Investigation of 25-Hydroxy Vitamin D Status and Related Factors in Hospitalised Patients with Type 2 Diabetes Mellitus

Objective: To investigate the distribution of 25-hydroxy Vitamin D level status in type 2 diabetes mellitus inpatients, as well as the differences in general conditions and clinical indicators in patients with different Vitamin D status. Methods: Retrospective analysis of 250 admitted type 2 diabetes inpatients admitted to the endocrinology department of qinghai provincial hospital of traditional chinese medicine from september 2022 to december 2023, collated and analysed the general data and laboratory indicators of the patient cases, and applied spss26.0 to process and analyse the data and explore the differences in the general conditions and commonly used clinical nutritional indicators of type 2 diabetes in patients with different 25-hydroxyVitamin D levels. The differences between the different 25-hydroxy Vitamin D levels in type 2 diabetes mellitus patients. Results: 1) A total of 250 inpatients with type 2 diabetes mellitus were included in this study, of which 56 cases (22.4%) were patients with 25 hydroxyvitamin D deficiency [25(OH)D P P P P > 0.05). 3) The distribution of some laboratory indexes among the three groups of patients was differentiated, with the average level of glycated haemoglobin in the lack group being significantly higher than that of the remaining two groups, the average level of albumin being significantly lower than that of the remaining two groups, and the average level of haemoglobin being significantly lower than that of the good group (P P > 0.05). Conclusion: The 25(OH)D level of type 2 diabetes mellitus inpatients is not optimistic. In clinical diagnosis and treatment, we should pay attention to the changes in 25 hydroxyvitamin D levels and other nutritional indexes of patients with type 2 diabetes mellitus, and focus on the control of blood glucose levels and timely supplementation of vitamins, proteins, and lipids, in order to improve the patients’ physical status, reduce the incidence of complications, and improve the clinical efficacy and the patients’ quality of life.

Causal relationship between circulating vitamin C and 25-hydroxyvitamin D concentrations and common mental disorders-a Mendelian randomization study

Mental disorders seriously affect people’s health and social stability.This Mendelian randomization(MR)study was designed to investigate the causal relationship between circulating vitamin C(VC)or 25-hydroxyvitamin D(25(OH)D)levels and mental disorders.The data used for the MR analysis were derived from the summary genome-wide association studies(GWAS)database for VC and 25(OH)D and from the Finn Gen consortium for fourteen mental disorders.Based on the inverse variance weighted(IVW)method,we found a potential causal association between circulating VC and anxiety disorders(IVW:OR=1.139,95%CI:1.023-1.269,P=0.018).However,no causal association was found between VC or 25(OH)D and other mental disorders(P>0.05).In the reverse MR analysis,individuals with Alzheimer’s disease was causally associated with higher concentrations of circulating VC(P=0.012),while individuals with anxiety disorders had a negative association between the concentrations of 25(OH)D(P=0.012).However,the current evidence does not support a causal relationship between VC or 25(OH)D and other mental disorders.In addition,there was no causal association between circulating VC and 25(OH)D(P>0.05).Future studies are needed to confirm these findings and to elucidate the mechanisms of potential causality.

Causal association between 25-hydroxyvitamin D status and cataract development:A two-sample Mendelian randomization study

BACKGROUND Vitamin deficiencies are linked to various eye diseases,and the influence of vitamin D on cataract formation has been noted in prior research.However,detailed investigations into the causal relationship between 25-(OH)D status and cataract development remain scarce.AIM To explore a possible causal link between cataracts and vitamin D.METHODS In this study,we explored the causal link between 25-(OH)D levels and cataract development using Mendelian randomization.Our analytical approach included inverse-variance weighting(IVW),MR-Egger,weighted median,simple mode,and weighted mode methods.The primary analyses utilized IVW with random effects,supplemented by sensitivity and heterogeneity tests using both IVW and MR-Egger.MR-Egger was also applied for pleiotropy testing.Additionally,a leave-one-out analysis helped identify potentially impactful single-nucleotide polymorphisms.RESULTS The analysis revealed a positive association between 25-(OH)D levels and the risk of developing cataracts(OR=1.11,95%CI:1.00-1.22;P=0.032).The heterogeneity test revealed that our IVW analysis exhibited minimal heterogeneity(P>0.05),and the pleiotropy test findings confirmed the absence of pleiotropy within our IVW analysis(P>0.05).Furthermore,a search of the human genotype-phenotype association database failed to identify any potentially relevant risk-factor single nucleotide polymorphisms.CONCLUSION There is a potential causal link between 25-(OH)D levels and the development of cataracts,suggesting that greater 25-(OH)D levels may be a contributing risk factor for cataract formation.Further experimental research is required to confirm these findings.

Thrombin increases the expression of cholesterol 25-hydroxylase in rat astrocytes after spinal cord injury

Astrocytes are important cellular centers of cholesterol synthesis and metabolism that help maintain normal physiological function at the organism level.Spinal cord injury results in aberrant cholesterol metabolism by astrocytes and excessive production of oxysterols,which have profound effects on neuropathology.25-Hydroxycholesterol(25-HC),the main product of the membrane-associated enzyme cholesterol-25-hydroxylase(CH25H),plays important roles in mediating neuroinflammation.However,whether the abnormal astrocyte cholesterol metabolism induced by spinal cord injury contributes to the production of 25-HC,as well as the resulting pathological effects,remain unclear.In the present study,spinal cord injury-induced activation of thrombin was found to increase astrocyte CH25H expression.A protease-activated receptor 1 inhibitor was able to attenuate this effect in vitro and in vivo.In cultured primary astrocytes,thrombin interacted with protease-activated receptor 1,mainly through activation of the mitogen-activated protein kinase/nuclear factor-kappa B signaling pathway.Conditioned culture medium from astrocytes in which ch25h expression had been knocked down by siRNA reduced macrophage migration.Finally,injection of the protease activated receptor 1 inhibitor SCH79797 into rat neural sheaths following spinal cord injury reduced migration of microglia/macrophages to the injured site and largely restored motor function.Our results demonstrate a novel regulatory mechanism for thrombin-regulated cholesterol metabolism in astrocytes that could be used to develop anti-inflammatory drugs to treat patients with spinal cord injury.

25-Hydroxyvitamin D Is Associated with Islet Homeostasis in Type-2 Diabetic Patients with Abdominal Obesity

Objective Isletαcells input is essential for insulin secretion fromβcells.The present study aims to investigate the association between 25-hydroxyvitamin D[25(OH)D]and islet function homeostasis in type-2 diabetes(T2D)patients.Methods A total of 4670 T2D patients from seven communities in Shanghai,China were enrolled.The anthropometric indices,biochemical parameters,serum 25(OH)D,and islet function[including C-peptide(C-p)and glucagon]were measured.Results The fasting plasma glucose(FPG),glycated hemoglobin(HbA1c),glucagon,and C-p levels exhibited a significantly decreasing trend in T2D patients as the 25(OH)D levels increased.Next,the population was divided into two groups:abdominal obesity and non-abdominal obesity groups.After adjustment,the 25(OH)D level was found to be associated with HbA1c,glucagon,and homeostasis model assessment ofβ(HOMA-β)in the non-abdominal obesity group.There was a significant relationship between 25(OH)D and HbA1c,glucagon,HOMA-IR,baseline insulin or C-p in the abdominal obesity group.In the abdominal obesity group,the ordinary least squares(OLS)regression and quantile regression revealed that 25(OH)D was obviously associated with glucagon and fasting C-p levels.In the abdominal obesity group,the moderate analysis revealed a significant interaction effect of 25(OH)D and glucagon on C-p(P=0.0124).Furthermore,the conditional indirect effect of 25(OH)D on the glucagon/C-p ratio was significantly lower at 1 standard deviation(SD)below the mean(P=0.0002),and lower at the mean of the course of diabetes(P=0.0007).Conclusion 25(OH)D was found to be negatively correlated to glucagon and C-p in T2D patients with abdominal obesity.The 25(OH)D influenced C-p in part by influencing glucagon.The effect of 25(OH)D on the glucagon/C-p ratio in T2D patients with abdominal obesity,in terms of islet homeostasis,is influenced by the course of diabetes.

Serum 1, 25-Hydroxyvitamin D: A Useful Index of Cognitive and Physical Functional Impairment in Healthy Older Adults in Japan: A Pilot Study

We enrolled 23 Japanese men (age: 76.0 ± 8.7) and 17 women (age: 78.3 ± 9.3) in this study. The physical function of even a person getting on a wheelchair could be tested in all subjects. Blood was collected by venipuncture and the serum 1, 25-hydroxy vitamin D (1, 25OHD) concentration was measured. The Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment-Japanese version (MoCA-J) was used for the cognitive function test. Physical function was measured objectively using the Timed UP and Go (TUG) and 4-m walking test (4MWS). A significant positive correlation was found between serum 1, 25OHD and MMSE or MoCA-J. It is expected that an elderly person can maintain a mean serum 1, 25OHD level of about 100 pg/mL for preventing early cognitive disorder. In the present study, a significant positive correlation was found between urinary 25-hydroxy vitamin D (25OHD)/creatinine and MMSE or MoCA-J. Our results showed that urinary 25OHD might be a useful biomarker for predicting cognitive disorder. There was a significant negative correlation between serum 1, 25OHD and TUG or 4MWS. These findings suggest that serum 1, 25OHD levels might serve as a useful index to improve cognitive and physical functional impairment.

CHBMISTRY OF HYODEOXYCHOLIC ACID 5. CONCISE SYNTHESIS OF 25-HYDROXYCHOLESTEROL FROM HYODEOXYCHOLIC ACID, A KEY INTERMEDIATE OF 25-HYDROXYVITAMIN D_3

25-Hydroxycholesterol, which is an important intermediate for the synthesis of 25-hvdroxyvitamin D_3 and 1α, 25-dihydroxyvitamin D_3, was prepared efficiently from hyodeoxycholic acid in 31% overall yield in seven steps.

Study on the correlation and predictive value of serum pregnancyassociated plasma protein A, triglyceride and serum 25-hydroxyvitamin D levels with gestational diabetes mellitus

BACKGROUND Gestational diabetes mellitus(GDM)is a concern due to its rapid increase in incidence in recent years.AIM To investigate the correlation and predictive value of serum pregnancyassociated plasma protein A(PAPP-A),triglyceride(TG),and 25-hydroxyvitamin D[25-(OH)D]with GDM in early pregnancy.METHODS A total of 99 patients in early pregnancy admitted to Peking University International Hospital from November 2015 to September 2017 were included,and underwent a fasting glucose test and oral glucose tolerance test screening at 24-28 wk of pregnancy.Of these cases with GDM,51 were assigned to group A and the remaining 48 cases without GDM were enrolled in group B.Serum PAPP-A,TG and 25-(OH)D in the two groups were compared and their correlation with blood sugar was analyzed.In addition,their diagnostic value in GDM was determined using receiver operating characteristic(ROC)curve analysis.RESULTS Group A had markedly lower serum PAPP-A and 25-(OH)D levels and a significantly higher serum TG level than group B,with statistical significance(P<0.05).Furthermore,Pearson analysis identified that PAPP-A and 25-(OH)D levels were negatively correlated with fasting blood glucose(FBG)levels(r=-0.605,P<0.001),(r=-0.597,P<0.001),while TG and FBG levels were positively correlated(r=0.628,P<0.001).The sensitivity,specificity,area under the curve(AUC)and optimal cut-off value of serum PAPP-A level in the diagnosis of GDM were 72.55%,82.35%,0.861 and 16.340,respectively,while the sensitivity of TG in diagnosing GDM was 86.27%,the specificity was 66.67%,the AUC was 0.813,with an optimal cut-off value of 1.796.The corresponding sensitivity,specificity,AUC and optimal cut-off value of serum 25-(OH)D were 64.71%,70.59%,0.721 and 23.140,respectively.Moreover,multivariate logistic regression analysis revealed that FBG,vascular endothelial growth factor,Flt-1,serum PAPP-A,TG,and 25-(OH)D were related risk factors leading to GDM in patients.CONCLUSION Serum PAPP-A,TG,and 25-(OH)D levels are all correlated with blood glucose changes in GDM,and are independent factors affecting the occurrence of GDM and have certain value in the diagnosis of GDM.

Effect of dietary canthaxanthin and 25-hydroxycholecalciferol supplementation on the performance of duck breeders under two different vitamin regimens

Background： Dietary canthaxanthin（CX）, 25-hydroxycholecalciferol（25-OH-D3） and vitamins have been widely reported to be involved in productive and reproductive performance of broiler breeders. However, limited information is available for duck breeders. In this study, a total of 1,560 Cherry Valley SM3 duck breeder females and 312 males were used to assess if the addition of CX and 25-OH-D3 could increase the performance of duck breeders under two different dietary vitamin regimens. Four diets were used under a 2 × 2 factorial arrangement with 2 kinds of vitamin premixes（REGULAR and HIGH; HIGH premix had higher levels of all vitamins except K3 than REGULAR premix）, and with or without the supplementation of the mixture of CX（6 mg/kg） and 25-OH-D3（0.069 mg/kg）. The ducks were fed ad libitum with pelleted diets based on corn-soybean meal from 38 to 77 wk of age.Results： HIGH vitamin premix decreased malondialdehyde（MDA） level（P 〈 0.001） of egg yolk, increased hatchability of fertile eggs（P = 0.029）, increased hatchability of total eggs（P = 0.029）, and decreased serum protein carbonyl level（P = 0.037） of breeder males. The mixture of CX and 25-OH-D3 increased serum calcium of breeder females（P = 0.010）, decreased the cracked egg rate（P = 0.001）, increased the pigmentation of egg yolk（P 〈 0.001）and male bill（P 〈 0.001）, and decreased MDA level of egg yolk（P 〈 0.001） and male serum（P = 0.034）. Interactive effects were observed in cracked egg rate（P = 0.038）, shell thickness（P = 0.011） and serum phosphorus（P = 0.026）of breeder females. HIGH vitamin premix together with the mixture of CX and 25-OH-D3 decreased cracked egg rate and increased shell thickness of duck breeders. Serum phosphorus was decreased in duck breeder females fed REGULAR vitamin premix without the addition of the CX and 25-OH-D3 mixture.Conclusions： Dietary HIGH vitamin premix increased antioxidant status of eggs and breeder males, and increased hatchability. The mixture of CX and 25-OH-D3 enhanced egg shell quality, and promoted pigmentation and antioxidant status of eggs and breeder males.

The Relationship between Serum 25-Hydroxyvitamin D and Resistin Levels in Saudi Diabetic Patients

Objectives: The aim of this study was to investigate the relationship between the levels of 25-hydroxyvitamin D and the adipokine resistin in Saudi diabetic patients and those at high risk to develop atherosclerotic cardiovascular diseases. Methodology: One hundred and sixty seven subjects were recruited for the cross-sectional study at King Fahad Medical City, Saudi Arabia. Blood samples were analyzed for biochemical parameters. Serum 25-hydroxyvitamin D and resistin levels were measured for all the participants. Result: Fifty six type-1, 55 type-2 diabetic patients and 56 healthy controls were recruited. Serum 25-hydroxyvitamin D level in the control group was 44.21 ± 41.80 μg/ml compared to 50.67 ± 35.60 μg/ml in the diabetic group (P = 0.427) with no significant different between type-2 diabetes mellitus and type-1 diabetes mellitus (P = 0.628). Resistin level in the control group was 14.00 ± 7.39μg/ml compared to 20.21 ± 16.94 μg/ml in the diabetic group (P ≤ 0.01), no significant difference between type-2 diabetes mellitus and type-1 diabetes mellitus (P = 0.817). Resistin in those taking vitamin D supplementation was 21.34 ± 18.27 μg/ml;and in those not taking vitamin D supplementation, it was 17.4 ± 11.19 μg/ml;(P = 0.237). There was significant negative correlation between 25-hydroxyvitamin D and resistin in type-2 diabetes mellitus (P ≤ 0.043) and no significant correlation was found between vitamin 25 (OH) D and resistin level in type-1 diabetes mellitus (P = 0.538). Blood urea and creatinine showed significant positive correlation with vitamin 25 (OH) D in one hand and resistin level on the other hand. Discussion and Conclusions: Several in vitro and in vivo studies have confirmed that the vitamin 25 (OH) D have numerous important functions in the body. The circulating vitamin 25 (OH) D and resistin levels were associated with general inflammation in renal diseases. This study showed significant negative correlation between resistin level and vitamin 25 (OH) D in type 2 diabetes mellitus reflecting their roles in glucose homeostasis. The positive correlation of resistin and vitamin D with urea may reflect their involvement in kidney dysfunction. The level of serum resistin showed slight increase in diabetic patients compared to control group and it was higher in type-2 diabetes mellitus. More efforts are needed to explore the physiological mechanism of vitamin 25 (OH) D and resistin action in metabolic disorders.

Visfatin and 25-Hydroxyvitamin D_(3) Levels Affect Coronary Collateral Circulation Development in Patients with Chronic Coronary Total Occlusion

Background:Coronary collateral circulation(CCC)plays a vital role in the myocardial blood supply,especially for ischemic myocardium.Evidence suggests that the visfatin and 25-hydroxyvitamin D_(3)[25(OH)D_(3)]levels are related to the degree and incidence of vascular stenosis associated with coronary artery disease;however,few studies have evaluated the effect of visfatin and 25(OH)D_(3) on CCC development in patients with chronic total occlusion(CTO).This study aimed to evaluate the relationship between the serum visfatin and 25(OH)D_(3) levels and CCC in patients with CTO.Methods:A total of 189 patients with CTO confirmed by coronary angiography were included.CCC was graded from 0 to 3 according to the Rentrop-Cohen classification.Patients with grade 0 or grade 1 collateral development were in-cluded in the poor CCC group(n=82),whereas patients with grade 2 or grade 3 collateral development were included in the good CCC group(n=107).The serum visfatin and 25(OH)D_(3) levels were measured by ELISA.Results:The visfatin level was significantly higher in the poor CCC group than in the good CCC group,and the 25(OH)D_(3) level was significantly lower in the poor CCC group than in the good CCC group(P=0.000).Correlation analysis showed that the Rentrop grade was negatively correlated with the visfatin level(r=−0.692,P=0.000)but positively correlated with the 25(OH)D_(3) level(r=0.635,P=0.000).Logistic regression analysis showed that the vis-fatin and 25(OH)D_(3) levels were independent risk factors for CCC(odds ratio 1.597,95%confidence interval 1.300-1.961,P=0.000 and odds ratio 0.566,95%confidence interval 0.444-0.722,P=0.000,respectively).The visfatin and 25(OH)D_(3) levels can effectively predict the CCC status.Conclusion:Serum visfatin and 25(OH)D_(3) levels are related to CCC development and are independent predictors of poor CCC.

Effect of Postmortem Ageing on Quality Parameters,Contents of Proteins,Lipids and 25-Hydroxyvitamin D and Oxidative Stability in the Camel Meat during Cold Storage

The effect of ageing was evaluated on quality parameters(pH,electrical conductivity(EC),osmolality,drip loss(DL)and cooking loss(CL)),proteins,fat and 25-hydroxyvitamin D(25-OH-D)total levels and antioxidant status(malondialdehyde(MDA)and catalase(CAT)activity)in meat of camels during storage at 4±1°C.Samples were taken from the brachial triceps muscle(triceps barchii)and were stored at 4±1°C for 10 d.Quality parameters,chemical composition and antioxidant status were assessed at 3 h and 24 h postslaughter and 5,7 and 10 d postmortem during cold storage.CAT activity significantly decreased while osmolality,EC,DL,CL and MDA contents significantly increased,from the 5th or 7th postmortem day of cold storage of the camel meat.However,proteins,lipids and 25-OH-D total contents showed no significant differences during all period of ageing.In conclusion,in the dromedary camel,ageing time of triceps muscle influenced significantly its quality characteristics and antioxidant status from the 5th or 7th postmortem day of refrigerated storage,without any variation of proteins,fat and 25-OH-D contents.

Effect of 25-Hydroxycholecalciferol (25-OH-D3) on Productive Performance and Bone Mineralization in Broiler

In order to evaluate the effect of 25-OH-D3 on productive performance of broilers and bone mineralization, an experiment in which 10,000 newly born Cobb mixed was used. The animals were divided into two groups: experimental received 25-OH-D3 at a dose of 50 mg/liter and a control group (0 mg/liter). Weight gain and European Production Efficiency Factor (EPEF) were higher (P < 0.05) for chickens that received 25-OH-D3. Mortality was lower (P < 0.05) for the group receiving 25-OH-D3. However feed conversion rate (FCR) and feed intake showed no significant difference between treatments. The amount of calcium in tibia was higher in the experimental group (P < 0.05). Based on the results obtained, it is concluded that the use of 25-OH-D3 improves production performance and bone mineral status broiler.

Upregulation of 25-hydroxyvitamin D_3-1α-hydroxylase by butyrate in Caco-2 cells

AIM: To investigate the possible involvement of 25-hydroxyvitamin D3-1α-hydroxylase [1α-25(OH)2D3] in butyrate-induced differentiation in human intestinal cell line Caco-2 cells.METHODS: Caco-2 cells were incubated either with 3 mmol/L butyrate and 1 μmol/L 25(OH)2D3 or with 1μmol/L 1α-25(OH)2D3 for various time intervals ranging from 0 to 72 h. Additionally, cells were co-incubated with butyrate and either 25(OH)2D3 or 1α-25(OH)2D3.1α-25(OH)2D3 mRNA was determined semi-quantitatively using the fluorescent dye PicoGreen. Immunoblotting was used for the detection of 1α-25(OH)2D3 protein.Finally, enzymatic activity was measured by ELISA.RESULTS: Both butyrate and 1α-25(OH)2D3 stimulated differentiation of Caco-2 cells after a 48 h incubation period, while 25(OH)2D3 had no impact on cell differentiation. Synergistic effects on differentiation were observed when cells were co-incubated with butyrate and vitamin D metabolite. Butyrate transiently upregulated 1α-25(OH)2D3 mRNA followed by a timely delayed protein upregulation. Coincidently, enzymatic activity was enhanced significantly. The induction of the enzyme allowed for comparable differentiating effects of both vitamin D metabolites.CONCLUSION: Our experimental data pr ovide a further mechanism for the involvement of the vitamin D signaling pathway in colonic epithelial cell differentiation by butyrate. The enhancement of 1α-25(OH)2D3 followed by antiproliferative effects of the vitamin D prohormone in the Caco-2 cell line suggest that 25(OH)2D3 in combination with butyrate may offer a new therapeutic approach for the treatment of colon cancer.

糖调节受损患者血清25(OH)D和免疫相关因子对亚临床动脉粥样硬化影响的研究

目的:研究糖调节受损患者血清25(OH)D和免疫相关因子对亚临床动脉粥样硬化(AS)的影响。方法:选取2019年12月至2021年4月枣庄市立医院收治的142例糖调节受损患者,根据经颈动脉超声检查和臂踝脉搏波传导速度分组,仅糖调节受损患者为对照组(n=86),并发亚临床AS为观察组(n=56)。比较两组患者血清25(OH)D和免疫因子,应用颈动脉超声检测测定颈动脉内中膜厚度,Pearson法测定血清颈动脉内中膜厚度与血清25(OH)D和免疫因子的相关性。采集基线资料和血液学指标,单因素和多因素Logistic回归分析确定亚临床AS的影响因素,应用ROC曲线评估血清25(OH)D和免疫因子对亚临床AS的诊断效能。结果:观察组患者血清25(OH)D[(24.01±4.87)mmol/L vs 3(0.74±5.01)mmol/L,t=7.909,P=0.000)明显低于对照组,观察组患者TNF-α[(48.32±8.02)ng/L vs(33.21±9.00)ng/L,t=10.199,P=0.000)和IL-6[(41.22±9.43)ng/L vs(30.21±7.01)ng/L,t=7.492,P=0.000)明显高于对照组。颈动脉内中膜厚度与血清25(OH)D呈负相关(r=-0.428,P<0.001),颈动脉内中膜厚度与血清TNF-α和IL-6呈正相关(r=0.574,0.577,P<0.001)。Logistic回归分析结果表明,血清25(OH)D(OR=0.520,95%CI:0.401~0.675)、血清TNF-α(OR=1.667,95%CI:1.131~2.457)和血清IL-6(OR=1.478,95%CI:1.213~1.802)等是亚临床AS发生的影响因素。ROC曲线结果显示,血清25(OH)D最佳截断值为28.32 mmol/L,其对应的敏感度为69.64%,特异度为70.93%,AUC为0.803(95%CI:0.749~0.855);血清TNF-α临界值为40.56 ng/L,其对应的敏感度为71.43%,特异度为72.09%,AUC为0.761(95%CI:0.717~0.823);血清IL-6截断值为36.13 ng/L,其对应的敏感度为60.71%,特异度为60.47%,AUC为0.627(95%CI:0.566~0.702);回归分析对应的敏感度为85.71%,特异度为81.40%,AUC为0.889(95%CI:0.830~0.915)。结论:血清25(OH)D与免疫相关因子单独和联合回归检测可有效预测亚临床AS的发生,上述指标与颈动脉内中膜厚度相关,且血清25(OH)D和免疫相关因子是亚临床AS发生的预测指标,临床宜根据指标进行针对性干预,值得进一步研究。

老年血液透析病人衰弱与血清瘦素及25-羟维生素D的相关性研究

目的探究老年血液透析病人血清瘦素及25-羟维生素D[25(OH)D]水平,并分析其与透析病人衰弱的相关性。方法选取2021年4月至2023年4月我院收治的150例老年血液透析病人,依据Fried表型评价病人的衰弱情况,分为非衰弱组(51例),衰弱前期组(74例)和衰弱组(25例)。比较3组一般资料、血清瘦素、25(OH)D及心功能。采用多因素Logistic回归分析老年血液透析病人衰弱的影响因素。结果3组年龄、糖尿病比例、透析龄、左室舒张末期内径,以及白蛋白、镁、IL-6、瘦素、25(OH)D水平比较,差异均有统计学意义(P<0.01)。多因素有序Logistic回归分析显示,年龄、透析龄、糖尿病、镁、IL-6、白蛋白、瘦素、25(OH)D、左室舒张末期内径是老年血液透析病人衰弱的独立影响因素(P<0.05)。结论针对白蛋白水平低、瘦素水平高、25(OH)D水平低的老年血液透析病人采取积极干预措施,有利于延缓衰弱的进展。

糖尿病周围神经病变伴抑郁症状患者血清同型半胱氨酸与25-羟维生素D表达及其临床意义

目的探讨糖尿病周围神经病变(DPN)伴抑郁症状患者血清同型半胱氨酸(Hcy)与25-羟维生素D[25-(OH)D]表达及其临床意义。方法选取DPN伴抑郁症状患者50例设为研究组,DPN未伴有抑郁症状患者32例设为对照组。采用酶循环法检测Hcy水平,电化学发光法检测25-(OH)D水平。比较两组患者Hcy、25-(OH)D水平以及研究组不同抑郁程度患者Hcy、25-(OH)D水平差异。采用Pearson相关分析探讨DPN伴抑郁症状患者的Hcy、25-(OH)D水平与HADM-17评分的相关性,采用Logistic回归分析探讨DPN伴抑郁症状患者抑郁程度的影响因素。结果研究组患者Hcy水平、HAMD-17评分高于对照组,25-(OH)D水平低于对照组(P<0.01)。重度抑郁患者Hcy水平高于轻度、中度抑郁患者,25-(OH)D水平低于轻度、中度抑郁患者(P<0.05)。Pearson相关性分析显示,DPN伴抑郁症状患者Hcy水平与HAMD评分呈显著正相关(r=0.886,P<0.05),25-(OH)D水平与HAMD-17评分呈显著负相关(r=-0.619,P<0.05)。单因素分析结果显示,DPN伴抑郁症状患者性别、收缩压、空腹血糖、文化程度、Hcy、25-(OH)D水平比较,差异有统计学意义(P<0.05或0.01)。Logistic回归分析结果显示,性别、空腹血糖、文化程度、Hcy、25-(OH)D水平是DPN伴抑郁症状患者抑郁程度的影响因素(P<0.01)。结论DPN伴抑郁症状患者Hcy水平升高,25-(OH)D水平降低,性别、空腹血糖、文化程度是DPN伴抑郁症状患者抑郁程度的影响因素。Hcy和25-(OH)D表达在评估DPN患者抑郁严重程度方面具有重要价值,能为患者后续治疗提供生物学信息参考。

咳嗽变异性哮喘患儿血清25(OH)D_(3)、IL-6水平变化与T淋巴细胞免疫平衡的关系及预测预后的价值分析

目的分析咳嗽变异性哮喘(CVA)患儿血清25-羟维生素D_(3)[25(OH)D_(3)]、白介素-6(IL-6)水平变化与T淋巴细胞免疫平衡的关系及预测预后的价值。方法选取98例CVA患儿作为研究组,49例健康儿童作为对照组。比较两组一般资料、血清25(OH)D_(3)、IL-6水平、T淋巴细胞免疫平衡指标,分析研究组血清25(OH)D_(3)、IL-6水平与免疫平衡指标的相关性,比较治疗4周后不同预后患儿治疗前后血清25(OH)D_(3)、IL-6水平及变化值(以△表示治疗前后变化值的绝对值),分析△25(OH)D_(3)、△IL-6与预后的相关性及治疗前血清25(OH)D_(3)、IL-6预测预后的价值。结果研究组血清25(OH)D_(3)水平、外周血CD4^(+)T淋巴细胞百分比低于对照组,血清IL-6水平高于对照组(P<0.05);研究组血清25(OH)D_(3)水平与外周血CD4^(+)T淋巴细胞百分比呈正相关,血清IL-6水平与外周血CD4^(+)T淋巴细胞百分比呈负相关(P<0.05);预后不良患儿治疗前、治疗后血清25(OH)D_(3)水平低于预后良好患儿,IL-6水平高于预后良好患儿,△IL-6小于预后良好患儿(P<0.05);研究组△IL-6与预后呈正相关(P<0.05);治疗前血清25(OH)D_(3)、IL-6单独预测CVA患儿预后不良的曲线下面积(AUC)分别为0.784、0.764,与单独预测比较,联合预测的AUC(0.926)明显增大,NRI、IDI均>0(P<0.05)。结论CVA患儿血清25(OH)D_(3)、IL-6水平变化与T淋巴细胞免疫平衡失调有关,且各指标联合在预测患儿预后方面具有良好应用价值。

首次复治菌阳肺结核合并糖尿病患者血清IAP、25(OH)D水平及对疗效的预测价值

目的探讨首次复治菌阳肺结核(TB)合并糖尿病(DM)患者血清免疫抑制酸性蛋白(IAP)、25-羟基维生素D[25(OH)D]表达变化及2者对治疗疗效的预测价值。方法选取本院2019年1月至2022年4月首次复治菌阳TB合并DM患者48例为实验组,另选同期单纯TB患者48例为对照组。测定并比较两组患者治疗前后血清IAP、25(OH)D水平;多因素Logistic回归分析影响菌阳TB合并DM患者痰菌阴转的可能因素;受试者工作特征(ROC)曲线评估IAP、25(OH)D对患者痰菌未转阴的预测价值。结果实验组痰菌阴转患者31例(64.58%)显著低于对照组痰菌阴转患者40例(83.33%)。治疗2个月后,实验组、对照组血清IAP均显著降低,25(OH)D水平均显著升高(P<0.05);且治疗2个月后实验组血清IAP水平显著低于对照组,25(OH)D水平显著高于对照组(P<0.05)。多因素Logistic回归分析显示,IAP高水平是首次复治菌阳TB合并DM患者痰菌未阴转的危险因素(P<0.05),25(OH)D高水平是首次复治菌阳TB合并DM患者痰菌未阴转的保护因素(P<0.05)。ROC曲线显示,IAP预测痰菌未阴转的AUC为0.719,25(OH)D预测痰菌未阴转的AUC为0.791,2者联合预测痰菌未阴转的AUC为0.871,明显高于2者单独诊断(Z_(联合vs IAP)=2.605、P=0.009;Z_(联合vs 25(OH)D)=2.408、P=0.016),且灵敏度、特异性分别为78.46%、82.86%。结论首次复治菌阳TB合并DM患者经治疗后血清IAP水平降低、25(OH)D水平升高,2者联合对菌阳TB合并DM患者痰菌未阴转具有一定预测价值。

基于25⁃羟基维生素D、血清学因子等对老年类风湿性关节炎合并间质性肺疾病Nomogram预测模型的构建和评价

目的基于25-羟基维生素D[25-(OH)D]、血清学因子等构建老年类风湿性关节炎合并间质性肺疾病(RA-ILD)的Nomogram预测模型,并进行模型评价。方法选取2020年5月—2022年10月收治的老年类风湿性关节炎(RA)220例,根据是否合并间质性肺疾病将其分为RA-ILD组(51例)和单纯RA组(169例)2组,比较2组一般资料和实验室相关指标[类风湿因子(RF)、抗环瓜氨酸抗体(anti-CCP)、抗角蛋白抗体(AKA)、类风湿关节炎活动度评分(DAS28)]、25-(OH)D、血清学因子[白细胞介素-33(IL-33)、白细胞介素-35(IL-35)、赖氨酰氧化酶样蛋白-2(LOXL-2)、涎液化糖链抗原-6(KL-6)、基质金属蛋白酶-8(MMP-8)]水平,分析老年RA患者25-(OH)D与各血清学因子的相关性,探讨老年RA-ILD发生的影响因素,根据影响因素、25-(OH)D及血清学因子构建老年RA-ILD的Nomogram预测模型,并对该模型进行评价。结果RA-ILD组和单纯RA组RF、DAS28比较差异有统计学意义(P<0.01);RA-ILD组25-(OH)D、IL-35、KL-6低于单纯RA组,IL-33、LOXL-2、MMP-8高于单纯RA组(P<0.05,P<0.01)。老年RA患者25-(OH)D与IL-35、KL-6呈正相关,与IL-33、LOXL-2、MMP-8呈负相关(P<0.05)。25-(OH)D、IL-35、KL-6、IL-33、LOXL-2、MMP-8、RF和DAS28均为老年RA-ILD发生的影响因素(P<0.01)。在Nomogram预测模型中直接获取各预测因素对应得分,得分之和对应的预测概率即为该老年患者RA-ILD发生的风险概率,该模型对老年RA-ILD发生具有良好预测效能,且具有良好校准度。结论基于25-(OH)D、血清学因子等构建老年RA-ILD发生的Nomogram预测模型,预测效能较高、校准度良好。