Vitamina D

vitamina D
  • 文章类型: Journal Article
    长期低磷酸盐血症,由血清磷(P)水平<2.5mg/dL定义,损害骨骼矿化组织的发育和质量,牙科,和听觉系统。P稳态主要取决于肠道吸收和肾脏排泄。低磷血症可能是由于P重新分布到细胞内空间,增加肾脏损失,或减少肠道吸收。低磷酸盐血症可分为急性或慢性,取决于时间进程。大多数情况下,无论是急性还是慢性,是由于后天的原因。然而,一些慢性病例可能有遗传起源。准确和早期诊断,随后进行适当的治疗,对限制其对身体的负面影响至关重要。
    Long-term hypophosphatemia, defined by serum phosphorus (P) levels <2.5mg/dL, impairs the development and quality of mineralized tissue of the skeletal, dental, and auditory systems. P homeostasis depends mainly on intestinal absorption and renal excretion. Hypophosphatemia may be due to the redistribution of P to the intracellular space, increased renal losses, or decreased intestinal absorption. Hypophosphatemia can be categorized as acute or chronic, depending on the time course. Most cases, either acute or chronic, are due to acquired causes. However, some chronic cases may have a genetic origin. Accurate and early diagnosis, followed by adequate treatment, is essential to limit its negative effects on the body.
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  • 文章类型: Journal Article
    维生素D(VD)缺乏与各种肿瘤有关。然而,VD与皮肤癌之间的关联存在争议.尽管在非黑色素瘤皮肤癌中,足够或甚至高水平的VD可能与更高的发展肿瘤的风险有关,这可能是由于阳光照射和VD水平之间的直接关联而产生的偏差。关于黑色素瘤,结果是矛盾的。大多数研究分析表明,较高水平的VD可以降低黑色素瘤的风险,与具有更好预后和增强的抗肿瘤反应的黑色素瘤相关,与黑色素瘤免疫治疗相关的不良事件也较少。然而,仍需要足够方法学质量的前瞻性研究来评估VD水平及其补充剂与皮肤癌发展/预后之间的关联.
    Vitamin D (VD) deficiency has been associated with various tumors. However, the association between VD and skin cancer is controversial. Although in non-melanoma skin cancer, adequate or even high levels of VD can be associated with a higher risk of developing tumors, this could be biased by the direct association between sun exposure and VD levels. Regarding melanoma, results are contradictory. Most studies analyzed state that higher levels of VD could reduce the risk of melanoma, be associated with melanomas with better prognosis and with an enhanced antitumor response, and also with fewer adverse events associated with melanoma immunotherapy. However, prospective studies of adequate methodological quality are still needed to assess the association between VD levels and its supplementation and development/prognosis in skin cancer.
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  • 文章类型: Journal Article
    目的:过敏性紫癜(HSP)和川崎病(KD)是儿童血管炎中两种主要的炎症性疾病。考虑到25-羟维生素D3的抗炎作用,我们决定研究血清25-羟维生素D3水平与这些疾病的类型和严重程度的关系。
    方法:本研究以254例KD和HSP血管炎患儿的历史队列进行。提取了所需的数据,使用来自患者电子文件的研究人员制作的问卷,然后在收集患者信息后进行分析。
    结果:在HSP组中,54%的参与者是男孩。同样,在KD组,男孩比女孩受影响更大。有和没有肾脏受累的HSP患者的25-羟基维生素D3水平比较(P=0.02),血尿(P=0.14),在有和没有心脏病的两组中,在KD患者中有或没有冠状动脉扩张(P<0.001)也有统计学意义。
    结论:研究结果表明,维生素D3水平不足与两种疾病并发症的恶化显着相关,因此,维生素D缺乏可能是HSP和KD患者严重程度的有效预测因素。
    OBJECTIVE: Henoch Schönlein purpura (HSP) and Kawasaki disease (KD) are two main inflammatory diseases among childhood vasculitis. Considering the anti-inflammatory effects of 25-hydroxyvitamin D3, we decided to investigate the association of serum 25-hydroxy vitamin D3 level with the type and severity of these conditions.
    METHODS: The present study was performed as a historical cohort of 254 affected children with KD and HSP vasculitis. The required data were extracted, using a researcher-made questionnaire from patients\' electronic file, and then they were analyzed after collecting information of the patients.
    RESULTS: In HSP group, 54% of participants were boys. Similarly, in KD group, boys were more affected than girls. The comparative 25-hydroxyvitamin vitamin D3 level in HSP patients with and without renal involvement (P=0.02), hematuria (P=0.14), and in two groups with and without heart disease, and also with and without coronary artery dilatation in KD patients (P<0.001) were significant.
    CONCLUSIONS: The findings showed that insufficient level of vitamin D3 were significantly associated with the exacerbation of complications of both diseases, and therefore it seems that vitamin D deficiency can be an effective predictive factor of severity in HSP and KD patients.
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  • 文章类型: Journal Article
    维生素D(VD)缺乏与各种肿瘤有关。然而,VD与皮肤癌之间的关联存在争议.尽管在非黑色素瘤皮肤癌中,足够或甚至高水平的VD可能与更高的发展肿瘤的风险有关,这可能是由于阳光照射和VD水平之间的直接关联而产生的偏差。关于黑色素瘤,结果是矛盾的。大多数研究分析表明,较高水平的VD可以降低黑色素瘤的风险,与具有更好预后和增强的抗肿瘤反应的黑色素瘤相关,与黑色素瘤免疫治疗相关的不良事件也较少。然而,仍需要足够方法学质量的前瞻性研究来评估VD水平及其补充剂与皮肤癌发展/预后之间的关联.
    Vitamin D (VD) deficiency has been associated with various tumors. However, the association between VD and skin cancer is controversial. Although in non-melanoma skin cancer, adequate or even high levels of VD can be associated with a higher risk of developing tumors, this could be biased by the direct association between sun exposure and VD levels. Regarding melanoma, results are contradictory. Most studies analyzed state that higher levels of VD could reduce the risk of melanoma, be associated with melanomas with better prognosis and with an enhanced antitumor response, and also with fewer adverse events associated with melanoma immunotherapy. However, prospective studies of adequate methodological quality are still needed to assess the association between VD levels and its supplementation and development/prognosis in skin cancer.
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  • 文章类型: Observational Study
    背景:维生素D缺乏与许多疾病的发展风险相关,包括癌症.在分子水平上,维生素D似乎有抗肿瘤作用。然而,维生素D缺乏在癌症发病机制中的作用仍未阐明,大量研究结果不一致.这项研究旨在确定黑色素瘤诊断过程中维生素D缺乏是否会增加发生非皮肤第二原发癌(SPC)的风险。
    方法:对2011年1月1日至2022年10月31日诊断为黑色素瘤的663例患者进行了回顾性研究。使用Kaplan-Meier曲线进行每个变量对后续非皮肤癌发展的影响,并通过对数秩检验评估差异。使用Cox比例风险单变量和多变量模型来量化每个变量在发展非皮肤瘤形成时间的影响。
    结果:在663名患者中,34开发了非皮肤SPC。维生素D水平与非皮肤SPC发育之间没有统计学上的显着关联(log-rank,p=0.761)。年龄>60岁,第三阶段/第四阶段,和结节性黑色素瘤亚型与SPC的发展显着相关。经过多变量分析,仅年龄>60岁(HR3.4;HRCI95%:1.5-7.6)和结节性黑色素瘤亚型(HR2.2;HRCI95%:1.0-4.8)纳入最终模型.
    结论:我们的研究结果表明,维生素D缺乏与黑色素瘤患者发生非皮肤SPC的风险增加无关。然而,60岁以上的年龄和结节性黑色素瘤亚型会增加非皮肤SPC发展的风险。
    BACKGROUND: Vitamin D deficiency associates with the risk of developing many diseases, including cancer. At the molecular level, vitamin D appears to have an antineoplastic effect. However, the role of vitamin D deficiency in cancer pathogenesis remains unelucidated and numerous studies have resulted in discordant results. This study aimed to determine whether vitamin D deficiency during melanoma diagnosis increases the risk of developing non-cutaneous second primary cancers (SPC).
    METHODS: A retrospective study on 663 patients diagnosed with melanoma between 1 January 2011 and 31 October 2022. The effect of each variable on the development of a subsequent non-cutaneous cancer was performed using Kaplan-Meier curves and differences were assessed by log-rank tests. Cox proportional hazard univariate and multivariate models were used to quantify the effect of each variable in the time to develop a non-cutaneous neoplasia.
    RESULTS: Out of 663 patients, 34 developed a non-cutaneous SPC. There was no statistically significant association between vitamin D levels and non-cutaneous SPC development (log-rank, p=0.761). Age>60 years, stage III/IV, and nodular melanoma subtype were significantly associated with the development of a SPC. After multivariate analysis, only age>60 years (HR 3.4; HR CI 95%: 1.5-7.6) and nodular melanoma subtype (HR 2.2; HR CI 95%: 1.0-4.8) were included in the final model.
    CONCLUSIONS: Our results suggest that vitamin D deficiency is not associated with an increased risk of developing non-cutaneous SPC in melanoma patients. However, age over 60 years and nodular melanoma subtype increase the risk for non-cutaneous SPC development.
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  • 文章类型: Observational Study
    背景:维生素D缺乏与许多疾病的发展风险相关,包括癌症.在分子水平上,维生素D似乎有抗肿瘤作用。然而,维生素D缺乏在癌症发病机制中的作用仍未阐明,大量研究结果不一致.这项研究旨在确定黑色素瘤诊断过程中维生素D缺乏是否会增加发生非皮肤第二原发癌(SPC)的风险。
    方法:对2011年1月1日至2022年10月31日诊断为黑色素瘤的663例患者进行了回顾性研究。使用Kaplan-Meier曲线进行每个变量对后续非皮肤癌发展的影响,并通过对数秩检验评估差异。使用Cox比例风险单变量和多变量模型来量化每个变量在发展非皮肤瘤形成时间的影响。
    结果:在663名患者中,34开发了非皮肤SPC。维生素D水平与非皮肤SPC发育之间没有统计学上的显着关联(log-rank,p=0.761)。年龄>60岁,第三阶段/第四阶段,和结节性黑色素瘤亚型与SPC的发展显着相关。经过多变量分析,仅年龄>60岁(HR3.4;HRCI95%:1.5-7.6)和结节性黑色素瘤亚型(HR2.2;HRCI95%:1.0-4.8)纳入最终模型.
    结论:我们的研究结果表明,维生素D缺乏与黑色素瘤患者发生非皮肤SPC的风险增加无关。然而,60岁以上的年龄和结节性黑色素瘤亚型会增加非皮肤SPC发展的风险。
    BACKGROUND: Vitamin D deficiency associates with the risk of developing many diseases, including cancer. At the molecular level, vitamin D appears to have an antineoplastic effect. However, the role of vitamin D deficiency in cancer pathogenesis remains unelucidated and numerous studies have resulted in discordant results. This study aimed to determine whether vitamin D deficiency during melanoma diagnosis increases the risk of developing non-cutaneous second primary cancers (SPC).
    METHODS: A retrospective study on 663 patients diagnosed with melanoma between 1 January 2011 and 31 October 2022. The effect of each variable on the development of a subsequent non-cutaneous cancer was performed using Kaplan-Meier curves and differences were assessed by log-rank tests. Cox proportional hazard univariate and multivariate models were used to quantify the effect of each variable in the time to develop a non-cutaneous neoplasia.
    RESULTS: Out of 663 patients, 34 developed a non-cutaneous SPC. There was no statistically significant association between vitamin D levels and non-cutaneous SPC development (log-rank, p=0.761). Age>60 years, stage III/IV, and nodular melanoma subtype were significantly associated with the development of a SPC. After multivariate analysis, only age>60 years (HR 3.4; HR CI 95%: 1.5-7.6) and nodular melanoma subtype (HR 2.2; HR CI 95%: 1.0-4.8) were included in the final model.
    CONCLUSIONS: Our results suggest that vitamin D deficiency is not associated with an increased risk of developing non-cutaneous SPC in melanoma patients. However, age over 60 years and nodular melanoma subtype increase the risk for non-cutaneous SPC development.
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  • 文章类型: Case Reports
    目的:各种磷钙代谢病理的临床和生化重叠可导致误诊和后续临床处理。一个例子是假性甲状旁腺功能减退症,如果不进行适当的生化测定,则可能与维生素D依赖性病(VDDR1)混淆。
    方法:两对兄弟姐妹,来自独立家庭,在青春期被临床诊断为由低钙血症引起的假性甲状旁腺功能减退症,甲状旁腺激素水平升高,磷值正常或升高。在排除了对GNAS的修改之后,对与其他鉴别诊断相关的基因进行了大规模测序研究。
    结果:在CYP27B1基因中发现了两种可能与表型相关的遗传变异。该基因中的致病变体与VDDR1A相关。对患者的临床生化重新评估证实了这种诊断和治疗方法。
    结论:尽管VDDR1A在成年期是一种罕见的病理诊断,在PTH值升高的低钙血症的情况下,测定维生素D的1,25(OH)2D3和25(OH)D3形式与达到正确诊断有关。
    The clinical and biochemical overlap of various pathologies of phosphocalcic metabolism can lead to misdiagnosis and consequent clinical management. One example is pseudohypoparathyroidism, which can be confused with vitamin D-dependent rickets (VDDR1) if appropriate biochemical determinations are not performed.
    Two pairs of siblings, from independent families, were clinically diagnosed in adolescence with pseudohypoparathyroidism due to hypocalcaemia, elevated parathyroid hormone levels and normal or elevated phosphorus values. After ruling out alterations in GNAS, a massive sequencing study of genes associated with other differential diagnoses was carried out.
    Two genetic variants in the CYP27B1 gene potentially associated with the phenotype were identified. Pathogenic variants in this gene are associated with VDDR1A. Clinical-biochemical re-evaluation of the patients confirmed this diagnosis and treatment was adapted.
    Although VDDR1A is an infrequently diagnosed pathology in adulthood, in cases of hypocalcaemia with elevated PTH values, determination of the 1,25(OH)2D3 and 25(OH)D3 forms of vitamin D is relevant to reach a correct diagnosis.
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  • 文章类型: Journal Article
    目的:基于欧美囊性纤维化(CF)的共识建议,建议在CF患者中增加维生素D(VD)的补充,并且水平不足或不足。我们研究的目的是确定这种新方案的安全性和有效性。
    方法:多中心非随机非对照实验研究。水平不足(<30ng/mL)的患者接受了增加剂量的VD(800至10000IU/天)。患者随访12个月,在此期间,他们的维生素和营养状况,评估肺功能和钙磷代谢.
    方法:配对数据t检验,多因素logistic回归分析。
    结果:30例1-39岁患者(中位数,9.1)完成了后续工作。两名患者因3个月时25-OHVD水平高于100ng/mL而退出研究,没有高钙血症的临床或实验室体征。12个月时,我们观察到平均25-OHVD水平增加7.6ng/mL(95%CI,4.6-10ng/mL),维生素状态改善:37%达到30ng/mL或更高的水平,在20和30ng/mL之间的50%水平和13%保持在低于20ng/mL的水平。我们发现改善的VD水平与肺功能之间没有关联。
    结论:拟议的方案实现了血清VD水平的升高和VD功能不全患者百分比的降低,尽管它还远未达到该实体建议的充足百分比。
    OBJECTIVE: Based on the European and American Cystic Fibrosis (CF) consensus recommendations, an increase in vitamin D (VD) supplementation in patients with CF and insufficient or defficient levels was proposed. The objective of our study was to determine the safety and efficacy of this new protocol.
    METHODS: Multicentre nonrandomized uncontrolled experimental study. Patients with insufficient levels (<30 ng/mL) received increasing doses of VD (between 800 and 10 000 IU/day). Patients were followed up for 12 months, during which their vitamin and nutritional status, pulmonary function and calcium and phosphate metabolism were assessed.
    METHODS: t test for paired data and multivariate logistic regression analysis.
    RESULTS: Thirty patients aged 1-39 years (median, 9.1) completed the follow-up. Two patients were dropped from the study on account of 25-OH VD levels greater than 100 ng/mL at 3 months without clinical or laboratory signs of hypercalcaemia. At 12 months, we observed an increase of 7.6 ng/mL (95% CI, 4.6-10 ng/mL) in the mean 25-OH VD level and an improvement in vitamin status: 37% achieved levels of 30 ng/mL or greater, 50% levels between 20 and 30 ng/mL and 13% remained with levels of less than 20 ng/mL. We found no association between improved VD levels and pulmonary function.
    CONCLUSIONS: The proposed protocol achieved an increase in serum VD levels and a decrease in the percentage of patients with VD insufficiency, although it was still far from reaching the percentages of sufficiency recommended for this entity.
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  • 文章类型: Journal Article
    背景:已经提出维生素D缺乏通过损害先天免疫应答来赋予获得结核感染的易感性。
    方法:在一项探索性研究中,我们检查了血清中25-羟维生素D3(25(OH)D3)的水平,和cathelicidin-一种在骨化三醇下诱导的抗菌肽-在鼻液中,会与获得结核病感染的风险有关。
    结果:在对231名结核病家庭接触者进行反复干扰素-γ释放试验的前瞻性队列中,我们连续分析了所有在随访时获得结核病感染的未感染接触者(“转化者”,n=18),以及年龄和性别匹配的对照组,未获得结核病感染的接触者(“非转化者”,n=36)。基线时转化者和非转化者血清25(OH)D3的中位数水平没有差异(14.9vs.13.2ng/ml,p=0.41),也没有随访(19.0vs18.6ng/ml,p=0.83)。同样,cathelicidin水平在两组之间没有差异。
    结论:这些数据证明维生素D缺乏症在结核感染易感性中的重要作用。
    BACKGROUND: Vitamin D deficiency has been proposed to confer susceptibility to acquiring tuberculosis infection by impairing the innate immune response.
    METHODS: In an exploratory study, we examined whether the levels of 25-hydroxyvitamin D3 (25(OH)D3) in serum, and cathelicidin - an antimicrobial peptide-induced under calcitriol - in the nasal fluid, would associate with the risk of acquiring tuberculosis infection.
    RESULTS: Within a prospective cohort of 231 tuberculosis household contacts tested with repeated interferon-gamma release assays, we serially analyzed all the uninfected contacts acquiring tuberculosis infection at follow-up (\"converters\", n=18), and an age and sex-matched control group of contacts not acquiring tuberculosis infection (\"non-converters\", n=36). The median levels of serum 25(OH)D3 did not differ between convertors and non-converters at baseline (14.9 vs. 13.2 ng/ml, p=0.41), nor at follow-up (19.0 vs 18.6ng/ml, p=0.83). Similarly, cathelicidin levels did not differ between both groups.
    CONCLUSIONS: These data argue against a major role for hypovitaminosis D in tuberculosis infection susceptibility.
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  • 文章类型: Journal Article
    BACKGROUND: In older adults, the association of frailty and sarcopenia with vitamin D deficiency is well known, but the association of the components of frailty syndrome has been poorly studied.
    OBJECTIVE: To determine the association of the components of frailty and sarcopenia with vitamin D insufficiency in older adults.
    METHODS: Adults were studied, in whom age, education, marital status, history of fractures, hospitalizations, anthropometric indicators, sarcopenia, Charlson index, polypharmacy, Fried\'s frailty phenotype, and plasma vitamin D were recorded; figures < 30 ng/mL were considered indicative of vitamin D insufficiency. Descriptive and inferential statistics were used for statistical analysis. The association was determined by binary logistic regression.
    RESULTS: One-hundred and seventy-five adults with a mean age of 71.7 ± 6.7 years (95% CI = 60-90 years) were studied. Binary logistic regression showed that the variables associated with vitamin D deficiency were exhaustion (OR = 2.6, 95% CI = 1.0-6.5, p = 0.03), frailty (OR = 9.2, 95% CI = 2.5-34.1, p = 0.001) and pre-frailty (OR = 4.6, 95% CI = 2.1-10.0, p < 0.001).
    CONCLUSIONS: The frail and pre-frail phenotypes, as well as exhaustion, are associated with vitamin D insufficiency.
    UNASSIGNED: En adultos mayores, la asociación de fragilidad y sarcopenia con deficiencia de vitamina D es conocida, pero poco se ha estudiado la asociación de los componentes del síndrome de fragilidad.
    OBJECTIVE: Determinar la asociación entre los componentes de fragilidad, sarcopenia e insuficiencia de vitamina D en adultos mayores.
    UNASSIGNED: Se estudiaron adultos de quienes se registró edad, escolaridad, estado civil, antecedentes de fracturas, hospitalizaciones, indicadores antropométricos, sarcopenia, índice de Charlson, polifarmacia, fenotipo de fragilidad de Fried y vitamina D plasmática; cifras < 30 ng/mL se consideraron indicativas de insuficiencia de vitamina D. Para el análisis estadístico se utilizó estadística descriptiva e inferencial. La asociación fue determinada mediante regresión logística binaria.
    RESULTS: Se estudiaron 175 adultos con un promedio de edad de 71.7 ± 6.7 años (IC 95 % = 60-90 años). La regresión logística binaria demostró que las variables asociadas a insuficiencia de vitamina D fueron agotamiento (RM = 2.6, IC 95 % = 1.0-6.5, p = 0.03), fragilidad (RM = 9.2, IC 95 % = 2.5-34.1, p = 0.001) y prefragilidad (RM = 4.6, IC 95 % = 2.1-10.0, p < 0.001).
    UNASSIGNED: Los fenotipos frágil, prefrágil y agotamiento se asocian a insuficiencia de vitamina D.
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