Serum vitamin D levels are positively associated with varicella zoster immunity in chronic dialysis patients.
Serum vitamin D levels are positively associated with varicella zoster immunity in chronic dialysis patients.
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DOI：
10.1038/srep07371
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发表时间：
2014-12-09
影响因子：
4.6
通讯作者：
Hung KY
中科院分区：
文献类型：
--
作者：
Chao CT;Lee SY;Yang WS;Yen CJ;Chiang CK;Huang JW;Hung KY
尿毒症导致免疫功能相对低下，慢性透析患者发生带状疱疹（HZ）的风险升高。我们试图研究维生素D状态与水痘-带状疱疹病毒（VZV）免疫之间的关系。在2012年至2013年期间建立了一个多中心流行血液透析队列。我们检测了生化参数，25-羟基- (25-OH-D)和1,25-二羟基维生素D，血清中维生素D结合蛋白水平。采用VZV特异性糖蛋白IgG和IgM滴度定量检测VZV免疫。88名患者入组，并对他们的血清进行分析。25-OH-D < 30 ng/ml（不足或缺乏）的慢性血液透析患者VZV-IgG明显低于25-OH-D充足的患者（p = 0.04）。如果单独分析活跃维生素D使用者，这种差异变得更加突出（p = 0.01）。广义相加模型显示，25-OH-D值高于27.8 ng/ml或生物可利用25-OH-D值高于3.88 ng/ml的小鼠VZV-IgG水平显著高于低值的小鼠。线性回归表明，总25-OH-D和生物利用度25-OH-D与较高的VZV-IgG水平显著相关（p = 0.003[总]和0.01[生物利用度]），而癌症患者的VZV-IgG水平较低。因此，维生素D可能是提高慢性透析患者VZV免疫力的潜在有用选择。
Uremia results in a relatively immunocompromised status, and patients under chronic dialysis have an elevated risk of developing herpes zoster (HZ). We sought to investigate the relationship between vitamin D status and immunity to varicella-zoster virus (VZV). A multicenter prevalent hemodialysis cohort was assembled between 2012 and 2013. We assayed the biochemical parameters, 25-hydroxy- (25-OH-D) and 1,25-dihydroxyvitamin D, vitamin D-binding protein levels in the sera. VZV immunity was quantitated using VZV-specific glycoprotein IgG and IgM titers. Eighty-eight patients were enrolled and their sera were analyzed. Chronic hemodialysis patients with 25-OH-D < 30 ng/ml (insufficiency or deficiency) had significantly lower VZV-IgG than those with sufficient 25-OH-D (p = 0.04). This discrepancy became more prominent if active vitamin D users alone were analyzed (p = 0.01). Generalized additive modeling showed that those with 25-OH-D higher than 27.8 ng/ml or bioavailable 25-OH-D higher than 3.88 ng/ml had significantly higher VZV-IgG levels than those with lower values. Linear regression suggested that both total and bioavailable 25-OH-D were significantly associated with higher VZV-IgG levels (p = 0.003 [total] and 0.01 [bioavailable]), whereas patients with cancer had lower VZV-IgG. Vitamin D may therefore be a potentially useful choice for raising VZV immunity in chronic dialysis patients.