血清维生素D水平和维生素D受体基因多态性对儿童慢性荨麻疹的影响研究

Effects of serum vitamin D level and vitamin D receptor gene polymorphism on chronic urticaria in children

目的研究血清维生素D水平和维生素D受体(VDR)基因多态性对儿童慢性荨麻疹发病的影响,为儿童慢性荨麻疹的遗传易感性的筛查提供临床依据。方法收集2021年12月至2023年1月深圳市坪山区妇幼保健院收治的儿童慢性荨麻疹100例(试验组)及同期健康儿童100例(对照组)的临床资料和外周血标本,用化学发光法测定25-羟基维生素D[25(OH)D]、IgE、IgG水平,通过PCR分别对VDR基因ApaI、BsmI、TaqI、FokI、Tru9I进行扩增,测序检测VDR基因多态性及相关的基因多态位点rs7975232、rs1544410、rs731236、rs2228570、rs757343的表达情况。结果试验组外周血中25(OH)D水平低于对照组,IgE和IgG水平高于对照组,差异均有统计学意义(P<0.05)。多因素logistic回归分析显示,rs757343位点T等位基因为儿童慢性荨麻疹发病的危险因素(OR=1.458,95%CI:1.015~2.153,P=0.047),rs757343位点CC基因型和25(OH)D为保护因素(OR=0.250,95%CI:0.056~0.786,P=0.031;OR=0.553,95%CI:0.373~0.713,P<0.001)。受试者工作特征(ROC)曲线分析显示,25(OH)D、白细胞计数、中性粒细胞百分比、淋巴细胞百分比、嗜碱性粒细胞百分比的曲线下面积分别为0.928、0.701、0.808、0.797、0.753,均>0.7。结论维生素D可以辅助诊断儿童荨麻疹并评估病情进展。25(OH)D是儿童慢性荨麻疹发病的保护因素,VDR基因rs757343位点T等位基因为危险因素,CC基因型为保护因素。

Objective To explore the correlation between serum vitamin D levels,vitamin D receptor gene polymorphism,and the incidence of chronic urticaria in children,and to provide clinical evidence for screening the genetic susceptibility of chronic urticaria in children.Methods Clinical data and peripheral blood samples were collected from 100 children with chronic urticaria in the test group and 100 healthy children in the control group who were admitted to the Dermatological Department of Pingshan Distinct Maternal and Child Health Hospital from December 2021 to January 2023.Chemiluminescent assays were used to measure the levels of 25(OH)D,IgE and IgG.PCR amplification was performed to amplify the VDR gene polymorphic sites ApaI,BsmI,TaqI,FokI,and Tru9I,followed by sequencing to assess the VDR gene polymorphism and the expression levels of the associated genetic polymorphic sites rs7975232,rs1544410,rs731236,rs2228570,and rs757343.Results The levels of 25(OH)D in the test group were lower than that in the control group,while IgE and IgG levels were higher than those in the control group,and the differences were statistically significant.Multivariate logistic regression analysis showed that the T allele of rs757343 was a risk factor for the incidence of chronic urticaria in children(OR=1.458,95%CI:1.015-2.153,P=0.047),while the CC genotype of rs757343 and 25(OH)D were protective factors(OR=0.250,95%CI:0.056-0.786,P=0.031;OR=0.553,95%CI:0.373-0.713,P<0.001).ROC curve analysis showed that the area under the curve for 25(OH)D,white blood cell count,neutrophil percentage,lymphocyte percentage,and basophil percentage were 0.928,0.701,0.808,0.797 and 0.753,all>0.7.Conclusion Vitamin D can assist in the diagnosis of uricaria in children and evaluate the progression of the disease.25(OH)D is a protective factor for the onset of chronic urticaria in children,the T allele of the VDR gene polymorphism rs757343 is a risk factor for chronic urticaria in children,while the CC genotype is a protective factor.