Gouni-Berthold Ioanna, Krone Wilhelm, Berthold Heiner K
Department of Internal Medicine II, University of Cologne, D-50937 Cologne, Germany.
Curr Vasc Pharmacol. 2009 Jul;7(3):414-22. doi: 10.2174/157016109788340686.
Cardiovascular disease (CVD) is a major cause of morbidity and mortality worldwide. Recently vitamin D deficiency has been identified as a potential risk factor for many diseases not traditionally associated with vitamin D, such as cancer and CVD. This review discusses the evidence suggesting an association between low 25-hydroxyvitamin D levels and CVD and the possible mechanisms mediating it. Vitamin D deficiency has been associated with CVD risk factors such as hypertension and diabetes mellitus, with markers of subclinical atherosclerosis such as intima-media thickness and coronary calcification as well as with cardiovascular events such as myocardial infarction and stroke as well as congestive heart failure. It could be suggested that vitamin D deficiency contributes to the development of CVD through its association with risk factors, such as diabetes and hypertension. However, direct effects of vitamin D on the cardiovascular system may also be involved. Vitamin D receptors are expressed in a variety of tissues, including cardiomyocytes, vascular smooth muscle cells and endothelial cells and vitamin D has been shown to affect inflammation and cell proliferation and differentiation. While much evidence supports a potential antiatherosclerotic effect of vitamin D, prospective, placebo-controlled randomized as well as mechanistic studies are needed to confirm this association. Since vitamin D deficiency is easy to screen for and treat, the confirmation of such an association could have important implications for both, patient care and health policy.
心血管疾病（CVD）是全球发病和死亡的主要原因。最近，维生素D缺乏已被确定为许多传统上与维生素D无关的疾病的潜在风险因素，如癌症和心血管疾病。这篇综述讨论了表明25-羟基维生素D水平低与心血管疾病之间存在关联的证据以及介导这种关联的可能机制。维生素D缺乏与心血管疾病风险因素如高血压和糖尿病相关，与亚临床动脉粥样硬化标志物如内膜中层厚度和冠状动脉钙化相关，还与心血管事件如心肌梗死、中风以及充血性心力衰竭相关。可以认为维生素D缺乏通过其与糖尿病和高血压等风险因素的关联促成了心血管疾病的发展。然而，维生素D对心血管系统的直接作用也可能涉及其中。维生素D受体在多种组织中表达，包括心肌细胞、血管平滑肌细胞和内皮细胞，并且维生素D已被证明会影响炎症以及细胞增殖和分化。虽然有很多证据支持维生素D具有潜在的抗动脉粥样硬化作用，但仍需要前瞻性、安慰剂对照的随机研究以及机制研究来证实这种关联。由于维生素D缺乏易于筛查和治疗，这种关联的确认可能对患者护理和卫生政策都具有重要意义。
