特发性脊柱侧弯患者血清维生素D水平及其临床意义-现代医学

特发性脊柱侧弯患者血清维生素D水平及其临床意义

单位：中国人民解放军第一六九中心医院骨科, 湖南衡阳 421002

分类号：R259

出版年·卷·期（页码）：2018·46·第一期（57-59）

摘要：

目的：探究特发性脊柱侧弯患者血清维生素D水平及其临床意义。方法：选取我院2014年1月至2017年1月诊断为特发性脊柱侧弯患者200例为观察组，并选取健康体检中心年龄、性别与之相匹配的健康受试者200例为对照组，比较两组受试者血清维生素D水平，并分析观察组患者血清维生素D水平与碱性磷酸酶（ALP）、血钙、血磷、Cobb's角及年龄的关系。结果：（1）观察组维生素D水平显著低于对照组，差异有统计学意义（P<0.05）。（2）观察组Cobb's角>45°的患者维生素D水平显著低于Cobb's角≤ 45°患者，差异有统计学意义（P<0.05）。（3）观察组维生素D水平与血钙呈正相关（r=0.175，P=0.01），与Cobb's角呈负相关（r=-0.425，P=0.02），与年龄、ALP、血磷无显著相关性。结论：维生素D缺乏可能与特发性脊柱侧弯的发生发展相关，检测维生素D有助于特发性脊柱侧弯严重程度的判断。

Objective:To investigate the level of serum vitamin D in patients with idiopathic scoliosis and its clinical significance. Methods:Two hundreds cases of idiopathic scoliosis diagnosed in our hospital from January 2014 to January 2017 were selected as the observation group and 200 cases healthy subjects whose age and gender matched were selected as the control group. Serum vitamin D level were compared between the two groups.The relationship between serum vitamin D level and alkaline phosphatase (ALP), serum calcium, serum phosphorus, Cobb's angle and age in observation group were analyzed. Results:(1)The level of vitamin D in observation group was significantly lower than that in the control group, the difference was statistically significant(P<0.05).(2)In the observation group the vitamin D of the patients whose Cobb's angle>45°were significantly lower than those whose Cobb's angle ≤ 45°, the difference was statistically significant (P<0.05). (3)The level of vitamin D was positively correlated with blood calcium (r=0.175,P=0.01),and negative correlated with Cobb's angle(r=-0.425,P=0.02).And there were no relationship between the level of vitamin D and age, ALP and serum phosphorus. Conclusion:Vitamin D deficiency may be associated with the occurrence and development of idiopathic scoliosis and detection of vitamins D could help to determine the severity of idiopathic scoliosis.

参考文献：

[1] LUO M,LI N,SHEN M,et al.Pedicle screw versus hybrid instrumentation in adolescent idiopathic scoliosis:A systematic review and meta-analysis with emphasis on complications and reoperations[J].Medicine (Baltimore),2017,96(27):e7337.
[2] TAVARES J M,LEDUR F R,LETAIF O B,et al.Anatomical and radiological characteristics in adolescent idiopathic scoliosis with surgical indication[J].Rev Bras Ortop,2017,52(3):344-348.
[3] BAE J W,CHO C H,MIN W K,et al.Associations between matrilin-1 gene polymorphisms and adolescent idiopathic scoliosis curve patterns in a Korean population[J].Mol Biol Rep,2012,39(5):5561-5567.
[4] ELFIKY T A,SAMARTZIS D,CHEUNG W Y,et al.The proximal thoracic curve in adolescent idiopathic scoliosis:surgical strategy and management outcomes[J].Global Spine J,2011,1(1):27-36.
[5] NIGWEKAR S U,THADHANI R.Vitamin D receptor activation:cardiovascular and renal implications[J].Kidney Int Suppl (2011),2013,3(5):427-430.
[6] 宋志霞,郭银凤,周敏,等.活性维生素D3通过抑制TRPC6表达发挥糖尿病肾病的保护作用[J].东南大学学报:医学版,2014,33(6):683-690.
[7] GOZDZIALSKA A,JASKIEWICZ J,KNAPIK-CZAJKA M,et al.Association of calcium and phosphate balance,vitamin D,PTH,and calcitonin in patients with adolescent idiopathic scoliosis[J].Spine (Phila Pa 1976),2016,41(8):693-697.
[8] SILVA R,FERNANDES R,ONO A,et al.Role of different hormones in the pathogenesis and severity of adolescent idiopathic scoliosis[J].Acta Ortop Bras,2017,25(1):15-17.
[9] BALIOGLU M B,AYDIN C,KARGIN D,et al.Vitamin-D measurement in patients with adolescent idiopathic scoliosis[J].J Pediatr Orthop B,2017,26(1):48-52.
[10] LEE J Y,SO T Y,THACKRAY J.A review on vitamin D deficiency treatment in pediatric patients[J].J Pediatr Pharmacol Ther,2013,18(4):277-291.
[11] 朱燕,肖建平,廖祥鹏.妊娠期母体维生素D水平对胎儿骨代谢的影响[J].东南大学学报:医学版,2013,32(5):636-639.
[12] WHITE C.Update on vitamin D:More than just a nutrient[J].Obstet Med,2014,7(1):4-7.
[13] KEISALA T,MINASYAN A,LOU Y R,et al.Premature aging in vitamin D receptor mutant mice[J].J Steroid Biochem Mol Biol,2009,115(3-5):91-97.
[14] SUH K T,EUN I S,LEE J S.Polymorphism in vitamin D receptor is associated with bone mineral density in patients with adolescent idiopathic scoliosis[J].Eur Spine J,2010,19(9):1545-1550.

服务与反馈：

【文章下载】【发表评论】【查看评论】【加入收藏】

提示：您还未登录，请登录！点此登录