血清1,25-二羟维生素D<sub>3</sub>水平与结直肠腺瘤的相关性

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摘要目的探讨血清1,25-二羟维生素D₃[1,25-dihydroxyvitamin D₃,1,25(OH)₂D₃]与结直肠腺瘤的相关性。方法纳入2016-02至2020-12于武警重庆总队医院消化内科就诊的结直肠息肉患者218例作为研究对象,根据其病理结果分为非腺瘤型组(n=104)、腺瘤型组(n=69)、低级别上皮内瘤变组(n=25)、高级别上皮内瘤变组(n=20),均进行血清1,25(OH)₂D₃水平的测定,采用多因素Logistic回归分析,1,25(OH)₂D₃与结直肠病理类型的相关性。结果 4组的血清1,25(OH)₂D₃水平非腺瘤型组最高(32.48±3.54),其次为腺瘤型组(29.48±3.35)、低级别上皮内瘤变组(29.40±3.41)及高级别上皮内瘤变组(28.65±2.11),腺瘤型组及上皮内瘤变组分别与非腺瘤型组相比,差异有统计学意义。上述4组的血清1,25(OH)₂D₃水平较低者分别为20例(19.23%)、39例(56.52%)、13例(52.00%)、7例(35.00%),4组比较差异有统计学意义。在校正年龄、吸烟、饮酒、糖尿病、骨质疏松、BMI≥25 kg/m²等混杂因素后,发现1,25(OH)₂D₃水平降低与结直肠息肉的病理类型的OR为5.774(95% CI,2.837-11.751)。结论结直肠息肉的病理学类型与维生素D缺乏有关,维生素D缺乏可能是结直肠腺瘤及上皮内瘤变的危险因素。

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关键词 ：血清1, 25-二羟维生素D₃, 结直肠, 腺瘤, 上皮内瘤变, 相关性

Abstract：Objective To investigate the association between serum levels of1,25-dihydroxyvitamin D₃ (1,25(OH)₂D₃) and colorectal adenomas. Methods Two hundred and eighteen cases of colorectal polyps admitted to our hospital between February 2016 and December 2020 were included in this study. According to pathological results, they were divided into the non-adenomatous group(n=104), adenomatous group(n=69), low-grade intraepithelial neoplasia group(n=25), and high-grade intraepithelial neoplasia group(n=20). Serum 1,25(OH)₂D₃ levels were tested. Results The serum level of 1,25(OH)₂D₃ was the highest in the non-adenomatous group(32.48±3.54), followed by the adenomatous group(29.48±3.35), the low-grade intraepithelial neoplasia group(29.40±3.41) and the high-grade intraepithelial neoplasia group(28.65±2.11). The serum levels of 1,25(OH)₂D₃ in the other three groups were significantly lower than in the non-adenomatous group. There were 20 cases (19.23%), 39 cases (56.52%), 13 cases (52.00%) and 7 cases (35.00%) with low serum 1,25(OH)₂D₃ levels in the above four groups respectively. There was statistically significant difference between the four groups. After adjustment for confounding factors,such as age, smoking, alcohol consumption, diabetes, osteoporosis, and BMI≥25, multivariate logistic regression analysis indicated that odds ratio between 1,25(OH)₂D₃ deficiency and colorectal adenomas was 5.774 (95%CI, 2.837-11.751). Conclusions The pathological types of colonic polyps are related to vitamin D deficiency, which may be a risk factor for colorectal adenomas and intraepithelial neoplasia.

Key words： serum 1, 25-dihydroxyvitamin D₃ colorectal adenomas intraepithelial neoplasia association

收稿日期: 2021-06-15

ZTFLH:

R574.62

通讯作者: 杨林辉,E-mail:dzswjyy@163.com

作者简介: 向姝,硕士,主治医师。

引用本文:

向姝, 杨林辉. 血清1,25-二羟维生素D₃水平与结直肠腺瘤的相关性[J]. 武警医学, 2021, 32(11): 946-949. XIANG Shu YANG Linhui. Association between serum levels of 1,25-dihydroxyvitamin D3 and colorectal adenomas. Med. J. Chin. Peop. Armed Poli. Forc., 2021, 32(11): 946-949.

链接本文:

http://journal08.magtechjournal.com/Jwk_wjyx/CN/ 或 http://journal08.magtechjournal.com/Jwk_wjyx/CN/Y2021/V32/I11/946

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