目的:据报道,维生素D(VD)缺乏有助于克罗恩病(CD)的进展,并影响CD患者的预后。这项研究调查了血清VD的作用,体重指数(BMI),肿瘤坏死因子α(TNF-α)在克罗恩病诊断中的应用.
方法:纳入2019年5月至2020年12月的CD患者(n=76)和健康受试者(n=76)。血清25-羟维生素D[25(OH)D]水平,BMI,和TNF-α水平,连同其他生化参数,在治疗前进行评估。单一和联合检测血清25(OH)D的诊断效能,BMI,使用受试者工作特征(ROC)曲线确定TNF-α。
结果:25(OH)D,BMI,和营养指标,包括血红蛋白,总蛋白质,白蛋白,高密度脂蛋白胆固醇,要低得多,CD患者的TNF-α水平明显高于健康受试者(均P<0.05)。单次检测25(OH)D的ROC曲线下面积,BMI,和TNF-α分别为0.887、0.896和0.838,最佳截止值为20.64ng/mL,19.77kg/m2,6.85fmol/mL,分别。联合检测25(OH)D的诊断效能,BMI,TNF-α最高,ROC曲线下面积为0.988(95CI:0.968-1.000)。
结论:25(OH)D的联合检测,TNF-α,BMI表现出很高的敏感性,特异性,和CD诊断的准确性;因此,在临床实践中对CD的诊断是有效的。
OBJECTIVE: Vitamin D (VD) deficiency was reported to contribute to the progression of Crohn\'s disease (CD) and affect the prognosis of CD patients. This study investigated the role of serum VD, body mass index (BMI), and tumor necrosis factor alpha (TNF-α) in the diagnosis of Crohn\'s disease.
METHODS: CD patients (n=76) and healthy subjects (n=76) were enrolled between May 2019 and December 2020. The serum 25-hydroxyvitamin D [25(OH)D] levels, BMI, and TNF-α levels, together with other biochemical parameters, were assessed before treatment. The diagnostic efficacy of the single and joint detection of serum 25(OH)D, BMI, and TNF-α was determined using receiver operating characteristic (ROC) curves.
RESULTS: The levels of 25(OH) D, BMI, and nutritional indicators, including hemoglobin, total protein, albumin, and high-density lipoprotein cholesterol, were much lower, and the TNF-α levels were much higher in the CD patients than in the healthy subjects (P<0.05 for all). The areas under the ROC curve for the single detection of 25(OH)D, BMI, and TNF-α were 0.887, 0.896, and 0.838, respectively, with the optimal cutoff values being 20.64 ng/mL, 19.77 kg/m2, and 6.85 fmol/mL, respectively. The diagnostic efficacy of the joint detection of 25(OH)D, BMI, and TNF-α was the highest, with an area under the ROC curve of 0.988 (95%CI: 0.968-1.000).
CONCLUSIONS: The joint detection of 25(OH)D, TNF-α, and BMI showed high sensitivity, specificity, and accuracy in CD diagnosis; thus, it would be effective for the diagnosis of CD in clinical practice.