常见可变免疫缺陷患者骨代谢改变:一项回顾性队列研究

IF 0.3 Q4 ALLERGY Astim Allerji Immunoloji Pub Date : 2020-05-08 DOI:10.21911/aai.501
G. Aytekin, Fatih Çölkesen, Eray Yıldız, Ş. Arslan, A. Çalışkaner
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引用次数: 0

摘要

目的:在欧洲免疫缺陷学会(ESID)登记系统中,常见变异免疫缺陷(CVID)是一种相对常见的原发性免疫缺陷疾病,其特征是B细胞分化受损伴低丙种球蛋白血症。炎症细胞因子增加、长期和/或复发性感染、胃肠道并发症和抗炎药是CVID患者骨密度(BMD)降低的危险因素。材料和方法:研究组包括32例CVID患者(男19例,女13例;平均年龄:37.33±13.70岁,女性40.6%),定期随访4年。根据骨密度将患者分为两组:低骨密度组和正常骨密度组。结果:17名患者(8名女性和9名男性)的骨密度正常(平均年龄34.94±11.41岁,女性47.1%),15名患者(5名女性和10名男性)骨密度低(平均年龄40.03±15.87岁,女性33.3%)。在低骨密度组中,3名患者患有骨质疏松症,12名患者患有骨量减少症。单因素回归分析显示,淋巴细胞减少症(比值比,OR:6.562,95%置信区间,CI:1.095-33.24,p=0.039)与低BMD显著相关。多元回归分析显示,较高的碱性磷酸酶(ALP)水平(OR:1.017,95%CI 1.001-1.033,p=0.041)、淋巴细胞减少症(OR:11.028,95%CI 1.326-91.709,p=0.026)和较低的叶酸水平(OR:12.84,95%CI 1.00 7-1.637,p=0.043)也是低BMD的独立预测因素。结论:即使存在一些局限性,如研究人群数量少、单一中心经验和横断面设计,我们建议临床免疫学家应警惕CVID患者的BMD降低,尤其是那些叶酸低、ALP水平高和淋巴细胞减少的患者。
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Bone Metabolism Alterations in Patients with Common Variable Immune Deficiency: A Retrospective Cohort Study
Objective: Common variable immunodeficiency (CVID) is a relatively frequent primary immunodeficiency disorder characterized by impaired B cell differentiation with hypogammaglobulinemia in the European Society for Immunodeficiencies (ESID) registry system. Increased inflammatory cytokines, prolonged and/or recurrent infections, gastrointestinal complications, and anti-inflammatory medications are risk factors for diminished bone mineral density (BMD) in CVID patients. Materials and Methods: The study group included 32 patients with CVID (19 males and 13 females; mean age: 37.33 ± 13.70 years, 40.6% female), who had been followed up on a regular basis for a period of four years. The patients were categorized into two groups according to their BMD: low BMD and normal BMD. Results: Seventeen patients (8 females and 9 males) had normal BMD (mean age 34.94 ± 11.41 years, 47.1% female) and fifteen patients (5 females and 10 males) had low BMD (mean age 40.03 ± 15.87 years, 33.3% female). In the low BMD group, three patients had osteoporosis and 12 patients had osteopenia. Univariate regression analysis revealed that lymphopenia (odds ratio, OR:6.562, 95% confidence interval, CI: 1.095-39.324, p=0.039) was significantly associated with low BMD. Multivariate regression analysis showed that higher alkaline phosphatase (ALP) levels (OR:1.017, 95% CI 1.001-1.033, p=0.041), lymphopenia (OR:11.028, 95% CI 1.326-91.709, p=0.026), and lower folic acid levels (OR:1.284, 95% CI 1.007-1.637, p=0.043) were also independent predictors for low BMD. Conclusion: Even with some limitations such as the small number for the study population, a single center experience, and a crosssectional design, we recommend that clinical immunologists should be alert for diminished BMD in CVID patients, especially those with low folic acid and high ALP levels and lymphopenia.
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来源期刊
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期刊介绍: Asthma Allergy Immunology has been published three times a year in April, August and December as the official and periodical journal of the Turkish National Society of Allergy and Clinical Immunology since 2003. All articles published in the journal have been available online since 2003. A peer reviewed system is used in evaluation of the manuscripts submitted to Asthma Allergy Immunology. The official language of the journal is English. The aim of the journal is to present advances in the field of allergic diseases and clinical immunology to the readers. In accordance with this goal, manuscripts in the format of original research, review, case report, articles about clinical and practical applications and editorials, short report and letters to the editor about allergic diseases and clinical immunology are published in the journal. The target reader population of the Asthma Allergy Immunology includes specialists and residents of allergy and clinical immunology, pulmonology, internal medicine, pediatrics, dermatology and otolaryngology as well as physicians working in other fields of medicine interested in allergy and immunological diseases.
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