Elisabet Lerma, M Ema Molas, M Milagro Montero, Ana Guelar, Alicia González, Judith Villar, Adolf Diez, Hernando Knobel
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引用次数: 10
摘要
维生素D缺乏是慢性疾病患者的一个重要问题,包括人类免疫缺陷病毒(HIV)感染患者。这项横断面研究的目的是确定在巴塞罗那参加的HIV患者中维生素D缺乏和甲状旁腺功能亢进的患病率和相关因素。测定胆钙化醇(25OH维生素D3)和甲状旁腺素水平。维生素D不足定义为25(OH) D < 20 ng/mL,缺乏定义为65 pg/mL。慢性肾衰竭、肝脏疾病、治疗或可能影响骨代谢的病例被排除在外。在纳入的566例患者中,56.4%的患者暴露于替诺福韦。维生素D不足的占71.2%,维生素D缺乏的占39.6%。对228例受试者进行甲状旁腺激素检测,其中86例(37.7%)呈高水平。维生素D缺乏的校正预测因子是非白人种族和精神疾病,而脂肪萎缩是一个保护因素。甲状旁腺功能亢进的独立危险因素为维生素D < 12 ng/mL (OR: 2.14, CI 95%: 1.19 ~ 3.82, P: 0.01)和替诺福韦暴露(OR: 3.55, CI 95%: 1.62 ~ 7.7, P: 0.002)。维生素缺乏症和甲状旁腺功能亢进症在年日照量高的地区发病率高。
Prevalence and Factors Associated with Vitamin D Deficiency and Hyperparathyroidism in HIV-Infected Patients Treated in Barcelona.
Vitamin D deficiency is an important problem in patients with chronic conditions including those with human immunodeficiency virus (HIV) infection. The aim of this cross-sectional study was to identify the prevalence and factors associated with vitamin D deficiency and hyperparathyroidism in HIV patients attended in Barcelona. Cholecalciferol (25OH vitamin D3) and PTH levels were measured. Vitamin D insufficiency was defined as 25(OH) D < 20 ng/mL and deficiency as <12 ng/mL. Hyperparathyroidism was defined as PTH levels >65 pg/mL. Cases with chronic kidney failure, liver disease, treatments or conditions potentially affecting bone metabolism were excluded. Among the 566 patients included, 56.4% were exposed to tenofovir. Vitamin D insufficiency was found in 71.2% and 39.6% of those had deficiency. PTH was measured in 228 subjects, and 86 of them (37.7%) showed high levels. Adjusted predictors of vitamin D deficiency were nonwhite race and psychiatric comorbidity, while lipoatrophy was a protective factor. Independent risk factors of hyperparathyroidism were vitamin D < 12 ng/mL (OR: 2.14, CI 95%: 1.19-3.82, P: 0.01) and tenofovir exposure (OR: 3.55, CI 95%: 1.62-7.7, P: 0.002). High prevalence of vitamin deficiency and hyperparathyroidism was found in an area with high annual solar exposure.