维生素D含量与幼年特发性关节炎的关系

Association of vitamin D concentrations with juvenile idiopathic arthritis

摘要:

目的 25 羟维生素D₃ [25(OH)D₃] 是维生素D(VitD)的主要产物,可反映体内活性VitD 的绝对含量。该文检测了幼年特发性关节炎(JIA)患儿血清25 羟维生素D₃ [25(OH)D₃] 水平的变化,以了解VitD 含量与JIA 发病、疾病活动度等的可能关系。方法 收集2013 年1 月至2014 年3 月确诊为JIA 的53 例患儿的血清标本,采用酶联免疫法检测其血清25(OH)D₃ 水平,并与同期106 例正常体检儿童(对照组)血清25(OH)D₃水平作比较。并分析JIA 患儿25(OH)D₃ 水平与JIA 亚型、疾病活动度、外周血超敏C 反应蛋白、血沉的相关性。结果 与对照组比较,JIA 组25(OH)D₃ 水平明显减低(中位数42.6 nmol/L vs 49.9 nmol/L,P<0.01)。JIA 组VitD 严重缺乏比例明显高于对照组(17.0% vs 6.6%,P<0.05)。JIA 患儿血清25(OH)D₃ 水平与JIA 亚型、疾病活动度、C 反应蛋白、血沉无明显相关性。结论 JIA 儿童VitD 含量明显减低,VitD 含量降低可能与JIA 的发生有关,但VitD 含量与JIA 亚型、疾病严重度及活动性无关。

Abstract:

Objective 25-Hydroxyvitamin D₃ [25(OH)D₃] is the main product of vitamin D and can reflect the absolute concentration of active vitamin D in the body. This study examined serum 25(OH)D₃ levels in children with juvenile idiopathic arthritis (JIA) in order to explore the association of vitamin D concentrations with the pathogenesis and disease activity of JIA. Methods Serum samples were collected from 53 children confirmed as having JIA between January 2013 and March 2014, as well as 106 healthy children (control group) who underwent physical examination in the same period. Serum concentrations of 25(OH)D₃ were measured using ELISA and compared between the cases and healthy controls. The association of serum 25(OH)D₃ levels with JIA subtypes, ACR Pediatric 30 Score, peripheral blood C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) were analyzed in children with JIA. Results Compared with the control group, the JIA group had significantly reduced serum 25(OH)D₃ levels (median: 42.6 nmol/L vs 49.9 nmol/L; P<0.01). The percentage of subjects with severe deficiency of vitamin D in the JIA group was significantly higher than that in the control group (17.0% vs 6.6%; P<0.05). Serum 25(OH)D₃ showed no significant correlations with JIA subtypes, ACR Pediatric 30 Score, CRP, and ESR in children with JIA. Conclusions Vitamin D concentrations are significantly decreased in children with JIA. Decreased vitamin D concentrations may be associated with the pathogenesis of JIA. However, vitamin D concentrations may have no correlations with JIA subtypes, disease severity, and disease activity.