减重手术患者维生素D_(3)的现状及影响因素分析

Analysis of current situation and influencing factors of vitamin D_(3) in patients undergoing bariatric surgery

目的 探讨接受减重手术的肥胖症患者术前维生素D_(3)(Vitamin D_(3),VitD_(3))的现状及影响因素。方法 选取2019年12月至2020年11月首都医科大学附属北京友谊医院行减重与代谢手术的肥胖症患者。收集患者的术前基线资料,分析肥胖人群VitD_(3)的现状,采用多重线性回归分析其VitD_(3)的影响因素。结果 共纳入患者346例,其中男67例,女279例,年龄18~58岁,平均(32.3±7.1)岁。所有患者的VitD_(3)水平均低于正常值,其中轻度缺乏占4.62%,中度缺乏占35.55%,重度缺乏占59.83%。多重线性回归分析结果显示,年龄、睾酮、甲状旁腺素(parathyroid hormone,PTH)、校正Ca^(2+)是影响肥胖患者VitD_(3)水平的主要影响因素(P <0.05),VitD_(3)随着游离T3、促甲状腺素、年龄和睾酮的增加而增加,随校正Ca^(2+)和PTH的增加而降低。结论 减重手术前,肥胖患者均存在VitD_(3)缺乏,且大多数患者VitD_(3)重度缺乏。VitD_(3)的影响因素较多,亟需关注减重手术的肥胖症患者VitD的补充与随访检查。

Objective To explore the current status and the influencing factors of vitamin D_3(VitD_3) in obese patients undergoing bariatric surgery.Methods Obese patients who underwent bariatric and metabolic surgery in Beijing Friendship Hospital affiliated to Capital Medical University from December 2019 to November 2020 were selected.The preoperative baseline data of patients were collected,and the current situation of VitD_(3) in obese people was analyzed.The influencing factors of VitD_(3) were analyzed by multiple linear regression.Results A total of 346 patients were included,including 67males and 279 females,aged from 18 to 58,with an average of(32.3±7.1) years.VitD_(3) in all patients was lower than the normal value,among which mild deficiency accounted for 4.62%,moderate deficiency accounted for 35.55% and severe deficiency accounted for 59.83%.Multiple linear regression analysis results showed that age,testosterone,parathyroid hormone(PTH),and corrected Ca~(2+) were the main influencing factors of VitD_(3) in obese patients(P<0.05).VitD_(3) increased with the increase of free T3,thyrotropin,age and testosterone,and decreased with the increase of corrected Ca~(2+) and PTH.Conclusions The obese patients were all deficient in VitD_(3) before bariatric surgery,and most of them were severely deficient in VitD_3.VitD_(3) has many influencing factors,and it is urgent to pay attention to the supplement and follow-up examination of VitD in obese patients undergoing bariatric surgery.