阻塞性睡眠呼吸暂停综合征患者血清25-羟维生素D浓度与左心室肥厚的关系  

Serum 25-Hydroxy Vitamin D Concentration is Positively Related to Left Ventricular Hypertrophy in Obstructive Sleep Apnea-hypopnea Syndrome Patients

作　　者：李帅兵[1] 杨帆[1] 荆莉[1] 马娟[1] 贾亚丹[1] 董少英[1] 郑卫峰[1] 赵洛沙[1] 

机构地区：[1]郑州大学第一附属医院心内科,河南省郑州市450052

出　　处：《中国动脉硬化杂志》2013年第2期169-172,181,共5页Chinese Journal of Arteriosclerosis

摘　　要：目的探讨在阻塞性睡眠呼吸暂停综合征患者中25-羟维生素D浓度与心脏结构异常的关系。方法选择2010年8月至2012年4月住院的337例阻塞性睡眠呼吸暂停综合征患者,采用酶联免疫法测定血清25-羟维生素D浓度,超声心动图测量并计算左心室质量指数,定义左心室质量指数≥125 g/m2(男)、≥120 g/m2(女)为左心室肥厚。结果 (1)与轻至中度阻塞性呼吸睡眠暂停综合征(5次/小时≤睡眠呼吸暂停低通气指数<30次/小时,n=111)组相比,重度阻塞性睡眠呼吸暂停综合征组(n=226)的左心室质量指数、左心室肥厚的发生率、体质指数显著增加(P<0.01),血清25-羟维生素D浓度明显降低。(2)多元回归分析显示四分位数25-羟维生素D浓度与左心室肥厚发生具有独立相关性(校正OR=4.11,95%CI:1.15～12.70,P<0.01),在校正肥胖及其他危险因素后,仍有相关性。另外,血清25-羟维生素D浓度与体质指数呈负相关。结论血清25-羟维生素D浓度降低提示重度阻塞性睡眠呼吸暂停综合征患者发生左心室肥厚的可能性增加。Aim To investigate whether increased plasma levels of serum 25-hydroxy vitamin D [ 25 （OH） VD ] are associated with cardiac structural and functional abnormalities in obstructive sleep apnea-hypopnea syndrome （OSAHS） pa- tients. Methods We documented 337 consecutive patients with OSAHS. Left ventricular hypertrophy （LVH） [ left ventricular mass index （LVMI）≥25 g/m^2 in male, and LVMI ≥ 120 g/m^2 in female ] was determined by echocardiography. The serum 25-hydroxy vitamin D concentration was measured by using enzyme-linked immunosorbent assay （ELISA） method. Results The LVMI, prevalence rate of LVH and body mass index （BMI） were higher in the subjects with severe OSAHS （apnoea-hypopnoea index≥30/h, LVH 75%, n = 226） than in those with mild to moderate OSAHS （LVH 40%, n = 111 ） （P 〈 0. 01 ）, and serum 25 （OH） VD levels were lower in the severe OSAHS groups. Although the serum 25 （OH） VD level showed a negative correlation with BMI, the results of binary logistic regression analysis demonstrated that the quar- tile value of 25 （OH）VD was an independent significant variable for the identification of LVH （adjusted OR in quartile = 4. 11, 95% CI ： 1. 15-12. 70, P 〈 0. 01 ）, even after adjusting for obesity and other risk factors. Conclusion Decreased serum levels of 25（OH） VD do seem to reflect an increased likelihood of LVH in patients with severe OSAHS.

关 键 词：阻塞性睡眠呼吸暂停综合征 25-羟维生素D 左心室肥厚 

分 类 号：R541[医药卫生—心血管疾病]