健康体检人群血清25-羟维生素D水平与动脉硬化的相关性  

Relationship between serum 25-hydroxyvitamin D and arterial stiffness in the physical examination population

作　　者：高文[1] 胡柳[1] 王文捷 黄玉钗 徐慧[1] 吕永曼[1] 万政策 Gao Wen;Hu Liu;Wang Wenjie;Huang Yuchai;Xu Hui;LüYongman;Wan Zhengce(Health Management Center,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China)

机构地区：[1]华中科技大学同济医学院附属同济医院健康管理中心,武汉430030

出　　处：《中华健康管理学杂志》2024年第11期837-842,共6页Chinese Journal of Health Management

摘　　要：目的探讨健康体检人群血清25-羟维生素D[25(OH)D]水平与动脉硬化的相关性。方法本研究为横断面研究, 连续纳入2016年1月至2022年4月在华中科技大学同济医学院附属同济医院健康管理中心进行臂踝动脉脉搏波传导速度(baPWV)和血清25(OH)D检测的41 090例成年健康体检者为研究对象, 收集其一般资料、人体测量指标及相关实验室指标等。根据baPWV≥1 800 cm/s和<1 800 cm/s将研究对象分为动脉硬化组(2 440例)和非动脉硬化组(38 650例), 根据血清25(OH)D≥30 μg/L、20~<30 μg/L和<20 μg/L将研究对象分为25(OH)D充足组(2 830例)、不足组(11 400例)和缺乏组(26 860例)。采用logistic回归分析评估血清25(OH)D水平与动脉硬化的相关性, 采用限制性立方样条函数分析血清25(OH)D水平与动脉硬化患病风险之间的剂量-反应关系。结果纳入分析的41 090例健康体检人群中, 男性25 001例, 女性16 089例, 检出动脉硬化者2 440例(5.94%);动脉硬化组年龄、体重指数、尿酸、肌酐、25(OH)D水平及血脂异常比例均显著高于非动脉硬化组[(60.1±9.8)比(46.0±10.4)岁、(25.3±3.4)比(24.5±3.4)kg/m^(2)、(356.2±99.6)比(345.0±95.8)μmol/L、(77.0±21.5)比(73.8±15.9)μmol/L、(18.51±7.93)比(18.11±7.27)μg/L、48.4%比38.5%], 肾小球滤过率显著低于非动脉硬化组[(87.2±16.1)比(99.1±14.0)ml·min^(-1)·1.73 m^(-2)](均P<0.05)。血清25(OH)D缺乏与动脉硬化患病风险呈正相关(OR=1.26, 95%CI:1.07~1.51), 25(OH)D每下降10 μg/L, 动脉硬化患病风险增加16%(均P_(趋势)<0.001)。25(OH)D缺乏组baPWV水平比充足组平均高12.45 cm/s(95%CI:3.89~21.02), 25(OH)D每下降10 μg/L, baPWV平均增加11.23 cm/s(95%CI:8.11~14.19)(均P_(趋势)<0.001)。血清25(OH)D缺乏与动脉硬化患病风险的关联在体重指数≥24 kg/m^(2)的人群中更为明显(P_(交互)=0.039)。血清25(OH)D水平与动脉硬化患病风险之间呈"L"型剂量-反应关系(P_(非线性)<0.001)。结论健康�ObjectiveTo investigate the relationship between serum 25-hydroxyvitamin D[25(OH)D]and arterial stiffness in the physical examination population.Methods It was a cross-sectional study,the data were collected from adults who received physical examination in the Health Management Center of Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology from January 2016 to April 2022,all the participants completed the tested for brachial and ankle pulse wave conduction velocity(baPWV)and serum 25(OH)D.The general information,anthropometric metrics and relevant laboratory data were recorded.A total of 41 090 participants were included.According to baPWV,the subjects were divided into arterial stiffness group(baPWV≥1800 cm/s,n=2440)and normal group(baPWV<1800 cm/s,n=38650).The subjects were categorized into three groups based on serum 25(OH)D level:sufficient group[25(OH)D≥30μg/L,n=2830],insufficient group[25(0H)D 20-<30μg/L,n=11400]and deficiency group[25(0H)D<20μg/L,n=26860].Logistic regression analysis was performed to assess the relationship between 25(OH)D and arterial stiffness.The dose-response relationship between serum 25(OH)D levels and the risk of arterial stiffness was analyzed using restricted cubic spline functions.Results Of the 41090 participants included,25001 were males and 16089 were females,2440 cases(5.94%)were detected with arterial stiffness.Compared with normal group,the age,body mass index,uric acid,creatinine,25(OH)D level and proportion of dyslipidemia were all significantly higher in the arterial stiffness group[(60.1±9.8)vs(46.0±10.4)years,(25.3±3.4)vs(24.5±3.4)kg/m^(2),(356.2±99.6)vs(345.0±95.8)μmol/L,(77.0±21.5)vs(73.8±15.9)μmol/L,(18.51±7.93)vs(18.11±7.27)μg/L,48.4%vs 38.5%],while the glomerular filtration rate was significantly lower[(87.2±16.1)vs(99.1±14.0)ml·min^(-1).1.73 m^(-2)](all P<0.05).The 25(0H)D deficiency was positively correlated with the risk of arteriosclerosis(OR=1.26,95%Cl:1.07-1.51),and the risk of arterial stiffness increas

关 键 词：体格检查 25-羟维生素D 动脉硬化 相关性 臂踝动脉脉搏波传导速度 

分 类 号：R151.41[医药卫生—营养与食品卫生学] R543.5[医药卫生—公共卫生与预防医学]