Elevated 1, 25-dihydroxyvitamin D levels are associated with protracted treatment in sarcoidosis.
Elevated 1, 25-dihydroxyvitamin D levels are associated with protracted treatment in sarcoidosis.
复制标题
DOI：
10.1016/j.rmed.2009.12.004
复制
发表时间：
2010-04
影响因子：
4.3
通讯作者：
Burke R
中科院分区：
文献类型：
--
作者：
Kavathia D;Buckley JD;Rao D;Rybicki B;Burke R
维生素D的活性代谢产物1，25-二羟维生素D对先天性和获得性免疫具有多形作用。来源于1，25-二羟维生素D的肉瘤样肉芽肿导致高钙血症，但1，25-二羟维生素D与该疾病的临床表型的关联目前尚不清楚。探讨血清1，25-二羟维生素D水平与结节病慢性化程度的关系。测定血清1，25-二羟维生素D水平，并分别通过结节病严重程度评分和结节病临床活动性分类评估其与结节病活动性和表型相关。招募了59名患者，其中44%具有亚急性发作和慢性疾病表型。不同胸片分期的血清1，25-二羟维生素D水平无显著差异（p = 0.092），也与结节病严重程度评分无相关性（r =-0.16; p = 0.216）。血清1，25-二羟维生素D水平与需要重复全身免疫抑制治疗方案或治疗>1年的患者相关（SCAC 6级）。血清1，25-二羟维生素D水平的四分位数增加与慢性表型的几率增加相关（OR 1.82，95%CI，1.11，2.99，p = 0.019）。大多数（71%）水平>51 pg/mL的患者需要按照SCAC 6级定义的长期免疫抑制治疗。在结节病患者中，1，25-二羟维生素D水平升高与慢性治疗需求相关。
Active vitamin D metabolite, 1, 25-dihydroxyvitamin D, has pleomorphic effects on both innate and acquired immunity. Sarcoid granuloma derived 1, 25-dihydroxyvitamin D leads to hypercalcemia, but the association of 1, 25-dihydroxyvitamin D with the clinical phenotype of the disease is currently unknown. To determine the relationship between serum 1, 25-dihydroxyvitamin D levels and the degree of sarcoidosis disease chronicity. Serum 1, 25-dihydroxyvitamin D levels were measured and associated with sarcoidosis activity and phenotypes as assessed by Sarcoidosis Severity Score and Sarcoidosis Clinical Activity Classification respectively. Fifty nine patients were recruited with 44% having a sub-acute onset, and the chronic disease phenotype. There was no significant difference in serum 1, 25-dihydroxyvitamin D levels by chest radiograph stage (p = 0.092) nor did the levels correlate with the Sarcoidosis Severity Score (r = −0.16; p = 0.216). Serum 1, 25-dihydroxyvitamin D levels were associated with patients requiring repeated regimens of systemic immunosuppressive therapy or >1 year of therapy (SCAC Class 6). Increasing quartiles of serum 1, 25-dihydroxyvitamin D level was associated increased odds of the chronic phenotype (OR 1.82, 95% CI, 1.11, 2.99, p = 0.019). The majority (71%) of the patients with levels >51 pg/mL required chronic immunosuppressive therapy as defined by SCAC class 6. In patients with sarcoidosis, elevated 1, 25-dihydroxyvitamin D levels are associated with chronic treatment needs.