摘要
目的 检测狼疮性肾炎(LN)患者血清维生素D(VitD)代谢物和维生素D受体(VDR)水平,分析其与淋巴细胞亚群分布的关系.方法 选取2022年4月至12月四川省绵阳市中心医院73名健康体检者为HC组,66例并发LN的系统性红斑狼疮(SLE)患者为LN组,62例单纯SLE患者为NonLN-SLE组.检测并比较各组淋巴细胞亚群、VitD代谢物和VDR水平,比较三组血清VitD营养评估情况,分析血清VitD代谢物及VDR与淋巴细胞亚群的相关性,分析LN发生的影响因素.结果 三组性别、总淋巴细胞、T淋巴细胞、B淋巴细胞、自然杀伤细胞、辅助性T细胞、抑制性T细胞、T淋巴细胞/总淋巴细胞、辅助性T细胞/总淋巴细胞、抑制性T细胞/总淋巴细胞、辅助性T细胞/抑制性T细胞、自然杀伤细胞/总淋巴细胞比较,差异有统计学意义(P＜0.05).三组总25羟基维生素 D[t-25(OH)D]、25 羟基维生素 D2[25(OH)D2]、25 羟基维生素 D3[25(OH)D3]、25(OH)D3/25(OH)D2、游离25羟基维生素D[F-25(OH)D]、C3-差向异构体-25羟基维生素D3[C3-epi-25(OH)D3](以下简称"C3-epi-D3")、25(OH)D3/C3-epi-D3及VDR比较,差异有统计学意义(P＜0.05).三组血清VitD营养评估结果比较,差异有统计学意义(P＜0.05).t-25(OH)D、F-25(OH)D、25(OH)D3、C3-epi-D3与抑制性T细胞/总淋巴细胞呈负相关(r＜0,P＜0.05),与辅助性T细胞/抑制性T细胞、自然杀伤细胞/总淋巴细胞、总淋巴细胞、T淋巴细胞、B淋巴细胞、自然杀伤细胞、辅助性T细胞呈正相关(r＞0,P＜0.05);VDR与抑制性T细胞/总淋巴细胞呈正相关(r＞0,P＜0.05),与辅助性T细胞/抑制性T细胞、自然杀伤细胞/总淋巴细胞、总淋巴细胞、T淋巴细胞、B淋巴细胞、自然杀伤细胞、辅助性T细胞、抑制性T细胞呈负相关(r＜0,P＜0.05).以HC组为参照,25(OH)D2和25(OH)D3是LN发生的保护因素,VDR是LN发生的危险因素(P＜0.05);以NonLN-SLE组为参照,25(OH)D2和25(OH)D3是LN发生的保护因素(P＜0.05).结论 LN患者VitD普遍缺乏;血清t-25(OH)D、25(OH)D3、C3-epi-D3和VDR与淋巴细胞亚群分布异常有一定相关性;25(OH)D3可能是LN发生的保护因素;VDR可能是LN发生的危险因素.
Abstract
Objective To detect the levels of serum vitamin D(VitD)metabolites and vitamin D receptor(VDR)in patients with lupus nephritis(LN),and to analyze their relationship with the distribution of lymphocyte subsets.Methods A total of 73 healthy subjects from Mianyang Central Hospital,Sichuan Province from April to December 2022 were selected as HC group,66 patients with systemic lupus erythematosus(SLE)complicated with LN were selected as LN group,and 62 patients with SLE alone were selected as NonLN-SLE group.Lymphocyte subsets,VitD metabolites,and VDR level were detected and compared among three groups,serum VitD nutritional assessment was compared among three groups,the correlation between serum VitD metabolites and VDR and lymphocyte subsets were analyzed,and the influencing factors of LN occurrence were analyzed.Results There were significant differences in sex,total lymphocytes,T lymphocytes,B lymphocytes,natural killer cells,helper T cells,suppressor T cells,T lymphocytes/total lymphocytes,helper T cells/total lymphocytes,suppressor T cells/total lymphocytes,helper T cells/suppressor T cells,and natural killer cells/total lymphocytes among three groups(P＜0.05).There were significant differences in total-25-hydroxylvitamin D[t-25(OH)D],25-hydroxylvitamin D2[25(OH)D2],25-hydroxylvitamin D3[25(OH)D3],25(OH)D3/25(OH)D2,free-25-hydroxylvitamin D[F-25(OH)D],C3-epimer-25-hydroxylvitamin D3[C3-epi-25(OH)D3](hereinafter referred to as"C3-epi-D3"),25(OH)D3/C3-epi-D3,and VDR among three groups(P＜0.05).There were significant differences in serum VitD nutrition evaluation result among three groups(P＜0.05).T-25(OH)D,F-25(OH)D,25(OH)D3,C3-epi-D3 were negatively correlated with suppressor T cells/total lymphocytes(r＜0,P＜0.05),and positively correlated with helper T cells/suppressor T cells,natural killer cells/total lymphocytes,total lymphocytes,T lymphocytes,B lymphocytes,natural killer cells,and helper T cells(r＞0,P＜0.05).VDR was positively correlated with suppressor T cells/total lymphocytes(r＞0,P＜0.05),and negatively correlated with helper T cells/suppressor T cells,natural killer cells/total lymphocytes,total lymphocytes,T lymphocytes,B lymphocytes,natural killer cells,helper T cells,and suppressor T cells(r＜0,P＜0.05).The HC group was used as reference,25(OH)D2 and 25(OH)D3 were protective factors for the occurrence of LN,and VDR was risk factor for the occurrence of LN(P＜0.05);NonLN-SLE group was used as reference,25(OH)D2 and 25(OH)D3 were protective factors for the occurrence of LN(P＜0.05).Conclusion VitD deficiency was common in LN patients;serum t-25(OH)D,25(OH)D3,C3-epi-D3,and VDR were correlated with abnormal distribution of lymphocyte subsets,25(OH)D3 may be a protective factor for the occurrence of LN;VDR may be a risk factor for the occurrence of LN.
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