摘要
Objective:Vitamin D deficiency is common in patients with ileal pouch-anal anastomosis(IPAA)for ulcerative colitis(UC).Whether vitamin D levels are further lowered in patients with concomitant IPAA and primary sclerosing cholangitis(PSC)is not known.The aim of this study was to evaluate the presence of PSC as a risk factor for vitamin D deficiency in patients with UC and IPAA.Methods:In this case control study,74 patients with concurrent IPAA and PSC were included in the study group,and 79 patients with IPAA,but without PSC,served as controls.Forty-four variables were analyzed.Univariate analysis and multivariate analysis with stepwise logistic regression were performed.Results:A total 153 eligible patients were included,with 74(48.4%)in the study group and 79(51.6%)in the control group.Vitamin D level in the study group was 18.961.4 ng/dL compared with 30.361.7 ng/d in the control group(P=0.011).Vitamin D deficiency(≤20 ng/dL)was present in 65(42.5%)patients.PSC occurred in 49(75.4%)of the 65 patients with vitamin D deficiency.In the multivariate analysis,only the presence of PSC(odds ratio[OR]:7.56;95% confidence interval[CI]:2.39–24.08;P=0.001)and vitamin D supplementation(OR:2.58;95% CI:1.57–9.19;P=0.018)remained associated with vitamin D deficiency.Conclusion:The presence of PSC was found to be an independent risk factor for vitamin D deficiency in UC patients with IPAA.These patients should be routinely screened and closely monitored for vitamin D deficiency.
目的:溃疡性结肠炎(UC)患者回肠储袋肛管吻合(IPAA)术后常出现维生素D缺乏。IPAA患者出现原发性硬化性胆管炎(PSC)后维生素D水平是否会进一步降低,目前仍不明了。本研究的目的是评估PSC是否是UC患者IPAA术后维生素D缺管的一个危险因素。方法:在该病例对照研究中,74例出现PSC的IPAA患者纳入研究组,79例未出现PSC的IPAA患者作为对照组。44项指标被纳入多因素逻辑回归模型中进行分析。结果:153例患者入组研究,其中研究组74例(48.4%),对照组79例(51.6%)。研究组维生素D水平是(18.961.4)ng/dL,明显低于对照组的(30.361.7)ng/dL(P=0.011)。共有65例(42.5%)患者出现维生素D缺乏,其中49例(75.4%)合并PSC。多因素分析显示,PSC的出现(OR=7.56,95%CI:2.29-24.08;P=0.001)和维生素D的补充(OR=2.58,95%CI:1.57-9.19;P=0.018)与维生素D缺乏密切相关。结论:PSC的出现是UC患者IPAA术后维生素D缺乏的独立危险因素。这些患者应该被筛查出来,以对其维生素D水平进行严密监测。
