对IMN病情评估有较高的临床价值。

Objective To investigate the clinical value of vitamin D levels in middle-aged and elderly patients with idiopathic membranous nephropathy(IMN).Methods A total of 100 middle-aged and elderly patients with IMN admitted to Guangxi Zhuang Autonomous Region Hospital for Nationalities from June 2021 to June 2022 were selected as observation group and 100 healthy subjects were selected as control group.The observation group was subdivided according to pathological stage,24 h urinary protein(24 h UP)level and albumin(ALB)level.The serum levels of vitamin D[25(OH)D],cystatin C(CysC),creatinine(Cr),urea nitrogen(BUN),β_(2) microglobulin(β_(2)-MG),ALB and 24 h UP were compared among all groups.Results Serum 25(OH)D and ALB levels in the observation group were significantly lower than those in the control group,Cr,CysC,β_(2)-MG in the observation group were significantly higher than those in the control group,the differences were statistically significant(P<0.05),but there was no significant difference in BUN between the two groups(P>0.05).The level of 25(OH)D in stageⅠgroup was significantly higher than that in stageⅡgroup and stageⅢ-Ⅳgroup,the level of 25(OH)D in stageⅡgroup was significantly higher than that in stageⅢ-Ⅳgroup,and the differences had statistical significance(P<0.05).There were no significant differences in Cr,BUN,CysC,β_(2)-MG,24 h UP and ALB among stageⅠ,ⅡandⅢ-Ⅳgroups(P>0.05).The serum 25(OH)D level in 24 h UP<3.5 g/24 h group was significantly higher than that in 24 h UP≥3.5 g/24 h group(P<0.05).The 25(OH)D level in ALB<25 g/L group was significantly lower than that in ALB≥25 g/L group(P<0.05).The serum 25(OH)D level was negatively correlated with CysC,β_(2)-MG and 24 h UP(r=-0.398,-0.387,-0.382,P<0.05),and positively correlated with ALB(r=0.463,P<0.05).Conclusion Vitamin D levels are generally low in middle-aged and elderly IMN patients,and vitamin D has high clinical value for IMN condition assessment.