Kim Dae Hyun, Sabour Siamak, Sagar Utpal N, Adams Suzanne, Whellan David J
Department of Medicine, Jefferson Medical College, Philadelphia, PA, USA.
Am J Cardiol. 2008 Dec 1;102(11):1540-4. doi: 10.1016/j.amjcard.2008.06.067. Epub 2008 Sep 24.
This cross-sectional study examined the burden of cardiovascular diseases (CVDs) using serum 25-hydroxyvitamin D (25[OH]D) and prevalence of hypovitaminosis D in adults with CVDs using data from NHANES 2001 to 2004. Serum 25(OH)D levels were divided into 3 categories (> or =30, 20 to 29, and <20 ng/ml), and hypovitaminosis D was defined as vitamin D <30 ng/ml. Of 8,351 adults who had 25(OH)D measured, mean 25(OH)D was 24.3 ng/ml, and the prevalence of hypovitaminosis D was 74%. The burden of CVDs increased with lower 25(OH)D categories, with 5.3%, 6.7%, and 7.3% coronary heart disease; 1.5%, 2.4%, and 3.2% heart failure; 2.5%, 2.0%, and 3.2% stroke; and 3.6%, 5.0%, and 7.7% peripheral arterial disease. Across all CVDs, hypovitaminosis D was more common in blacks than Hispanics or whites. Compared with persons at low risk for CVDs (68%), it was more prevalent in those at high risk (75%; odds ratio [OR] 1.32, 95% confidence interval [CI] 1.05 to 1.67), with coronary heart disease (77%; OR 1.48, 95% CI 1.14 to 1.91), and both coronary heart disease and heart failure (89%; OR 3.52, 95% CI 1.58 to 7.84) after controlling for age, race, and gender. In conclusion, hypovitaminosis D was highly prevalent in US adults with CVDs, particularly those with both coronary heart disease and heart failure.
这项横断面研究利用2001年至2004年美国国家健康和营养检查调查(NHANES)的数据,研究了血清25-羟基维生素D(25[OH]D)水平与心血管疾病(CVD)负担之间的关系,以及维生素D缺乏症在患有CVD的成年人中的患病率。血清25(OH)D水平分为3类(≥30、20至29和<20 ng/ml),维生素D缺乏症定义为维生素D<30 ng/ml。在8351名检测了25(OH)D的成年人中,25(OH)D的平均水平为24.3 ng/ml,维生素D缺乏症的患病率为74%。随着25(OH)D类别降低,CVD负担增加,冠心病的患病率分别为5.3%、6.7%和7.3%;心力衰竭的患病率分别为1.5%、2.4%和3.2%;中风的患病率分别为2.5%、2.0%和3.2%;外周动脉疾病的患病率分别为3.6%、5.0%和7.7%。在所有CVD中,黑人中维生素D缺乏症比西班牙裔或白人更常见。与CVD低风险人群(68%)相比,高风险人群中更普遍(75%;优势比[OR]为1.32,95%置信区间[CI]为1.05至1.67),在控制年龄、种族和性别后,冠心病患者中(77%;OR为1.48,95%CI为1.14至1.91),以及冠心病和心力衰竭患者中(89%;OR为3.52,95%CI为1.58至7.84)。总之,维生素D缺乏症在美国患有CVD的成年人中非常普遍,尤其是那些同时患有冠心病和心力衰竭的人。