类风湿性关节炎患者维生素D水平与动脉僵硬度的相关性研究  

Association Between Serum Vitamin D and Arterial Stiffness in Rheumatoid Arthritis

作　　者：苏红 梁潇 杜京奚 王鹏 杨勇 Su Hong;Liang Xiao;Du Jingxi;Wang Peng;Yang Yong(Department of Ultrasound Diagnostics,Shaanxi Honorary Military Rehabilitation Hospital,Weinan,Shaanxi 714200,China;Department of Ultrasound Medicine,The Second Affiliated Hospital of Airforce Military Medical University,Xi'an 710038,China)

机构地区：[1]陕西省荣誉军人康复医院功能科,陕西省渭南市714200 [2]空军军医大学第二附属医院超声医学科,西安市710038

出　　处：《中国超声医学杂志》2022年第11期1295-1298,共4页Chinese Journal of Ultrasound in Medicine

基　　金：空军军医大学第二附属医院临床研究项目(No.2021LCYJ030)。

摘　　要：目的 探究类风湿性关节炎(RA)患者维生素D水平与动脉僵硬度“金标准”指标颈-股脉搏波传播速度(PWV)的相关性及影响因素。方法 纳入首次诊断为RA的患者55例及年龄、性别、体质量指数匹配的健康对照组55例。研究对象的颈-股PWV采用超声多普勒技术测量,血清25-羟维生素D、血糖、血脂等生化检查均采用标准方法完成。结果 RA患者的25-羟维生素D含量为(25.95±8.61)μg/L,与对照组[(32.45±8.19)μg/L]相比显著降低,差异有统计学意义(P<0.000 1)。RA患者的颈-股PWV为(8.16±1.72)m/s,显著高于对照组[(7.02±1.36)m/s,P=0.000 2]。维生素D含量与颈-股PWV间存在显著相关性(r=-0.509,P<0.000 1),采用多因素线性回归校正混杂因素后,两者之间依然存在独立相关性(P=0.005)。对于RA患者,年龄(P=0.037)、颈-股PWV(P=0.002)与维生素D水平独立相关。结论 RA患者的25-羟维生素D水平显著降低,动脉僵硬度显著增高,两者之间存在独立的负相关关系,本研究为进一步探究RA患者维生素D缺乏与心血管疾病的关联机制提供了证据与新思路。Objective To explore the association between serum vitamin D and carotid-femoral pulse wave velocity(cfPWV), the “gold standard” index of arterial stiffness in rheumatoid arthritis(RA). Methods A total of 55 patients who were first diagnosed with RA were included in this study, and 55 healthy controls matched in age, sex and body mass index were also included. The cfPWV of subjects was measured by Doppler ultrasonography, and biochemical examinations of serum 25-hydroxyvitamin D, blood glucose and blood lipids were performed by standard methods. Results RA patients had significantly lower 25-hydroxyvitamin D than that of healthy group [(25.95±8.61) vs(32.45±8.19) μg/L, P<0.000 1], the cfPWV increased significantly [(8.16±1.72) vs(7.02±1.36) m/s, P=0.000 2]. For all subjects, there was a significant correlation between cfPWV and vitamin D(r=-0.509, P<0.000 1). After adjustment for the confounding factors, the correlation between cfPWV and vitamin D remained significant(P=0.005). To patients with RA, age(P=0.037), carotid-femoral PWV(P=0.002) independently related with vitamin D level. Conclusions RA patients has significantly lower levels of vitamin D and significantly higher arterial stiffness, and an independent negative association is found between them, which provided evidence and new ideas for further exploration in association between vitamin D deficiency and cardiovascular disease in RA.

关 键 词：类风湿性关节炎 动脉僵硬度 脉搏波传播速度 维生素D 超声多普勒 

分 类 号：R593.22[医药卫生—内科学]