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广西医科大学第一附属医院内分泌科,南宁,530021
纸质出版日期:2018,
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陈翠红, 秦映芬. 广西南宁格雷夫斯病患者维生素D缺乏和不足危险因素分析[J]. 重庆医科大学学报, 2018,43(12):1572.
Chen Cuihong, Qin Yingfen. Risk factors for vitamin D deficiency and insufficiency in patients with Graves disease in Nanning,Guangxi Province,China[J]. Journal of Chongqing Medical University, 2018,43(12):1572.
目的:探讨不同维生素D营养状况格雷夫斯病(Graves disease,GD)患者临床特征及GD患者发生维生素D缺乏和不足的危险因素。方法:收集328名GD患者病例资料,依据患者维生素D水平分为维生素D缺乏和不足组[25(OH)D3<75 nmol/L]和维生素D正常组[25(OH)D3≥75 nmol/L],比较2组年龄、性别构成、促甲状腺激素(thyroid stimulating hormone,TSH)、游离三碘甲状腺原氨酸(free triiodothyronine,FT3)、游离甲状腺素(free thyroxine,FT4)、促甲状腺素受体抗体(thyrotropin receptor an-tibody,TRAb)、甲状腺过氧化物酶抗体(thyroid peroxide antibody,TPOAb)及甲状腺球蛋白抗体(thyroglobulin antibody,TGAb)等水平以探讨2组临床特征;单因素及多因素logistic回归分析GD患者发生维生素D缺乏不足的危险因素。结果:GD患者维生素D缺乏和不足的检出率为64.02%。维生素D缺乏和不足GD患者年龄小于维生素D正常GD患者,差异具有统计学意义[(34.89±12.25) vs. (39.11±11.97),P<0.05]。2组性别及季节构成存在显著差异(P<0.05)。多因素logistic回归分析,结果显示GD患者发生维生素D缺乏和不足的危险因素为性别及季节,与甲状腺抗体、甲状腺功能及肝功能无相关关系(P>0.05)。女性GD患者发生维生素D缺乏和不足风险为男性GD患者的3.052倍(OR=3.052,95%CI=1.641~5.676,P<0.05),而冬季发生维生素D缺乏和不足的风险为夏季的2.173倍(OR=2.173,95%CI=1.303~3.623,P<0.05)。结论:女性GD患者冬季时较男性患者及夏季时更容易出现维生素D缺乏和不足,应注意预防。同时,在研究GD患者维生素D水平时应注意校正以上危险因素。
Objective:To investigate the clinical characteristics of different vitamin D status in patients with Graves disease(GD) and the risk factors for vitamin D deficiency and insufficiency in GD patients. Methods:The medical data of 328 patients with GD were collected. These patients were divided into two groups according to their vitamin D levels:vitamin D deficiency and insufficiency group [25(OH)D3 <75mmol/L] and vitamin D sufficiency group[25(OH)D3≥75mmol/L]. Age,sex,the levels of thyroid stimulating hor-mone,free triiodothyronine,free thyroxine,thyrotropin receptor antibody(TRAb),thyroid peroxide antibody(TPOAb),and thyroglobu-lin antibody(TGAb) were compared to investigate the clinical characteristics of these two groups. Univariate and multivariate logistic regression analyses were used to identify the risk factors for vitamin D deficiency and insufficiency in patients with GD. Results:The prevalence of vitamin D deficiency and insufficiency in GD patients was 64.02%. The age of the vitamin D deficiency and insuffi-ciency group was significantly younger than that of the vitamin D sufficiency group (34.89±12.25 vs. 39.11±11.97,P<0.05). There were significant differences in sex and seasonal compositions between the two groups(both P<0.05). The multivariate logistic regression analysis showed that the risk factors for vitamin D deficiency and insufficiency in GD patients were sex and season;no association with thyroid antibody,thyroid function,or liver function was found(P >0.05). The risk of vitamin D deficiency and insufficiency in fe-male GD patients was 3.052 times higher than that in male GD patients(odds ratio[OR]=3.052,95% confidence interval(CI):1.641 to 5.676,P<0.05). Moreover,the risk of vitamin D deficiency and insufficiency in winter was 2.173 times higher than that in summer(OR=2.173,95% CI=1.303 to 3.623,P<0.05). Conclusion:The risk of vitamin D deficiency and insufficiency is higher in female GD patients than in male GD patients and in winter than in summer,which prevention measures should be taken for. In the mean-time,the above risk factors should be adjusted when studying the vitamin D level in GD patients.
Graves病维生素D缺乏危险因素
Graves diseasevitamin D deficiencyrisk factor
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