自身免疫性疾病患者血清维生素D水平分析

An Analysis of Serum Vitamin D Levels in Patients with Autoimmune Diseases

目的分析常见自身免疫性疾病患者血清25-羟基维生素D[25(OH)D,VD]的水平状况,以及在不同种类自身免疫性疾病中VD水平是否存在差异。方法纳入就诊于风湿免疫科的住院患者303例,其中类风湿性关节炎(rheumatoid arthritis,RA)93例、系统性红斑狼疮(systemic lupus erythematosus,SLE)47例、干燥综合征(Sjogren’s syndrome,SS)75例、混合性结缔组织病(connective tissue disease,CTD)48例、其他自身免疫性疾病40例,运用电化学发光法检测患者血清VD水平,根据性别、年龄、自身免疫性疾病种类分组,分析自身免疫性疾病患者各组VD水平正常、不足、缺乏的比例,以及VD与年龄、性别的关系。另外,根据VD水平分组,进一步分析VD缺乏、不足、正常的男性和女性自身免疫性疾病患者年龄的差异。结果男性自身免疫性疾病患者的VD水平明显高于女性。男性和女性自身免疫性疾病患者VD缺乏、不足和正常的比率相比差异均有统计学意义。不同年龄段患者之间和不同种类自身免疫性疾病患者之间的VD水平差异均有统计学意义,50~59、60~69、>70岁年龄段的VD水平显著高于10~29岁。RA组的VD水平明显高于SLE组和SS组。相关性分析显示,无论男性患者还是女性患者,VD水平和年龄呈正相关。RA和SS患者中的VD水平和年龄呈明显正相关。没有观察到CTD和SLE患者中VD水平和年龄明显相关。结论自身免疫性疾病患者普遍缺乏维生素D,并且缺乏程度有性别和年龄倾向。在不同种类自身免疫性疾病患者中尤其是年轻女性系统红斑狼疮患者诊疗中需加强维生素D的监测,进行个性化治疗。

Objective To analyze the level of serum 25-hydroxyvitamin D(VD)in patients with common autoimmune diseases and to evaluate potential variations in VD levels among different types of autoimmune diseases.Methods Serum VD levels of 303 inpatients in the Rheumatic Immunology Department were detected by electrochemiluminescence method.These patients were divided into multiple groups:93 cases of rheumatoid arthritis(RA)and 47 cases of systemic lupus erythematosus(SLE),75 cases of Sj gren’s syndrome(SS),48 cases of connective tissue disease(CTD)and 40 cases of other autoimmune connective tissue disease.These patients were also divided into groups according to sex,age and types of autoimmune diseases.The levels of VD and the proportion of normal,insufficient and deficient VD in each group of patients with autoimmune diseases,as well as the relationship between VD and age and sex were analyzed.According to the level of VD,the age differences of male and female patients with autoimmune diseases with deficiency,insufficiency and normal VD were further analyzed.Results VD level of male patients with autoimmune disease was significantly higher than that of female patients.There were significant differences in the rates of VD deficiency,deficiency and normal between male and female patients with autoimmune diseases.There were differences in VD levels among patients of different age groups and different types of autoimmune diseases.VD levels were significantly higher in the 50-59,60-69 and over 70 age groups than in the 10-29 age groups.VD level in RA group was significantly higher than that in SLE group and SS group.Correlation analysis showed that the level of VD was positively correlated with age in both male and female patients.The level of VD in patients with RA and SS was positively correlated with age.No significant correlation between VD level and age was observed in patients with CTD and SLE.Conclusion Patients with autoimmune diseases are generally deficient in vitamin D,and the degree of deficiency shows a gender and age tendency.It is necessary to strengthen vitamin D monitoring and personalized treatment in patients with different types of autoimmune diseases,especially in young women with systemic lupus erythematosus.