vitD在伴或不伴过敏性支气管肺曲霉菌病哮喘患者中的情况
2018/01/19
摘要
vitD缺乏被认为是ABPA和囊性纤维化患者致病因素之一。vitD缺乏是否也发生在ABPA合并哮喘患者中尚不明确。因此，本研究旨在评价伴或不伴ABPA哮喘患者的vitD水平。在前瞻性研究中，在哮喘患者(n=75), ABPA患者（n=158）和健康受试者(n=50)进行血浆vitD (25[OH]D)测定。vitD水平<20 ng/mL被认作vitD缺乏。健康人群组(15.3 [12.7-17.9])、哮喘组(19.2 [16.3-22.1])和ABPA组(18.9 [16.9-20.8])之间vitD水平无差异（p=0.22）。vitD缺乏可见于70%健康人群，64%哮喘患者和65%ABPA患者，且小组间无明显差异（p=0.79）。无论是否伴有vitD缺乏，ABPA患者在哮喘控制、肺功能、免疫状况和支气管扩张严重程度均无差异。而无论是否伴有ABPA，vitD缺乏在哮喘患者中同样高发，但在ABPA合并哮喘病理机制中并无显著作用。
Abstract
Vitamin D deficiency is believed to a pathogenetic factor in patients with allergic bronchopulmonary aspergillosis (ABPA) and cystic fibrosis. Whether vitamin D deficiency is also prevalent in ABPA complicating asthma, remains unknown. Herein, we evaluate vitamin D levels in asthmatic patients with and without ABPA. In a prospective study, plasma vitamin D (25[OH]D) levels were measured in consecutive subjects with asthma (n=75), ABPA (n=158) and healthy volunteers (n=50). Vitamin D levels <20 ng/mL were considered as vitamin D deficiency. There was no difference in mean (95% CI) vitamin D levels between healthy controls (15.3 [12.7-17.9]), asthmatics (19.2 [16.3-22.1]) and subjects with ABPA (18.9 [16.9-20.8]) (p=0.22). Vitamin D deficiency was encountered in 70%, 64% and 65% of the healthy controls, asthmatics and ABPA subjects, respectively, and was not different between the groups (p=0.79). There was no difference in the asthma control, pulmonary function, immunological findings and the severity of bronchiectasis, in patients with ABPA, with and without vitamin D deficiency. Vitamin D deficiency is equally prevalent in asthmatic patients with or without ABPA in the Indian subcontinent, and does not appear to play a major role in the pathogenesis of ABPA complicating asthma.
vitD缺乏被认为是ABPA和囊性纤维化患者致病因素之一。vitD缺乏是否也发生在ABPA合并哮喘患者中尚不明确。因此，本研究旨在评价伴或不伴ABPA哮喘患者的vitD水平。在前瞻性研究中，在哮喘患者(n=75), ABPA患者（n=158）和健康受试者(n=50)进行血浆vitD (25[OH]D)测定。vitD水平<20 ng/mL被认作vitD缺乏。健康人群组(15.3 [12.7-17.9])、哮喘组(19.2 [16.3-22.1])和ABPA组(18.9 [16.9-20.8])之间vitD水平无差异（p=0.22）。vitD缺乏可见于70%健康人群，64%哮喘患者和65%ABPA患者，且小组间无明显差异（p=0.79）。无论是否伴有vitD缺乏，ABPA患者在哮喘控制、肺功能、免疫状况和支气管扩张严重程度均无差异。而无论是否伴有ABPA，vitD缺乏在哮喘患者中同样高发，但在ABPA合并哮喘病理机制中并无显著作用。
（上海交通大学医学院附属瑞金医院呼吸与危重症医学科 周剑平 万欢英 摘译）
（Mycoses. 2018 Jan 4. doi: 10.1111/myc.12744. [Epub ahead of print]）
Vitamin D levels in asthmatic patients with and without allergic bronchopulmonary aspergillosis.
Mycoses. 2018 Jan 4. doi: 10.1111/myc.12744. [Epub ahead of print]
Agarwal R et al.
Abstract
Vitamin D deficiency is believed to a pathogenetic factor in patients with allergic bronchopulmonary aspergillosis (ABPA) and cystic fibrosis. Whether vitamin D deficiency is also prevalent in ABPA complicating asthma, remains unknown. Herein, we evaluate vitamin D levels in asthmatic patients with and without ABPA. In a prospective study, plasma vitamin D (25[OH]D) levels were measured in consecutive subjects with asthma (n=75), ABPA (n=158) and healthy volunteers (n=50). Vitamin D levels <20 ng/mL were considered as vitamin D deficiency. There was no difference in mean (95% CI) vitamin D levels between healthy controls (15.3 [12.7-17.9]), asthmatics (19.2 [16.3-22.1]) and subjects with ABPA (18.9 [16.9-20.8]) (p=0.22). Vitamin D deficiency was encountered in 70%, 64% and 65% of the healthy controls, asthmatics and ABPA subjects, respectively, and was not different between the groups (p=0.79). There was no difference in the asthma control, pulmonary function, immunological findings and the severity of bronchiectasis, in patients with ABPA, with and without vitamin D deficiency. Vitamin D deficiency is equally prevalent in asthmatic patients with or without ABPA in the Indian subcontinent, and does not appear to play a major role in the pathogenesis of ABPA complicating asthma.
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