بررسی وضعیت سطح سرمی ویتامین D قبل از عمل جراحی در بیماران مبتلا به بیماری‌های دژنراتیو ستون فقرات

نوع مقاله : مقاله های پژوهشی

نویسندگان

1 دانشجوی پزشکی، دانشکده‌ی پزشکی، دانشگاه آزاد اسلامی، واحد نجف‌آباد، اصفهان، ایران

2 گروه جراحی اعصاب، دانشکده‌ی پزشکی، دانشگاه آزاد اسلامی، واحد نجف‌آباد، اصفهان، ایران

3 استادیار، گروه بهداشت، دانشکده‌ی پزشکی، دانشگاه آزاد اسلامی، واحد نجف‌آباد، اصفهان، ایران

چکیده

مقدمه: مطالعات اپیدمیولوژیک شیوع بالایی از کمبود ویتامین را در مناطق مختلف دنیا و از جمله کشورمان گزارش کرده‌اند. هدف از اجرای این مطالعه، تعیین شیوع کمبود ویتامین D در بیماران مبتلا به بیماری دژنراتیو ستون فقرات (فتق دیسک بین مهره‌ای، تنگی کانال نخاعی و ناپایداری ستون فقرات) که کاندیدای عمل جراحی ستون فقرات بودند و نیز بررسی ارتباط کمبود این ویتامین با سن، جنسیت، چاقی، مصرف سیگار، مصرف مکمل و ... و اندازه‌گیری این متغیرها بود.روش‌ها: در این مطالعه‌ی مقطعی و غیر مداخله‌ای، سطح سرمی D(OH)25 به روش الکتروکمی لومینسانس تعیین شد. وضعیت سایر متغیرها از طریق پرسش‌نامه‌های مربوط مشخص گردید. جهت تجزیه و تحلیل داده‌ها، از آزمون‌های تک متغیره و آنالیز رگرسیون چندگانه استفاده شد.یافته‌ها: در مجموع، 110 بیمار وارد مطالعه شدند. میانگین سطح سرمی D(OH)25، ng/ml 75/18 ± 45/27 بود. 5/44 درصد دچار کمبود ویتامین D [ng/ml 20 > D(OH)25] بودند و 3/17 درصد سطح ناکافی ویتامین D [ng/ml 30 > D(OH)25 ≥ 20] داشتند. در گروه با سابقه‌ی مصرف مکمل، هیپوویتامینوز D همچنان شیوع 6/47 درصد داشت. شیوع کمبود ویتامین D به صورت معنی‌داری در گروه سنی جوان‌تر (39-20 سال) (003/0 = P) و نیز افراد بدون سابقه‌ی مصرف مکمل (001/0 P <) بالاتر بود. در مقابل، زنان در مقایسه با مردان به طور معنی‌داری سطوح بالاتر ویتامین D (030/0 = P) و به همان نسبت، میزان بیشتری (001/0 > P) از مصرف مکمل ویتامین D را داشتند. در مورد سایر متغیرها، ارتباط معنی‌داری مشاهده نشد.نتیجه‌گیری: کمبود ویتامین D در بیماران با بیماری‌های دژنراتیو ستون فقرات حتی بیماران تحت درمان با مکمل ویتامین، شیوع بالایی دارد. از طرفی، استناد به عوامل خطر از قبل شناخته شده مثل سن بالا و جنس مؤنث به تنهایی جهت تعیین احتمال کمبود، کافی نیست. از این رو، غربال‌گری کمبود با سنجش سطح سرمی D(OH)25 و به دنبال آن، درمان کامل و صحیح در بیماران مبتلا به بیماری‌های دژنراتیو ستون فقرات به ویژه بیماران با مداخلات جراحی توصیه می‌گردد.

کلیدواژه‌ها

عنوان مقاله [English]

Preoperative Status of the Serum Level of Vitamin D in Patients with Degenerative Diseases of the Spine

نویسندگان [English]

  • Mohammadreza Taji 1
  • Farid Zolfaghari 2
  • Alireza Faridmoayer 2
  • Bahram Soleymani 3
1 Student of Medicine, School of Medicine, Islamic Azad University, Najafabad Branch, Isfahan, Iran
2 Department of Neurosurgery, School of Medicine, Islamic Azad University, Najafabad Branch, Isfahan, Iran
3 Assistant Professor, Department of Health, School of Medicine, Islamic Azad University, Najafabad Branch, Isfahan, Iran
چکیده [English]

Background: Epidemiological studies have reported a high prevalence of vitamin D deficiency in different regions of the world, including Iran. This study aimed to determine the prevalence of vitamin D deficiency in patients with degenerative diseases of spine, which underwent spine surgery, and to assess the relationship between vitamin D deficiency and age, sex, obesity, smoking, and taking supplements.Methods: In this cross-sectional and non-interventional study, the serum level of 25(OH)D was determined via electrochemiluminescence immunoassay method. Other variables were firmed through relevant questionnaires. To analyze the data, univariate and multiple regression analysis were used.Findings: 110 patients enrolled the study. The mean serum level of 25(OH) D was 27.45 ± 18.75 ng/ml. 44.5% of patients showed vitamin D deficiency [25(OH)D < 20 ng/ml], and in 17.3% of the patients, the serum level of 25(OH)D was insufficient [20 ng/ml ≤ 25(OH)D < 30 ng/ml]. In group with the history of taking supplements, the prevalence of hypovitaminosis D was 47.6%. The prevalence of vitamin D deficiency was significantly higher in younger age group (20-39 years old) (P = 0.003) and the ones without the history of taking supplements (P < 0.001). Compared to men, women showed significantly higher levels of vitamin D (P = 0.030), as well as higher levels of consumption of vitamin D supplements. There was no significant correlation between other variables.Conclusion: A high prevalence of vitamin D deficiency was seen in patients with degenerative diseases of spine, even in patients treated with vitamin supplements. On the other hand, considering the risk factors alone seems not to be sufficient in determining the likelihood of deficiency. So, it is recommended to screen vitamin D deficiency via measuring the serum level of 25(OH)D and consequently to treat properly and sufficiently patients with degenerative diseases of spine, especially patients with surgical interventions.

کلیدواژه‌ها [English]

  • Vitamin D
  • Spine
  • Intervertebral disc degeneration

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مجله دانشکده پزشکی اصفهان
دوره 33، شماره 338 - شماره پیاپی 338
مرداد و شهریور 1394
صفحه 901-916

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  • تاریخ دریافت: 20 اسفند 1393
  • تاریخ بازنگری: 11 آبان 1403
  • تاریخ پذیرش: 17 فروردین 1401

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