Clinical Nutrition: 出现急性呼吸窘迫综合征的重症COVID-19患者的维生素D缺乏更为严重

2022-05-20 xuyihan MedSci原创

维生素D(简称VD)是一种脂溶性维生素,乃环戊烷多氢菲类化合物,一组结构上与固醇有关,功能上可防止佝偻病的维生素,最主要的是维生素D3与D2。

维生素D具有很强的免疫调节作用,并且有研究已证明补充维生素D可预防呼吸道感染。但是,维生素D缺乏症在所有年龄组和国家都非常普遍,而且尚未确定维生素 D 缺乏与多器官功能障碍之间的因果关系。因此,维生素 D 作为治疗危重患者的补充添加剂仍然存在争议。本项研究旨在分析维生素 D 水平对COVID-19引起的急性呼吸窘迫综合征(ARDS) 患者的临床和免疫学影响。

 

这是一项针对确诊COVID-19感染且存在急性呼吸窘迫综合症(ARDS)的接受重症监护的患者的单中心回顾性研究。在患者入院时和第10-15天测量其体内的 25-羟基维生素 D 和 1,25-二羟基维生素 D 血清水平、促炎和抗炎细胞因子和免疫细胞亚群。从患者数据管理系统中提取临床参数。维生素 D 的干预措施为通过肠内营养喂食维生素D3 。

 

共有39名 COVID-19 ARDS 患者符合纳排条件,其中 26 名被纳入本研究。研究结果显示96%的人患有严重的 COVID-19 ARDS。所有之前未补充维生素D的患者 (n=22) 血清 25-羟基维生素D水平明显不足。补充维生素D可以使血清 25-羟基维生素 D 水平升高,但第10天的25-羟基维生素 D 水平并未增加。只有循环浆母细胞在 25-羟基维生素 D 水平≥30 ng/ml 的患者中较高(p=0.029)。1,25-二羟基维生素 D 水平低于 20 pg/ml 的患者需要更长的机械通气时间(p=0.045)。

 

本项研究结果证实绝大多数 COVID-19 ARDS 患者存在维生素 D 缺乏症。25-羟基维生素 D 状态与临床过程的变化无关,而1,25-二羟基维生素 D 水平低与机械通气时间延长有关。

 

 

原始出处:

QuirinNotz. Et al. Vitamin D deficiency in critically ill COVID-19 ARDS patients. Clinical Nutrition.2022

版权声明:
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料,版权均属于梅斯医学所有。非经授权,任何媒体、网站或个人不得转载,授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章,或“梅斯号”自媒体发布的文章,仅系出于传递更多信息之目的,本站仅负责审核内容合规,其内容不代表本站立场,本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系,我们将立即进行删除处理。
在此留言
评论区 (5)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=1661710, encodeId=7de91661e1083, content=<a href='/topic/show?id=1b3c1315481' target=_blank style='color:#2F92EE;'>#nutrition#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13154, encryptionId=1b3c1315481, topicName=nutrition)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=6f0d25331316, createdName=膀胱癌, createdTime=Sat Nov 26 21:57:34 CST 2022, time=2022-11-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1297584, encodeId=dfc1129e584b2, content=<a href='/topic/show?id=c0385134ab' target=_blank style='color:#2F92EE;'>#COVID-19患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5134, encryptionId=c0385134ab, topicName=COVID-19患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6976269, createdName=zhangph, createdTime=Fri May 20 00:57:34 CST 2022, time=2022-05-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1432318, encodeId=54fa1432318bc, content=<a href='/topic/show?id=f9b9e9124a8' target=_blank style='color:#2F92EE;'>#综合征#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79124, encryptionId=f9b9e9124a8, topicName=综合征)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Fri May 20 00:57:34 CST 2022, time=2022-05-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1507837, encodeId=f181150e83710, content=<a href='/topic/show?id=8764484014' target=_blank style='color:#2F92EE;'>#clinical#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4840, encryptionId=8764484014, topicName=clinical)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1ee59933733, createdName=zll0628, createdTime=Fri May 20 00:57:34 CST 2022, time=2022-05-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1582295, encodeId=7fb6158229516, content=<a href='/topic/show?id=e46f396832b' target=_blank style='color:#2F92EE;'>#呼吸窘迫#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=39683, encryptionId=e46f396832b, topicName=呼吸窘迫)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=22be16898890, createdName=12498cf9m40(暂无昵称), createdTime=Fri May 20 00:57:34 CST 2022, time=2022-05-20, status=1, ipAttribution=)]
  2. [GetPortalCommentsPageByObjectIdResponse(id=1661710, encodeId=7de91661e1083, content=<a href='/topic/show?id=1b3c1315481' target=_blank style='color:#2F92EE;'>#nutrition#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13154, encryptionId=1b3c1315481, topicName=nutrition)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=6f0d25331316, createdName=膀胱癌, createdTime=Sat Nov 26 21:57:34 CST 2022, time=2022-11-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1297584, encodeId=dfc1129e584b2, content=<a href='/topic/show?id=c0385134ab' target=_blank style='color:#2F92EE;'>#COVID-19患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5134, encryptionId=c0385134ab, topicName=COVID-19患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6976269, createdName=zhangph, createdTime=Fri May 20 00:57:34 CST 2022, time=2022-05-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1432318, encodeId=54fa1432318bc, content=<a href='/topic/show?id=f9b9e9124a8' target=_blank style='color:#2F92EE;'>#综合征#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79124, encryptionId=f9b9e9124a8, topicName=综合征)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Fri May 20 00:57:34 CST 2022, time=2022-05-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1507837, encodeId=f181150e83710, content=<a href='/topic/show?id=8764484014' target=_blank style='color:#2F92EE;'>#clinical#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4840, encryptionId=8764484014, topicName=clinical)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1ee59933733, createdName=zll0628, createdTime=Fri May 20 00:57:34 CST 2022, time=2022-05-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1582295, encodeId=7fb6158229516, content=<a href='/topic/show?id=e46f396832b' target=_blank style='color:#2F92EE;'>#呼吸窘迫#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=39683, encryptionId=e46f396832b, topicName=呼吸窘迫)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=22be16898890, createdName=12498cf9m40(暂无昵称), createdTime=Fri May 20 00:57:34 CST 2022, time=2022-05-20, status=1, ipAttribution=)]
  3. [GetPortalCommentsPageByObjectIdResponse(id=1661710, encodeId=7de91661e1083, content=<a href='/topic/show?id=1b3c1315481' target=_blank style='color:#2F92EE;'>#nutrition#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13154, encryptionId=1b3c1315481, topicName=nutrition)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=6f0d25331316, createdName=膀胱癌, createdTime=Sat Nov 26 21:57:34 CST 2022, time=2022-11-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1297584, encodeId=dfc1129e584b2, content=<a href='/topic/show?id=c0385134ab' target=_blank style='color:#2F92EE;'>#COVID-19患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5134, encryptionId=c0385134ab, topicName=COVID-19患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6976269, createdName=zhangph, createdTime=Fri May 20 00:57:34 CST 2022, time=2022-05-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1432318, encodeId=54fa1432318bc, content=<a href='/topic/show?id=f9b9e9124a8' target=_blank style='color:#2F92EE;'>#综合征#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79124, encryptionId=f9b9e9124a8, topicName=综合征)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Fri May 20 00:57:34 CST 2022, time=2022-05-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1507837, encodeId=f181150e83710, content=<a href='/topic/show?id=8764484014' target=_blank style='color:#2F92EE;'>#clinical#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4840, encryptionId=8764484014, topicName=clinical)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1ee59933733, createdName=zll0628, createdTime=Fri May 20 00:57:34 CST 2022, time=2022-05-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1582295, encodeId=7fb6158229516, content=<a href='/topic/show?id=e46f396832b' target=_blank style='color:#2F92EE;'>#呼吸窘迫#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=39683, encryptionId=e46f396832b, topicName=呼吸窘迫)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=22be16898890, createdName=12498cf9m40(暂无昵称), createdTime=Fri May 20 00:57:34 CST 2022, time=2022-05-20, status=1, ipAttribution=)]
  4. [GetPortalCommentsPageByObjectIdResponse(id=1661710, encodeId=7de91661e1083, content=<a href='/topic/show?id=1b3c1315481' target=_blank style='color:#2F92EE;'>#nutrition#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13154, encryptionId=1b3c1315481, topicName=nutrition)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=6f0d25331316, createdName=膀胱癌, createdTime=Sat Nov 26 21:57:34 CST 2022, time=2022-11-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1297584, encodeId=dfc1129e584b2, content=<a href='/topic/show?id=c0385134ab' target=_blank style='color:#2F92EE;'>#COVID-19患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5134, encryptionId=c0385134ab, topicName=COVID-19患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6976269, createdName=zhangph, createdTime=Fri May 20 00:57:34 CST 2022, time=2022-05-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1432318, encodeId=54fa1432318bc, content=<a href='/topic/show?id=f9b9e9124a8' target=_blank style='color:#2F92EE;'>#综合征#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79124, encryptionId=f9b9e9124a8, topicName=综合征)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Fri May 20 00:57:34 CST 2022, time=2022-05-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1507837, encodeId=f181150e83710, content=<a href='/topic/show?id=8764484014' target=_blank style='color:#2F92EE;'>#clinical#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4840, encryptionId=8764484014, topicName=clinical)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1ee59933733, createdName=zll0628, createdTime=Fri May 20 00:57:34 CST 2022, time=2022-05-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1582295, encodeId=7fb6158229516, content=<a href='/topic/show?id=e46f396832b' target=_blank style='color:#2F92EE;'>#呼吸窘迫#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=39683, encryptionId=e46f396832b, topicName=呼吸窘迫)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=22be16898890, createdName=12498cf9m40(暂无昵称), createdTime=Fri May 20 00:57:34 CST 2022, time=2022-05-20, status=1, ipAttribution=)]
    2022-05-20 zll0628
  5. [GetPortalCommentsPageByObjectIdResponse(id=1661710, encodeId=7de91661e1083, content=<a href='/topic/show?id=1b3c1315481' target=_blank style='color:#2F92EE;'>#nutrition#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13154, encryptionId=1b3c1315481, topicName=nutrition)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=6f0d25331316, createdName=膀胱癌, createdTime=Sat Nov 26 21:57:34 CST 2022, time=2022-11-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1297584, encodeId=dfc1129e584b2, content=<a href='/topic/show?id=c0385134ab' target=_blank style='color:#2F92EE;'>#COVID-19患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5134, encryptionId=c0385134ab, topicName=COVID-19患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6976269, createdName=zhangph, createdTime=Fri May 20 00:57:34 CST 2022, time=2022-05-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1432318, encodeId=54fa1432318bc, content=<a href='/topic/show?id=f9b9e9124a8' target=_blank style='color:#2F92EE;'>#综合征#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79124, encryptionId=f9b9e9124a8, topicName=综合征)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Fri May 20 00:57:34 CST 2022, time=2022-05-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1507837, encodeId=f181150e83710, content=<a href='/topic/show?id=8764484014' target=_blank style='color:#2F92EE;'>#clinical#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4840, encryptionId=8764484014, topicName=clinical)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1ee59933733, createdName=zll0628, createdTime=Fri May 20 00:57:34 CST 2022, time=2022-05-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1582295, encodeId=7fb6158229516, content=<a href='/topic/show?id=e46f396832b' target=_blank style='color:#2F92EE;'>#呼吸窘迫#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=39683, encryptionId=e46f396832b, topicName=呼吸窘迫)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=22be16898890, createdName=12498cf9m40(暂无昵称), createdTime=Fri May 20 00:57:34 CST 2022, time=2022-05-20, status=1, ipAttribution=)]

相关资讯

Am J Clin Dermatol:维生素D对特应性皮炎的影响真的这么大吗?

血清25-羟基维生素D可能与特应性皮炎(AD)有关,补充维生素D(VD)可能会减轻AD的严重程度,本研究的目的是调查血清25(OH)D水平与AD的关系,以及补充VD对AD严重程度的影响。

Circulation:维生素K2和维生素D对主动脉瓣钙化的疗效

在AVC评分为>300 AU的老年男性中,2年的MK-7 +维生素D补充治疗并不能改变AVC的进展。

苏黎世大学最新研究:三种简单方式可让70岁以上老年人患癌风险降低61%!

Frontiers in Aging:通过三种简单方式——2000IU/天的维生素D、1克/天的omega-3s再加上简单的力量锻炼,就能够使70岁以上老年人

CGH:血清25-羟基维生素 D与非酒精性脂肪肝的严重程度负相关

非酒精性脂肪性肝病(NAFLD)是指除外酒精和其他明确的损肝因素所致的肝细胞内脂肪过度沉积为主要特征的临床病理综合征,与胰岛素抵抗和遗传易感性密切相关的获得性代谢应激性肝损伤。

BMC MED:复旦郁金泰团队研究,充足的室外阳光照射就可以有效预防老年痴呆,尤其是老年人!

阳光照射与痴呆症风险呈J型关联。给予阳光照射的详细指导可以有效预防痴呆症。