Correlation between 25-hydroxyvitamin D and anemia and inflammatory factors in patients with maintenance hemodialysis

Cao Jing

doi:10.3969/j.issn.1674-7151.2024.02.006

Abstract：Objective To analyze the correlation between 25-hydroxyvitamin D[25(OH)D]and anemia and inflammatory factors in patients with maintenance hemodialysis.Methods The 145 patients with uremia who underwent maintenance hemodialysis treatment in the inpatient department of Pinghu Traditional Chinese Medicine Hospital and 111 healthy individuals from October 2021 to October 2023 were selected as study objects,and were respectively included in research group and control group.The level of hemoglobin(Hb)in all study objects was detected using fully automated blood cell analyzer,the levels of interleukin-6(IL-6),serum amyloid A(SAA)and C-reactive protein(CRP)were detected using immunofluorescence dry quantitative instrument,and the level of 25(OH)D was detected using fully automated chemiluminescence analyzer.According to the level of 25(OH)D,the patients in research group were divided into severe deficiency group[63 cases,25(OH)D<15 μg/L],mild deficiency group[62 cases,15 μg/L≤25(OH)D<20 μg/L]and non deficiency group[20 cases,25(OH)D≥20 μg/L].The incidence of anemia and the differences in the levels of aforementioned indicators between research group and control group,as well as patients with different levels of 25(OH)D were compared.The correlations between 25(OH)D level and anemia occurrence,Hb and serum inflammatory factors in patients with maintenance hemodialysis were analyzed using Spearman correlation method.Results The incidence of anemia in research group was significantly higher than that in control group(88.97%vs.5.41%,P<0.05).The levels of Hb and 25(OH)D in research group were significantly lower than those in control group,while the levels of CRP,IL-6 and SAA were significantly higher than those in control group[Hb(g/L):105.97±22.40 vs.147.39±28.05;25(OH)D(μg/L):15.82±3.27 vs.41.61±9.34;CRP(mg/L):7.31±2.46 vs.1.46±0.39;IL-6(ng/L):23.61±6.78 vs.3.34±1.06;SAA(mg/L):160.50±49.37 vs.4.10±1.25;all P<0.05].The incidence of anemia in severe deficiency group and mild deficiency group was significantly higher than that in non deficiency group(95.24%,90.32%vs.65.00%,both P<0.05),while there was no statistically significant difference between severe deficiency group and mild deficiency group(P>0.05).The level of Hb in non deficiency group was significantly higher than those in mild deficiency group and severe deficiency group[g/L:125.35±12.09 vs.107.55±8.43,98.25±7.61,both P<0.05].The levels of CRP,IL-6 and SAA in severe deficiency group were significantly higher than those in mild deficiency group and non deficiency group[CRP(mg/L):8.30±0.95 vs.6.85±0.74,5.61±0.58;IL-6(ng/L):24.74±1.39 vs.23.43±1.32,20.62±1.47;SAA(mg/L):165.40±3.86 vs.163.19±4.37,136.49±11.20;all P<0.05].Correlation analysis showed that CRP,IL-6 and SAA were negatively correlated with 25(OH)D level in patients with maintenance hemodialysis(r values were-0.879,-0.854 and-0.840,P values were 0.002,0.003 and 0.003,respectively),while anemia and Hb were positively correlated with 25(OH)D(r values were 0.813 and 0.832,P values were 0.005 and 0.004,respectively).Conclusions There is a relative deficiency of 25(OH)D in patients with maintenance hemodialysis with uremia,and it is correlated with anemia occurrence and serum inflammatory factors.25(OH)D deficiency may be involved in the process of anemia and inflammatory response in patients with maintenance hemodialysis.