原发性高血压患者血清25-羟维生素D浓度与颈动脉内膜中层厚度的关系  

Relationship between serum 25-hydroxy vitamin D concentration and carotid artery intima-media thickness in patients with primary hypertension

作　　者：徐敏[1] 缪培智[1] 李宁[1] 郑宏超[1] 

机构地区：[1]上海市徐汇区中心医院心内科,200031

出　　处：《中国心血管杂志》2015年第2期101-104,共4页Chinese Journal of Cardiovascular Medicine

摘　　要：目的 研究原发性高血压患者血清25-羟维生素D[25（OH）D]浓度与颈动脉内膜中层厚度（IMT）的关系。方法 入选210例原发性高血压患者,所有患者均检测血清空腹血糖（FPG）、总胆固醇（TC）、三酰甘油（TG）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、高敏C反应蛋白（hs-CRP）、25（OH）D,同时测量收缩压（SBP）、舒张压（DBP）,用彩色多普勒超声测量颈动脉IMT,并询问年龄、糖尿病、高血压病程及吸烟史。所有患者依据血清25（OH）D浓度的四分位数分为4组：Q1组（〈18.10 ng/ml,51例）,Q2组（18.10~25.95 ng/ml,54例）,Q3组（25.95~37.90 ng/ml,54例）,Q4组（〉37.90 ng/ml,51例）,研究血清25（OH）D浓度与颈动脉IMT的关系。结果 在原发性高血压患者中,血清25（OH）D低浓度组（Q1组）的颈动脉IMT及颈动脉斑块发生率明显高于高浓度组（Q4组）,分别为51.00%和23.53%,差异有统计学意义（P=0.026）;Pearson相关分析显示颈动脉IMT与年龄、糖尿病、LDL-C、hs-CRP、高血压病程呈正相关,与血清25（OH）D浓度呈负相关;多元回归分析显示血清25（OH）D浓度与颈动脉IMT及颈动脉斑块发生率均具有独立相关性,分别为r=-0.005,P〈0.01和r=-0.048,P〈0.01。结论 原发性高血压患者血清25（OH）D浓度降低是颈动脉IMT增加的独立危险因素。Objective To evaluate the relationship between serum 25-hydroxy vitamin D [25（OH）D] concentration and carotid artery intima-media thickness （ IMT） in patients with primary hypertension. Methods We selected 210 primary hypertensive patients, the levels of fasting plasma glucose （FPG）, total cholesterol （ TC）, triglyceride （ TG）, high-density lipoprotein （ HDL-C）, low-density lipoprotein （LDL-C）, high sensitive C reactive protein （ hs-CRP）, 25 （ OH） D, systolic blood pressure （SBP）, diastolic blood pressure （DBP） and carotid IMT were measured, and age, prior medical histories including duration of hypertension, diabetes mellitus and smoking status were obtained. The patients were divided into four quartile groups according to the serum 25（OH）D levels （Q1： 〈 18. 10 ng/ ml, 51 cases;Q2： 18. 10 - 25. 95 ng/ ml, 54 cases; Q3： 25. 95 - 37. 90 ng/ ml, 54 cases; Q4： ＆gt; 37. 90 ng/ ml, 51 cases）. Results Carotid IMT and carotid artery plaque prevalence were significantly higher in subjects with low 25（OH）D compared to those with high 25 （ OH） D （51. 00% vs. 23. 53% , P = 0. 026） . Pearson correlation analysis showed that carotid IMT was positively correlated with age, duration of hypertension, diabetes mellitus, LDL-C, hs-CRP, and was negatively correlated with 25（OH）D. Multivariate regression analysis showed that serum 25（OH） D concentration was an independent predictor of carotid IMT （r = -0. 005,P 〈 0. 01）and carotid artery plaque prevalence （r = - 0. 048,P 〈 0. 01）. Conclusions Serum 25＆amp;nbsp;（OH）D level is negatively correlated with carotid IMT.

关 键 词：高血压 25-羟维生素D 颈动脉内膜中层厚度 

分 类 号：R544.11[医药卫生—心血管疾病]