また、「Hypovitaminosis D is Associated with Poor Outcome in Dogs with Protein Losing Enteropathy」という文献が発表されています。 http://onlinelibrary.wiley.com/doi/10.1111/jvim.13647/full この中の「ESCG-P-1」 Hypovitaminosis D is Associated with Poor Outcome in Dogs with Protein Losing Enteropathy ビタミンＤ濃度とＰＬＥの犬の予後の関係
K. Allenspach, J. Rizzo, Y.M. Chang. Royal Veterinary College, North Mymms, UK
Hypovitaminosis D has previously been shown to be prevalent amongst dogs with protein losing enteropathy (PLE). Outcome is generally poor in canine PLE, and there is a lack of studies identifying underlying risk factors. The hypothesis of this study was that low vitamin D3 serum concentrations could be a risk factor for bad outcome in such patients. Medical records for dogs seen at the Royal Veterinary College between 2005 and 2014 were reviewed to identify dogs with a diagnosis of PLE confirmed by histopathology. Dogs were included in the study if they had serum samples frozen within 30 minute after sampling, had been kept at −80 degrees C until analysis, and if clinical activity scoring (CCECAI) had been recorded at the time of diagnosis. Forty-three dogs were included in the study. Follow-up with referring veterinarians was made to determine outcome of patients. Patients were divided into two groups: patients deceased due to PLE (poor outcome group, n = 22) and patients alive or deceased due to another disease (good outcome group, n = 21). Treatments for patients were allocated to two groups: one group consisted of patients who were prescribed diet only and the other group received diet and immunosuppressive agents. Samples were sent on dry ice to Michigan State University's Diagnostic Center for Population and Animal Health. Ionised calcium (iCa) was measured using an ion specific electrode and 25(OH)D was measured using a commercially available radio-immunoassay that has been validated for use in veterinary medicine. Comparisons of outcome groups for age, CCECAI, treatment, serum 25(OH)D and iCa were performed using a Mann-Whitney U test or Chi2. Logistic regression analysis was performed to determine possible risk factors for poor outcome.
Results: CCECAI scores, age, and iCa concentrations between the two groups were not significantly different. There was a significantly greater number of dogs treated with food alone in the group with good outcome (13/22) than in the poor outcome group (2/21, P = 0.001). Furthermore, median serum 25(OH)D concentration was significantly lower in patients with poor outcomes (16.5 nmol/L, range 0–66 nmol/L) compared to patients with good outcomes (37 nmol/L, range 6–81 nmol/L, P = 0.017). Using logistical regression, 25(OH)D serum concentration was a statistically significant factor for poor outcome (P = 0.03), with an increase of 25(OH)D serum concentration reducing the odds of having a poor outcome (odds ratio = 0.96, 95% CI: 0.93–0.997).
Further studies are required to investigate vitamin D as a potential adjuvant therapeutic agent in PLE patients.
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