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Vitamin D levels and their associations with survival and major disease outcomes in a large cohort of patients with chronic graft-vs-host disease.
Katic, Masenjka; Pirsl, Filip; Steinberg, Seth M; Dobbin, Marnie; Curtis, Lauren M; Pulanic, Drazen; Desnica, Lana; Titarenko, Irina; Pavletic, Steven Z.
Afiliação
  • Katic M; Masenjka Katic, Trg 101. brigade HV 2, Zagreb, Croatia, mashakatic@gmail.com.
Croat Med J ; 57(3): 276-86, 2016 Jun 30.
Article em En | MEDLINE | ID: mdl-27374829
AIM: To identify the factors associated with vitamin D status in patients with chronic graft-vs-host disease (cGVHD) and evaluate the association between serum vitamin D (25(OH)D) levels and cGVHD characteristics and clinical outcomes defined by the National Institutes of Health (NIH) criteria. METHODS: 310 cGVHD patients enrolled in the NIH cGVHD natural history study (clinicaltrials.gov: NCT00092235) were analyzed. Univariate analysis and multiple logistic regression were used to determine the associations between various parameters and 25(OH)D levels, dichotomized into categorical variables: ≤20 and >20 ng/mL, and as a continuous parameter. Multiple logistic regression was used to develop a predictive model for low vitamin D. Survival analysis and association between cGVHD outcomes and 25(OH)D as a continuous as well as categorical variable: ≤20 and >20 ng/mL; <50 and ≥50 ng/mL, and among three ordered categories: ≤20, 20-50, and ≥50 ng/mL, was performed. RESULTS: 69 patients (22.3%) had serum 25(OH)D ≤20 ng/mL. Univariate analysis showed that supplement intake, nutritional status (severely malnourished, moderately malnourished, well-nourished), race (African-American, other), and estimated creatinine clearance (eCCr) were associated with 25(OH)D levels. A predictive model was developed based on supplement intake, nutritional status, race, and eCCr, accurately predicting 77.9% of patients with 25(OH)D ≤20 and 65.2% of those with 25(OH)D >20 ng/mL. No association was found between vitamin D and major cGVHD characteristics, but patients with 25(OH)D ≤20 ng/mL had somewhat decreased survival. CONCLUSION: Nutritional status and adequate supplementation are important to maintain 25(OH)D >20 ng/mL in cGVHD patients. Intervention studies and more research is needed to reveal the underlying mechanism of vitamin D metabolism in cGVHD setting.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Vitamina D / Deficiência de Vitamina D / Índice de Gravidade de Doença / Doença Enxerto-Hospedeiro Tipo de estudo: Etiology_studies / Incidence_studies / Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Child / Female / Humans / Male / Middle aged País/Região como assunto: Europa Idioma: En Revista: Croat Med J Assunto da revista: MEDICINA Ano de publicação: 2016 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Vitamina D / Deficiência de Vitamina D / Índice de Gravidade de Doença / Doença Enxerto-Hospedeiro Tipo de estudo: Etiology_studies / Incidence_studies / Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Child / Female / Humans / Male / Middle aged País/Região como assunto: Europa Idioma: En Revista: Croat Med J Assunto da revista: MEDICINA Ano de publicação: 2016 Tipo de documento: Article