투석 환자들에서 25-(OH) Vit. D3 결핍 유무 및 부갑상선 호르몬 수치의 계절 변동

Abstract

Background : The purpose of this study is to quantify the prevalence of serum 25-(OH) vitamin D3 (Vit. D3) deficiency and seasonal variation of bone mineral metabolism markers on dialysis patients between the winter and summer season. Methods : An observational study in 100 dialysis outpatients was performed. Exclusion criteria were received any vitamin D compounds or 2ndary hyperparathyroidism (iPTH> 500pg/ml) or acute GI bleeding or infection or history of parathyroidectomy. Blood samples were collected for serum calcium, phosphorus, intact PTH and vitamin D metabolites. Winter season samples were collected from January 2011 to February 2011. Summer season samples were carried out between July 2011 and August 2011. Results : The prevalence of vitamin D depletion(serum 25(OH) vit. D3 < 30ng/mL), including deficiency(serum 25(OH) vit. D3 <15ng/mL), was 94.3%(67/71) during summer season and further increased 98.5%(70/71) in winter season. In the winter season, mean iPTH level was 175.79±151.22pg/mL. serum 25-(OH) Vit. D3 level was 11.67±5.99ng/mL and 1,25-(OH)2 Vit. D3 level was 9.78±3.93pg/m. In the summer season, mean iPTH level was 138.68± 99.35pg/mL ; the 25-(OH) Vit. D3 level increased from 11.67±5.99ng/mL to 17.28±8.41ng/mL ; 1,25-(OH)2 Vit. D3 level increased from 9.78±3.93pg/mL to 12.13±6.83pg/mL compared with winter season. Conclusion : We observed a high prevalence of 25-(OH) Vit. D3 deficiency among patients with hemodialysis in the winter season especially. Like normal population, 25-(OH) Vit. D3 and 1,25-(OH)2 Vit. D3 level were affected by summer season. Prospective studies in hemodialysis patients are needed to identify optimal levels of 25-(OH) Vit. D3