ObjectiveTo investigate the role of 1,25-dihydroxyvitamin D3 in the posterior transforaminal lumbar interbody fusion (TLIF) for patients with osteoporosis and lumbar degenerative disease. MethodsBetween November 2011 and October 2012,44 patients with osteoporosis and lumbar degenerative disease were treated with TLIF and the clinical data were retrospectively analyzed.The patients were divided into 2 groups based on the administration of 1,25-dihydroxyvitamin D3.After TLIF operation,1,25-dihydroxyvitamin D3 was used in 21 patients (trial group),and was not used in 23 patients (control group).There was no significant difference in gender,age,etiology,affected segment,and disease duration between 2 groups (P>0.05).Lumbar interbody fusion was observed by X-ray and thin-section CT scan reconstruction of lumbar spine according to Brantigan assessment system at 6 months after operation and last follow-up.Clinical outcome was evaluated by Oswestry disability index (ODI) before and after operation. ResultsThe patients of 2 groups were followed up 12-27 months (mean,14.5 months).No fixation loosening or breaking occurred during follow-up.ODI scores in both groups were significantly improved at 6 months after operation and last follow-up (P<0.05) when conpared with preoperative value.Although at preoperation there was no significant difference in ODI score between 2 groups (P>0.05),ODI score of trial group was significantly lower than that of control group at 6 months after operation and last follow-up (P<0.05).At 6 months after operation,the interbody fusion rate was 76.19% (16/21) in trial group and 43.48% (10/23) in control group,showing significant difference (χ2=3.60,P=0.03); at last follow-up,the fusion rate was 95.24% (20/21) in trial group and 65.22% (15/23) in control group,showing significant difference (χ2=4.38,P=0.02). Conclusion1,25-dihydroxyvitamin D3 can improve the lumbar interbody fusion rate and general conditions in the patients with osteoporosis and lumbar degenerative disease.
Objective To explore the relationship between 25-hydroxy vitamin D [25(OH)D] and metabolic syndrome (MS) in non-dialysis patients with stage 3–5 chronic kidney disease (CKD). Methods Between January 2014 and May 2015, a total of 61 non-dialysis patients with stage 3–5 CKD were included. The patients’ height, weight, blood lipid, levels of 25(OH)D and serum creatinine were conducted. The relationship between 25(OH)D and MS was analyzed. Results The average level of 25(OH)D was (39.99±17.66) nmol/L. Normal level (≥75 mmol/L) of 25(OH)D was observed in 3.3% (2/61) of the patients, insufficiency of 25(OH)D (≥37.5 nmol/L and <75 nmol/L) was observed in 50.8% (31/61), and deficiency (<37.5 nmol/L) was observed in 45.9% (28/61). The prevalence of MS was 67.2% ( 41/61). The body mass index (BMI), proportion of hypertension, proportion of diabetes mellitus, level of triglyceride in the MS group were higher than those in the non-MS group, while the levels of high-density lipoprotein and 25(OH)D were lower in the MS group than those in the non-MS group, and the differences were statistically significant (P<0.05). The patients’ BMI, proportion of hypertension, level of triglyceride and proportion of MS in the 25(OH)D deficiency group were higher than those in the 25(OH)D non-deficiency group, meanwhile, the level of high-density lopoprotein was lower in the 25(OH)D deficiency group than that in the 25(OH)D non-deficiency group, and the differences were statistically significant (P<0.05). Serum 25(OH)D level was correlated negatively with BMI (r=–0.35, P=0.006) and the level of triglyceride (r=–0.16, P=0.039), and correlated positively with the level of high-density lipoprotein (r=0.18, P=0.026). Conclusions Low level of 25(OH)D and MS are both of high incidence rate in non-dialysis patients with stage 3–5 CKD. 25(OH)D is associated with MS.
Objective To explore the association between 25-hydroxyvitamin D (25OHD) level and risk of the onset of metabolic syndrome (MS) in people in Chengdu. Methods In total, 474 participants were selected randomly by cluster sampling from one urban district and two rural villages in Longquanyi district of Chengdu. The data of sociodemographic information, lifestyle and family history were collected by questionnaires. Binary logistic regression was performed to assess the relationship between baseline 25OHD level and incident of MS, while multiple linear regression was conducted to analyze the relationship between baseline 25OHD level and insulin resistance. Results Four hundred seventy-four people were enrolled in the cohort study, 39 of them developed MS, with the incidences of 20.8 events per 1 000 person years. Among women, low 25OHD status was significantly associated with the risk of developing MS (OR=4.29, 95%CI 1.05 to 29.50, P=0.044) after adjustment for multiple potential confounders. In a multiple linear regression analysis, low 25OHD level of baseline was independently associated with the increased HOMA-IR over a 4-year period among Chengdu individuals (P<0.05) and was independently related to the decreased ISIcomp over a 4-year period in female (P<0.05). Conclusions The current prospective study suggests that low 25OHD level may contribute to increase insulin resistance in Chengdu population. Furthermore, low 25OHD level may increase the risk of MS among women in Chengdu.
ObjectiveTo investigate the clinical value of peripheral blood vitamin D level in predicting the outcome of weaning from mechanical ventilation in critically ill patients.MethodsA total of 130 critically ill patients who undergoing mechanical ventilation for more than 48 hours in our hospital were recruited from June 2014 to June 2017. Serum 25(OH)D3 was detected on admission and before spontaneous breathing test (SBT) meanwhile general clinical data and laboratory examination indexes were recorded. The cases were divided into a successful weaning group and a failure weaning group according to the outcome of weaning from mechanical ventilation. Logistic regression equation was used to analyze the relationship between vitamin D level and failure weaning, and a receiver operating characteristic (ROC) curve was used to analyze the predictive value for failure weaning.ResultsThere were 46 patients with failure weaning among 130 patients (35.38%). Compared with the successful weaning group, the failure weaning group had significantly higher Acute Physiology and Chronic Health EvaluationⅡ score, longer duration in intensive care unit, higher respiratory rate, higher rapid shallow breathing index, higher C-reactive protein, higher N-terminal prohormone of brain natriuretic peptide, higher serum creatinine, and significantly lower albumin (all P<0.05). 25(OH)D3 level classifications on admission and before SBT in the failure weaning group were worse than those in the successful weaning group (P<0.05). 25(OH)D3 levels of the failure weaning group were lower than those of the successful weaning group [on admission: (18.16±4.33) ng/ml vs. (21.60±5.25) ng/ml, P<0.05; before SBT: (13.50±3.52) ng/mlvs. (18.61±4.30) ng/ml, P<0.05]. Multivariate logistic regression analysis showed that 25(OH)D3 levels on admission and before SBT were independent risk factors for failure weaning (OR values were 2.257 and 2.613, respectively, both P<0.05). ROC curve analysis showed that areas under ROC curve were 0.772 and 0.836, respectively, with sensitivities of 80.3% and 85.2%, specificities of 69.0% and 71.0%, respectively.Conclusions25(OH)D3 deficiency or insufficiency is common in critically ill patients. The lower the level of vitamin D, the higher the risk of failure weaning. So it may be an independent predictor of failure weaning.
Nuclear receptors are transcriptional regulators involved in almost all biological processes such as cell growth, differentiation, apoptosis, substance metabolism and tumor formation, and they can be regulated by small molecules that bind to them. Autophagy is a special way of programmed cell death and it is a highly conserved metabolic process. Once autophagy defects or excessive autophagy occur, the disease will develop. In recent years, numerous studies have shown that nuclear receptors are related to autophagy. Therefore, this paper mainly reviews the research progress on nuclear receptors involved in the regulation of autophagy, and focuses on the mechanism of several nuclear receptors involved in the regulation of autophagy, aiming at understanding the molecular basis of how nuclear receptors participate in regulating autophagy, as well as providing possible ideas and strategies for the treatment of corresponding diseases.
ObjectiveTo explore the correlation of BMI and 25 hydroxyvitamin D3 level with colon cancer.MethodsA total of 100 cases who underwent colonoscopy and were excluded from bowel diseases at the physical examination center of the First Hospital of Qinhuangdao from March 2017 to October 2017 were retrospectively selected as the control group. A total of 100 patients who underwent colonoscopy at general surgery or physical examination center and were confirmed to have colon cancer by pathological examination were included in the colon cancer group. The height, weight and body mass index (BMI) were measured in the morning, and the level of 25 hydroxyvitamin D3 (25(OH)D3) was determined by fasting blood sampling.Results① There was no statistical significance in age and 25(OH)D3 level between the two groups (P>0.05), and BMI of the colon cancer group was significantly higher than that of the control group (P<0.05). ② The proportion of overweight and obesity in the colon cancer group was significantly higher than that in the control group (P<0.05), and the proportion of vitamin D deficiency was significantly higher as well (P<0.05). ③ Logistic regression analysis showed that the incidence of colon cancer in patients with vitamin D deficiency was 12.263 times higher than that in patients without vitamin D deficiency, and the incidence of colon cancer in patients with overweight and obesity was 2.215 times higher than that in patients with normal BMI, with statistically significant differences (P<0.05).ConclusionThe incidence of colon cancer in patients with vitamin D deficiency and those with BMI of overweight or obesity is significantly increased.
ObjectiveTo summarize the current research progress of the relationship between vitamin D and the development and progression of hepatocellular carcinoma (HCC), and relevant clinical translational application researches.MethodsThe related literatures at home and abroad were searched to review the studies on the synthesis and metabolism of vitamin D, classic and non-classical effects of vitamin D, and the relationship between vitamin D and the development and progression of HCC, as well as relevant clinical translational application.ResultsVitamin D was an important cytokine that regulated the body’s mineral and bone metabolism, and its anti-proliferation, pro-differentiation, pro-apoptosis, anti-inflammation, immune regulation, and other non-classical effects, had received more and more attentions in recent years. The existing studies had found that vitamin D was closely associated with HCC, which affected the development and progression of HCC through various mechanisms. Epidemiology showed that vitamin D levels were closely related to the prognosis of HCC patients. Whether vitamin D could be used as a clinical prognostic indicator and treatment plan for HCC still needed further clinical evidence to confirm.ConclusionVitamin D plays an important role in the regulation of the development and progression of HCC, and exploration of the association between vitamin D and HCC and related clinical translation problems are expected to provide a new approach for the prevention and treatment of HCC.
Objective The research was performed to investigate the relationship between serum 25-hydroxyvitamin D (25(OH)D) levels and the risk of adverse pregnancy outcomes. Methods We enrolled females who were in the first trimester of pregnancy and had arranged antenatal care at the Weifang Maternal and Child Health Hospital between January 2017 and December 2019. The liquid chromatography-tandem mass spectrometry (LC-MS/MS) method was used to detect serum concentrations of 25(OH)D. The health status of the expectant mothers and fetuses and the incidence of adverse pregnancy outcomes of newborns were monitored through the outpatient, prenatal, and delivery stages in the hospital. Results An initial total of 6 770 females were signed up, while 4 997 females were eventually included. The median value of 25(OH)D concentration was 15.40 ng/mL, and the incidence rate of vitamin D deficiency [25(OH)D < 20 ng/mL] was 71.26%. The occurrence rates of gestational diabetes mellitus (GDM), pre-eclampsia, premature rupture of membranes (PROM), oligohydramnios, polyhydramnios, cesarean delivery, spontaneous abortion or stillborn fetus, fetal malformation, premature delivery, fetal macrosomia, low birth weight, small for gestational age infant, and asphyxia of newborn were 28.31%, 2.27%, 23.47%, 12.68%, 0.51%, 45.71%, 1.44%, 0.93%, 9.26%, 5.05%, 11.68%, 2.68%, 3.18%, and 1.16%, respectively. After adjusting for age, parity, season, pre-existing hypertension, pre-existing diabetes, and vitamin D supplementation, no relationship between 25(OH)D levels and adverse pregnancy outcomes was found (P>0.05). Conclusions Levels of 25(OH)D do not affect the risk of adverse pregnancy outcomes in females during the first trimester of pregnancy.
Objective To summarize the changes of serum vitamin D level in patients with primary hyperparathyroidism (pHPT), the correlation between vitamin D and clinical manifestations, and feasible pathogenesis of pHPT. Method The literatures related to vitamin D and pHPT in recent years were reviewed. Results The level of vitamin D was decreased in patients with pHPT. Vitamin D level was negatively correlated with the weight of parathyroid adenoma, parathyroid hormone and blood calcium level, and positively correlated with bone mineral density. Conclusions Vitamin D nutritional status affects the severity of symptoms, main biochemical indexes and main clinical complications of patients with pHPT. There are various reasons accounted for the decline of vitamin D level, and the specific pathogenesis needs to be further explored. For patients with pHPT, vitamin D should be supplemented carefully and appropriately before surgical operation.
ObjectiveTo introduce patients with long-term hypocalcemia and normal parathyroid hormone (PTH) values after total thyroidectomy, and to analyze the possible causes of this phenomenon. MethodsThe medical records of 1 010 consecutive patients with total thyroidectomy treated in the Center for Diagnosis and Treatment of Thyroid Disease, the First Affiliated Hospital of Kunming Medical University from January 2019 to December 2020 were collected. Seven patients with normal PTH and blood calcium before operation and at least 2 times of PTH with hypocalcemia detected more than 6 months after operation were followed-up to understand the symptoms of hypocalcemia, vitamin D level and calcium consumption. ResultsSeven patients with thyroid papillary carcinoma underwent total thyroidectomy without parathyroid autotransplantation, and there were 6 cases with mild deficiency or insufficient of vitamin D before operation. The follow-up time was 12–28 months, and the median follow-up time was 19 months. Seven patients developed hypocalcemia after continuous administration of calcium and calcitriol, and vitamin D levels remained mild deficiency or insufficient, PTH decreased by more than 50% in 6 patients one year after operation compared with that before operation. ConclusionsPatients with long-term normal PTH values and hypocalcemia after total thyroidectomy have obviously lower PTH levels than those before operation. The possible factors are parathyroid damage during operation and vitamin D deficiency. Such these patients should be more properly referred to as “parathyroid insufficiency”.