基于C-反应蛋白水平探讨不同炎症状态下血清维生素的变化特点

Study on the changes of serum vitamin in different inflammatory states based on CRP levels

目的:探讨C-反应蛋白(CRP)水平与血清维生素的关系,明确炎症是维生素缺乏的重要诱因。方法:回顾性分析2021年9月至2023年7月天津市第三中心医院营养科诊治551例病人的临床资料,根据CRP化验结果分为:无/轻度炎症组(CRP <10 mg/L)89例、中度炎症组(10 mg/L≤CRP <50 mg/L)148例和重度炎症组(CRP≥50 mg/L)314例,比较三组病人临床特征和血清维生素水平,进一步研究炎症对血清维生素的影响。结果:共纳入551例病人,检测9种水溶性维生素和4种脂溶性维生素,机体CRP水平与血清维生素C、维生素B3、维生素B9、维生素A、25-羟维生素D3、25-羟维生素D呈负相关,相关系数分别为:-0.33、-0.11、-0.16、-0.33、-0.09、-0.12;CRP与血清维生素B6呈正相关,相关系数为0.16。三组炎症亚组分析显示,血清维生素C、维生素B9、维生素A、25-羟维生素D3和25-羟维生素D水平随着炎症程度加重逐步降低(P <0.001);随着炎症加重,血清维生素B3水平仅在重度炎症状态时出现明显下降(P <0.01);血清维生素B2、维生素B5、维生素B6水平,中重度炎症组高于无/轻度炎症组(P <0.001)。维生素B7、维生素B12、维生素E和维生素K水平与CRP无相关性,且三组炎症亚组分析差别无统计学意义(P> 0.05)。结论:部分维生素水平受机体炎症状态影响,临床发现炎症指标异常增高时,尤其应进一步监测血清维生素C、B9、B3、A、D水平,警惕维生素缺乏。

Objective:To investigate the correlation between C-reactive protein(CRP)and vitamin levels,and to Elucidate that inflammation is a crucial cause of vitamin deficiency.Methods:The clinical data of 551 patients treated by the Department of Nutrition of Tianjin Third Central Hospital were retrospectively analyzed from September 2021 to July 2023.Based on CRP levels,the patients were categorized into three groups:the no/mild inflammation group(89 cases,CRP<10 mg/L),the moderate inflammation group(148 cases,10 mg/L≤CRP<50 mg/L),and the severe inflammation group(314 cases,CRP≥50 mg/L).Clinical characteristics and serum vitamin levels of the three groups were compared to further Investigate the effects of inflammation on serum vitamin concentrations.Results:A total of 551 patients were included in the analysis of nine water-soluble vitamins and four fat-soluble vitamins.CRP levels were negatively correlated with serum vitamin C,vitamin B3,vitamin B9,vitamin A,25-OH vitamin D3 and 25-OH vitamin D,and the correlation coefficients were as follows:-0.33,-0.11,-0.16,-0.33,-0.09,-0.12.Conversely,CRP was positively correlated with serum vitamin B6,and the correlation coefficient was 0.16.Analysis of the three inflammatory subgroups revealed that serum levels of vitamin C,vitamin B9,vitamin A,25-OH vitamin D3 and 25-OH vitamin D were progressively decreased with the severity of inflammation(P<0.001).With the exacerbation of inflammation,the serum vitamin B3 level decreased significantly only in the condition of severe inflammation(P<0.01).Serum levels of vitamin B2,vitamin B5 and vitamin B6 in moderate to severe inflammation group were higher than those in no/mild inflammation group(P<0.001).Levels of Vitamin B7,vitamin B12,vitamin E and vitamin K levels were not correlated with CRP,and no statistical significance was observed in the analysis of inflammation subgroups among the three groups(P>0.05).Conclusions:Certain vitamin levels are influenced by the body's inflammatory state.When clinically found abnormal increase in inflammatory indicators,the serum levels of vitamin C,B9,B3,A,and D should be further monitored to be vigilant against vitamin deficiency.