2020 年第 5 期 第 15 卷

多发性骨髓瘤患者血清25-羟基维生素D表达及临床意义

Expression and clinical significance of 25-hydroxy vitamin D in patients with multiple myeloma

作者：崔彦杰;黄国虹;刘红春;王昌敏

英文作者：Cui Yanjie Huang Guohong Liu Hongchun Wang Changmin

单位：新疆维吾尔自治区人民医院临床检验中心，乌鲁木齐830001

英文单位：Clinical Laboratory Center People′s Hospital of Xinjiang Uygur Autonomous Region Urumqi 830001 China

关键词：多发性骨髓瘤；25-羟维生素D；肿瘤负荷；预后

英文关键词：Multiplemyeloma;25-HydroxyvitaminD;Tumorload;Prognosis

• 摘要：

• 目的 探究25-羟基维生素D［25-(OH)D］在多发性骨髓瘤（MM）患者血清中的表达及其临床意义。方法 选取2016年4月至2018年12月于新疆维吾尔自治区人民医院初次诊断为MM的83例患者，同期选取本院健康体检人员40名为对照组。检测血清中25-(OH)D及β2微球蛋白(β2-MG)、血红蛋白、白蛋白、钙离子、乳酸脱氢酶水平，结合患者骨损伤情况及疾病分期进行比较分析。结果 MM患者血清25-(OH)D水平明显低于对照组［(12.4±2.7)μg/L比（21.3±3.2）μg/L］，差异有统计学意义（P＝0.007）。多发性骨髓瘤骨病患者(62例)25-(OH)D充足率明显低于无骨病患者（21例）,其缺乏率和严重缺乏率均明显高于无骨病组［3.2%（2/62）比19.0%（4/21）、40.3%（25/62）比33.3%（7/21）、30.6%（19/62）比9.5%（2/21）］，差异均有统计学意义（均P＜0.05）。国际分期系统分期Ⅲ期MM患者血清25-(OH)D水平明显低于Ⅰ、Ⅱ期患者［（7.5±2.9）μg/L比（20.2±4.2）、（18.8±3.8）μg/L］，差异均有统计学意义（均P＜0.05）；Ⅰ期与Ⅱ期MM患者之间比较差异无统计学意义（P＞0.05）。Durie-Salmon分期Ⅲ期MM患者血清25-(OH)D水平明显低于Ⅰ、Ⅱ期患者［（8.5±2.4）μg/L比（23.8±4.5）、（17.5±3.6）μg/L］，且Ⅱ期MM患者明显低于Ⅰ期患者，差异均有统计学意义(均P＜0.05)。Pearson相关性分析显示，MM患者血清25-(OH)D水平与血红蛋白水平(r＝0.452，P=0.021)、白蛋白水平(r＝0.212，P＝0.007)呈正相关；与β2-MG水平(r＝-0.415，P=0.023)、钙离子水平(r＝-1.063，P＝0.009)呈负相关。结论血清25-(OH)D在MM患者中表达水平偏低，可能与MM患者的肿瘤负荷及预后相关。

• Objective To observe the expression level of 25-hydroxy vitamin D［25-(OH)D］ in patients with multiple myeloma（MM） and to explore its clinical significance. Methods From April 2016 to December 2018, 83 patients with newly diagnosed MM and 40 healthy volunteers were recruited at People′s Hospital of Xinjiang Uygur Autonomous Region. Serum contents of 25-(OH)D, β2-microglobulin, hemoglobin, albumin, calcium ion and lactate dehydrogenase were analyzed among patients with different stages of bone disease. Results Serum 25-(OH)D level in MM patients was significantly lower than that in healthy people［(12.4±2.7)μg/L vs （21.3±3.2）μg/L, P＝0.007］. Higher rate of 25-(OH)D adequacy and lower rates of deficiency/serious deficiency were observed in MM patients with bone disease（n=62）［3.2%（2/62）, 40.3%（25/62）, 30.6%（19/62） vs 19.0%（4/21）, 33.3%（7/21）, 9.5%（2/21） in MM patients without bone disease (n=21),all P＜0.05］. Serum 25-(OH)D level in International Staging System stage Ⅲ was significantly lower than that in stage Ⅰ and Ⅱ［（7.5±2.9）μg/L vs （20.2±4.2）,（18.8±3.8）μg/L, both P＜0.05］; no statistical difference was observed between stage Ⅰ and Ⅱ（P＞0.05）. Serum 25-(OH)D level decreased with greater Durie-Salmon stage［（23.8±4.5）, （17.5±3.6）μg/L, （8.5±2.4）μg/L for stage Ⅰ, Ⅱ, Ⅲ, all P＜0.05］. Pearson test showed that serum 25-(OH)D level was positively correlated with hemoglobin(r＝0.452, P=0.021) and albumin(r＝0.212, P＝0.007); it was negatively correlated with β2-MG(r＝-0.415, P=0.023) and calcium ion(r＝-1.063, P＝0.009). ConclusionThe expression of 25-(OH)D in patients with MM is low, which may be associated with the severity and prognosis of disease.