CAJ | 학술논문

目的探讨人体血清25-羟维生素D[25-hydroxy vitamin D,25 (OH)D]与肝硬化发病风险的关系.方法采用巢式病例对照研究设计,用酶联免疫吸附法检测来自营养干预试验队列中282例肝硬化患者和564例随机对照人群基线血清的25 (OH)D及3项肝炎病毒血清学标志物(HBsAg、抗-HBc、抗-HCV)水平,并从调查问卷中收集研究对象相关基线特征信息.以846例研究对象25 (OH)D浓度四分位数为依据将其分为4个区间,用logistic回归模型评价各区间血清25 (OH)D浓度与肝硬化发病风险的关联程度.结果病例组和对照组25 (OH)D浓度分别为(15.3,13.8) nmol/L与(20.2,16.6) nmol/L,两组比较,差异有统计学意义(t=5.169,P=0.002);以第1区间(最低浓度组)为参考水平,第2、3、4区间OR值及95％置信区间(95％CI)分别为0.495 (0.333 ～ 0.736)、0.452 (0.303 ～ 0.675)、0.349 (0.231 ～ 0.527),对可能的影响因素进行调整后,第2、3、4区间OR值及95％ CI分别为0.499 (0.328 ～ 0.759)、0.427(0.278 ～ 0.654)、0.344 (0.222 ～ 0.532),25 (OH)D浓度的升高与肝硬化发病风险的下降存在线性关系(x2=25.200,P＜0.01).结论肝硬化发病风险随血清25 (OH)D浓度的增高而降低,维生素D可能是肝硬化发病的一项保护因素.
목적 탐토인체혈청25-간유생소D[25-hydroxy vitamin D,25 (OH)D]여간경화발병풍험적관계.방법 채용소식병례대조연구설계,용매련면역흡부법검측래자영양간예시험대렬중282례간경화환자화564례수궤대조인군기선혈청적25 (OH)D급3항간염병독혈청학표지물(HBsAg、항-HBc、항-HCV)수평,병종조사문권중수집연구대상상관기선특정신식.이846례연구대상25 (OH)D농도사분위수위의거장기분위4개구간,용logistic회귀모형평개각구간혈청25 (OH)D농도여간경화발병풍험적관련정도.결과 병례조화대조조25 (OH)D농도분별위(15.3,13.8) nmol/L여(20.2,16.6) nmol/L,량조비교,차이유통계학의의(t=5.169,P=0.002);이제1구간(최저농도조)위삼고수평,제2、3、4구간OR치급95％치신구간(95％CI)분별위0.495 (0.333 ～ 0.736)、0.452 (0.303 ～ 0.675)、0.349 (0.231 ～ 0.527),대가능적영향인소진행조정후,제2、3、4구간OR치급95％ CI분별위0.499 (0.328 ～ 0.759)、0.427(0.278 ～ 0.654)、0.344 (0.222 ～ 0.532),25 (OH)D농도적승고여간경화발병풍험적하강존재선성관계(x2=25.200,P＜0.01).결론 간경화발병풍험수혈청25 (OH)D농도적증고이강저,유생소D가능시간경화발병적일항보호인소.
Objective To explore the relation between serum vitamin D (25(OH)D) concentrations and liver cirrhosis.Methods A nested case control study was designed based on the Nutrition Intervention Trial (NIT) cohort,from which non-degraded serum samples and complete baseline and follow-up data were available for 282 individuals diagnosed with liver cirrhosis and 564 healthy controls.The serum samples were tested by enzyme-linked immunosorbent assay to detect and quantify 25(OH)D,as well as hepatitis B virus surface antigen and core antibody and hepatitis C virus antibody.The study participants were divided into four groups according to quartile range of 25(OH)D concentration and logistic regression modeling was used to evaluate the relation with liver cirrhosis risk by estimating odds ratios (ORs) and 95％ confidence intervals (CIs).Results The liver cirrhosis group had a significantly lower concentration of 25(OH)D than the control group (median and quartile range in nmol/L,cases:15.3 and 13.8；controls:20.2 and 16.6；t =5.169,P =0.002).When the first interval was set as the reference level,the ORs(95％ CIs) of the second,third,and fourth intervals were:0.495(0.333 ～ 0.736),0.452(0.303 ～ 0.675),and 0.349(0.231 ～ 0.527).After adjusting the analysis for the presence of pathogenic-related confounding factors,the ORs(95％ CIs) of the second,third,and fourth intervals were:0.499(0.328 ～ 0.759),0.427(0.278 ～ 0.654),and 0.344(0.222～ 0.532).The 25(OH)D level was inversely correlated with risk of liver cirrhosis (x2 =25.200,P ＜ 0.001).Conclusion Risk of liver cirrhosis increases as 25(OH)D serum concentration decreases.Vitamin D might function as a protective factor against development of cirrhosis.