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目的探讨慢性肾脏病(CKD)非透析患者25-羟维生素D3[25-(OH)D3]水平以及影响25-(OH)D3水平的相关因素。方法测定138例CKD非透析患者血清25-(OH)D3水平,并收集其体重指数(BMI)、血白蛋白、24-h尿蛋白和肾小球滤过率(GFR)资料。结果血清25-(OH)D3为(42.87±20.32)nmol/L。25-(OH)D3不足者(≥37.5nmol/L且<75nmol/L)占48.6%(67/138),缺乏者(<37.5nmol/L)占45.7%(63/138)。在BMI≥30kg/m2、血白蛋白<35g/L、24-h尿蛋白≥1.5g、估算GFR<45ml/min患者,25-(OH)D3水平较低(P<0.01或P<0.05)。25-(OH)D3水平与估算GFR、白蛋白呈正相关,与BMI、24-h尿蛋白呈负相关(P<0.01)。BMI及24-h尿蛋白是25-(OH)D3水平的独立影响因素。结论 BMI、血白蛋白、24-h尿蛋白、估算GFR影响CKD非透析患者25-(OH)D3水平,肥胖及大量蛋白尿是25-(OH)D3水平不足的重要影响因素。
Objective To investigate the levels of 25-hydroxyvitamin D3 [25- (OH) D3] and the related factors affecting the level of 25- (OH) D3 in non-dialysis patients with chronic kidney disease (CKD). Methods Serum levels of 25- (OH) D3 were measured in 138 CKD non-dialysis patients and their body mass index (BMI), serum albumin, 24-h urinary protein and glomerular filtration rate (GFR) were measured. Results Serum 25- (OH) D3 was (42.87 ± 20.32) nmol / L. Lack of 25- (OH) D3 (≥37.5nmol / L and <75nmol / L) accounted for 48.6% (67/138), and deficiency (<37.5nmol / L) accounted for 45.7% (63/138). The level of 25- (OH) D3 was lower (P <0.01 or P <0.05) in patients with BMI≥30kg / m2, serum albumin <35g / L, 24-h urinary protein≥1.5g and GFR <45ml / . The level of 25- (OH) D3 was positively correlated with estimated GFR and albumin, and negatively correlated with BMI and 24-h urinary protein (P <0.01). BMI and 24-h urinary protein are independent determinants of 25- (OH) D3 levels. Conclusions BMI, serum albumin and 24-h urinary protein, GFR, 25- (OH) D3 level in CKD non-dialysis patients, obesity and macroalbuminuria are the important influencing factors of insufficient level of 25- (OH) D3.