Study On Vitamin D Metabolism In Serum And Intestinal Mucosa Of 37 Adult Patients With Chylorrhea

Objective:To analyze the expression of 25-hydroxyvitamin D [25(OH)D] in serum and vitamin D receptor(VDR)in descending duodenum of adult patients with celiac disease and their correlation with the clinical characteristics of celiac disease.Methods:From September 1,2020 to May 1,2022,37 patients(celiac disease group)diagnosed as celiac disease in the Department of Gastroenterology of People’s Hospital of Xinjiang Uygur Autonomous Region were included.At the same time,37 patients(non-celiac group)who had suspected symptoms of celiac disease but the diagnosis of celiac disease were excluded were selected according to gender,age and nationality at a ratio of 1:1.General data and clinical characteristics of all patients were collected,including diarrhea,bone mineral density(BMD),Marsh stage,etc.Serum 25(OH)D levels were detected in all patients,and the expression of VDR in the descending duodenum was evaluated by immunohistochemical staining.Independent sample t test,chi-square test and Spearman correlation analysis were used for statistical analysis.Results:The serum 25(OH)D level in the celiac group was lower than that in the non-celiac group(12.40 ±8.93)μ g/L ratio(16.78 ± 7.09)μ g/L,the proportion of patients with high VDR expression in small intestine tissue in the celiac group was lower than that in the non-celiac group 46.0%(17/37)and 75.7%(28/37),and the difference was statistically significant(t=-2.52,χ2=6.86,both P<0.05);The proportion of diarrhea patients in the celiac disease group was higher than that in the non-celiac disease group [45.9%(17/37)vs 21.6%(8/37)],and the difference was statistically significant(χ2=4.89,P<0.05).The serum 25(OH)D in the celiac diarrhea group and the non-celiac group was both positively correlated with the VDR expression in the descending duodenum of the group(r=0.75,0.64,both P<0.001),and were not related to the diarrhea symptoms of the patients in the group(both P>0.05).There was a positive correlation between serum 25(OH)D and BMD in the celiac disease group(r=0.48,P=0.017),and a strong correlation between serum 25(OH)D and BMD in the non-celiac group(r=0.93,P<0.001).The VDR expression level in the descending duodenum of the celiac disease group was negatively correlated with the Marsh stage(r=-0.36,P=0.031),while the VDR expression level in the non-celiac group was not related to the Marsh stage(P>0.05).Conclusions:Vitamin D metabolism imbalance exists in the serum and duodenal mucosa of adult patients with celiac disease,which is related to the severity of osteoporosis and histopathology.It is suggested that patients with celiac disease need to receive treatment to regulate vitamin D metabolism.