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补充剂量维生素D3改善了接受血造干细胞移植的成年人中维生素D缺乏症:一项随机对照试验
Ni Bai1, Karen Lee1, Wasithep Limvorapitak2
1Division of Hematology, Department of Medicine, Leukemia Bone Marrow Transplant Program of British Columbia, University of British Columbia, Vancouver, Canada.
PloS one
|October 26, 2023
概括
在全源造血干细胞移植 (aHSCT) 之前,单次高剂量维生素D3加载剂量在第30天改善了维生素D水平. 这种方法对先前存在的维生素D缺乏症患者尤其有益.
科学领域:
- 移植医学 移植医学
- 营养科学 营养科学
- 骨的新陈代谢 骨的新陈代谢
背景情况:
- 接受全源造血干细胞移植 (aHSCT) 的患者面临维生素D缺乏的高风险.
- 维持足够的维生素D水平对于患者的康复和移植后的骨健康至关重要.
研究的目的:
- 在aHSCT之前评估维生素D3加载剂量的有效性,以达到足够的移植后维生素D水平 (血清25(OH) D≥75nmol/L).
- 用双能X射线吸收计 (DXA) 评估维生素D3充满剂量对骨健康的影响.
主要方法:
- 一项随机对照试验,涉及74名接受aHSCT的患者.
- 患者被分配到高维生素D的组 (100,000 IU加载剂量加每天2,000 IU) 或对照组 (每天2,000 IU).
- 血清25(OH) D水平在基线,30日和aHSCT后的100天被测量;DXA扫描进行了骨健康评估.
主要成果:
- 虽然基线维生素D的充足度很低 (<50%),但在移植后,在两组患者中,具有足够水平的患者比例都增加了.
- 富含维生素D的组在第30天显示出更高的足够性趋势 (89.7%vs. 74.3%) 和在第30天显著更高的25(OH) D水平 (29±25.2vs. 14±21.9nmol/L).
- 基线维生素D不足独立预测了移植后缺乏 (OR=4.16,p=0.03),两组都经历了骨损失,在对照组的股骨部更为明显.
结论:
- 一次维生素D3充满剂量有效增加了aHSCT后的第30天的血清25(OH) D水平.
- 负载剂量策略对基线维生素D缺乏症患者特别有益.
- 虽然在第100天没有达到首要优势结果,但充满剂量在改善维生素D状态方面显示出短期益处.
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