Snijder M B, Lips P, Seidell J C, Visser M, Deeg D J H, Dekker J M, van Dam R M
Institute of Health Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
J Intern Med. 2007 Jun;261(6):558-65. doi: 10.1111/j.1365-2796.2007.01778.x.
Evidence is accumulating that the vitamin D endocrine system has physiological functions beyond bone health including a role in the regulation of blood pressure. Effects of poor vitamin D status on blood pressure may be mediated by elevated parathyroid hormone (PTH) levels.
To evaluate whether serum 25-hydroxyvitamin D [25(OH)D] and PTH levels are independently associated with blood pressure in a population-based study of older men and women.
Subjects were participants of the Longitudinal Aging Study Amsterdam, aged 65 years and older. In 1205 participants, serum 25(OH)D and PTH levels were determined and diastolic and systolic blood pressure were measured. Linear and logistic regression analyses were performed with adjustments for age, sex, region, season, lifestyle factors (physical activity, smoking, alcohol intake), and waist circumference.
Serum 25(OH)D was not significantly associated with diastolic (beta 0.00, P = 0.98) or systolic (beta 0.06, P = 0.11) blood pressure. In contrast, higher ln-PTH levels were significantly associated with higher diastolic (beta 1.93, P = 0.03) and systolic (beta 4.67, P = 0.01) blood pressure. Higher PTH levels were associated with a substantially higher prevalence of hypertension (OR 2.00, 95% CI 1.31-3.06 for the highest versus the lowest quartile), whereas 25(OH)D showed no significant association (OR 0.89, 95% CI 0.47-1.69 for the lowest versus the highest 25(OH)D category).
These results indicate that PTH is a potentially modifiable determinant of blood pressure in the general elderly population. Serum 25(OH)D, however, was not associated with blood pressure, possibly due to the relatively high levels in our population.
越来越多的证据表明，维生素D内分泌系统具有超出骨骼健康的生理功能，包括在血压调节中发挥作用。维生素D状态不佳对血压的影响可能由甲状旁腺激素（PTH）水平升高介导。
在一项基于人群的老年男性和女性研究中，评估血清25-羟维生素D [25(OH)D]和PTH水平是否与血压独立相关。
研究对象为阿姆斯特丹纵向衰老研究中65岁及以上的参与者。对1205名参与者测定血清25(OH)D和PTH水平，并测量舒张压和收缩压。进行线性和逻辑回归分析，并对年龄、性别、地区、季节、生活方式因素（身体活动、吸烟、饮酒）和腰围进行调整。
血清25(OH)D与舒张压（β=0.00，P=0.98）或收缩压（β=0.06，P=0.11）无显著相关性。相比之下，较高的ln-PTH水平与较高的舒张压（β=1.93，P=0.03）和收缩压（β=4.67，P=0.01）显著相关。较高的PTH水平与高血压患病率显著升高相关（最高四分位数与最低四分位数相比，OR=2.00，95%CI 1.31-3.06），而25(OH)D无显著相关性（最低25(OH)D类别与最高类别相比，OR=0.89，95%CI 0.47-1.69）。
这些结果表明，PTH是一般老年人群中血压的一个潜在可改变的决定因素。然而，血清25(OH)D与血压无关，可能是由于我们研究人群中的水平相对较高。
