بررسي سطح سرمي ويتامين D در بيماران مبتلا به كهير مزمن و مقايسه ي آن با افراد سالم در شهر اصفهان

Serum Vitamin D Levels in Patients with Chronic Urticaria and its Comparison with Healthy Individuals in Isfahan City, Iran

ﻣﻘﺪﻣﻪ: ﮐﻬﯿﺮ ﻣﺰﻣﻦ، ﯾﮏ اﺧﺘﻼل اﻟﺘﻬﺎﺑﯽ ﭘﻮﺳﺘﯽ اﺳﺖ ﮐﻪ ﺣﺪاﻗﻞ ﺷﺶ ﻫﻔﺘﻪ از ﻣﺪت ﺑﯿﻤﺎري ﮔﺬﺷﺘﻪ ﺑﺎﺷﺪ. اﻣﺮوزه، ﻧﻘﺶ وﯾﺘﺎﻣﯿﻦ D در ﺑﯿﻤﺎري ﻫﺎي اﻟﺘﻬﺎﺑﯽ از ﺟﻤﻠﻪ ﮐﻬﯿﺮ ﺑﺴﯿﺎر ﻣﻮرد ﺗﻮﺟﻪ اﺳﺖ. ﻫﺪف از اﻧﺠﺎم اﯾﻦ ﻣﻄﺎﻟﻌﻪ، ﺑﺮرﺳﯽ ارﺗﺒﺎط وﯾﺘﺎﻣﯿﻦ D و ﮐﻬﯿﺮ ﻣﺰﻣﻦ ﺑﻮد. روش ﻫﺎ: در اﯾﻦ ﻣﻄﺎﻟﻌﻪ ي ﻣﻘﻄﻌﯽ، 40 ﺑﯿﻤﺎر ﻣﺒﺘﻼ ﺑﻪ ﮐﻬﯿﺮ ﻣﺰﻣﻦ و 40 ﻓﺮد ﺳﺎﻟﻢ ﺑﺎ داﻣﻨﻪ ي ﺳﻨﯽ 18-60 ﺳﺎل از ﺑﯿﻦ ﻣﺮاﺟﻌﻪ ﮐﻨﻨﺪﮔﺎن ﺑﻪ ﮐﻠﯿﻨﯿﮏ ﺳﺮﭘﺎﯾﯽ ﺑﯿﻤﺎرﺳﺘﺎن اﻟﺰﻫﺮاي )س( اﺻﻔﻬﺎن در ﺳﺎل ﻫﺎي 1396-97 ﺗﺤﺖ ﻣﻄﺎﻟﻌﻪ ﻗﺮار ﮔﺮﻓﺘﻨﺪ. در ﮐﻠﯿﻪ ي اﯾﻦ اﻓﺮاد، ﺳﻄﺢ وﯾﺘﺎﻣﯿﻦ D ﺑﺎ روش HPLC) High-performance liquid chromatography( اﻧﺪازه ﮔﯿﺮي ﺷﺪ. ﺳﻄﺢ 25-ﻫﯿﺪروﮐﺴﯽ وﯾﺘﺎﻣﯿﻦ D ﺑﻪ ﻣﯿﺰان ﮐﻤﺘﺮ از 20 ﻧﺎﻧﻮﮔﺮم/ﻣﯿﻠﯽ ﻟﯿﺘﺮ ﺑﻪ ﻋﻨﻮان ﮐﻤﺒﻮد )Deficiency( و ﺳﻄﺢ 20-30 ﻧﺎﻧﻮﮔﺮم/ﻣﯿﻠﯽ ﻟﯿﺘﺮ ﺑﻪ ﻋﻨﻮان ﻧﺎﮐﺎﻓﯽ )Insufficiency( در ﻧﻈﺮ ﮔﺮﻓﺘﻪ ﺷﺪ. داده ﻫﺎ ﺑﺎ روش ﻫﺎي آﻣﺎري ﻣﻨﺎﺳﺐ ﻣﻮرد واﮐﺎوي ﻗﺮار ﮔﺮﻓﺘﻨﺪ. ﯾﺎﻓﺘﻪ ﻫﺎ: ﻣﯿﺰان ﻣﺘﻮﺳﻂ وﯾﺘﺎﻣﯿﻦ D ﺳﺮم در ﮔﺮوه ﻣﻮرد 21/6 و در ﮔﺮوه ﺷﺎﻫﺪ 30/8 ﻧﺎﻧﻮﮔﺮم/ﻣﯿﻠﯽ ﻟﯿﺘﺮ ﺑﻮد. در ﮔﺮوه ﺑﯿﻤﺎران، 42/5 درﺻﺪ و در ﮔﺮوه ﺷﺎﻫﺪ 22/5 درﺻﺪ ﺳﻄﺢ وﯾﺘﺎﻣﯿﻦ D ﮐﻤﺘﺮ از 20 ﻧﺎﻧﻮﮔﺮم/ﻣﯿﻠﯽ ﻟﯿﺘﺮ و ﻫﻤﭽﻨﯿﻦ در ﮔﺮوه ﻣﻮرد 42/5 درﺻﺪ و در ﮔﺮوه ﺷﺎﻫﺪ 25/0درﺻﺪ ﺳﻄﺢ وﯾﺘﺎﻣﯿﻦ D ﺑﯿﻦ 20-30 ﻧﺎﻧﻮﮔﺮم/ﻣﯿﻠﯽ ﻟﯿﺘﺮ داﺷﺘﻨﺪ. ﺑﻨﺎﺑﺮاﯾﻦ، ﺷﯿﻮع ﮐﻤﺒﻮد و ﺳﻄﺢ ﻧﺎﮐﺎﻓﯽ وﯾﺘﺎﻣﯿﻦ D در ﺑﯿﻤﺎران 85/0 درﺻﺪ و در ﮔﺮوه ﺷﺎﻫﺪ 47/5 درﺻﺪ ﺑﻮد. ﻧﺘﯿﺠﻪ ﮔﯿﺮي: اﯾﻦ ﻣﻄﺎﻟﻌﻪ ﻧﺸﺎن ﻣﯽ دﻫﺪ ﮐﻪ ﺷﯿﻮع ﮐﻤﺒﻮد وﯾﺘﺎﻣﯿﻦ D در ﻣﺒﺘﻼﯾﺎن ﺑﻪ ﮐﻬﯿﺮ ﻣﺰﻣﻦ ﻧﺴﺒﺖ ﺑﻪ اﻓﺮاد ﺳﺎﻟﻢ ﺑﯿﺸﺘﺮ اﺳﺖ، اﻣﺎ ﯾﺎﻓﺘﻦ راﺑﻄﻪ ي ﻋﻠﺖ و ﻣﻌﻠﻮﻟﯽ ﺑﯿﻦ ﮐﻬﯿﺮ ﻣﺰﻣﻦ و وﯾﺘﺎﻣﯿﻦ D ﻧﯿﺎزﻣﻨﺪ ﻣﻄﺎﻟﻌﺎت وﺳﯿﻊ ﺗﺮي ﻣﯽ ﺑﺎﺷﺪ.

Background: Urticaria is an inflammatory skin disorder lasting for six weeks or longer. Nowadays, the role of vitamin D in inflammatory disease such as urticaria is a matter of great interest. The aim of this study was to investigate the relationship between vitamin D and chronic urticaria. Methods: In this cross-sectional study, 40 patients with chronic urticaria and 40 healthy individuals aged 18 to 60 years were studied during the years 2017-2018 in Alzahra hospital, Isfahan, Iran. In all cases, vitamin D levels were measured using high-performance liquid chromatography (HPLC) method. Levels of 25-hydroxyvitamin D less than 20 ng/ml were considered as deficiency and levels of 20-30 ng/ml were considered as insufficiency. Data were analyzed with appropriate statistical tests. Findings: The mean serum vitamin D level was 21.6 ng/ml in the patients group and 30.8 ng/ml in the control group. In the patient group 42.5%, and in the control group 22.5%, had vitamin D level of less than 20 ng/ml, and in the patient group 42.5%, and in the control group 25%, had vitamin D level of between 20-30 ng/ml. Therefore, the prevalence of vitamin D deficiency and insufficiency in patients and in the control group was 85% and 47.5%, respectively. Conclusion: This study shows that vitamin D deficiency is more common in people with chronic urticaria than in normal population. However, finding a cause-and-effect relationship between chronic urticaria and vitamin D requires more extensive studies.