血清 25-羟维生素 D 和甲状旁腺激素浓度与美国成年人血压的独立相关性。
Independent associations of serum concentrations of 25-hydroxyvitamin D and parathyroid hormone with blood pressure among US adults.
机构信息
Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia 30341, USA.
出版信息
J Hypertens. 2010 Sep;28(9):1821-8. doi: 10.1097/HJH.0b013e32833bc5b4.
OBJECTIVE
Vitamin D deficiency or high levels of parathyroid hormone (PTH) appear to be emerging risk factors for hypertension. This study examined whether serum concentrations of 25-hydroxyvitamin D [25(OH)D] and PTH were independently associated with blood pressure and the presence of hypertension or prehypertension among the United States adults.
METHODS
Cross-sectional data from 7228 participants (aged > or =20 years) in the 2003-2006 National Health and Nutrition Examination Survey were analyzed. The least square means and the regression coefficients of systolic blood pressure, diastolic blood pressure, and pulse pressure across quintiles of serum 25(OH)D and PTH were estimated by conducting multiple linear regression analyses. The adjusted prevalence ratios with 95% confidence intervals for hypertension and prehypertension were estimated using the log-binomial method.
RESULTS
Among participants not taking blood pressure medications (n = 5414), the mean age- and sex-adjusted systolic and diastolic blood pressure decreased linearly across quintiles of serum 25(OH)D but increased linearly across quintiles of serum PTH (P < 0.001 for all); these relationships remained significant even after extensively adjusting for covariates. Similarly, across quintiles of serum 25(OH)D, the age-adjusted prevalence of hypertension and the adjusted prevalence ratios for both hypertension and prehypertension decreased linearly (P < 0.001 for all). In contrast, the prevalence of hypertension and prehypertension increased nonlinearly (P < 0.05 for both) and the adjusted prevalence ratios for hypertension increased linearly across quintiles of serum PTH (P < 0.001).
CONCLUSION
Serum concentrations of 25(OH)D and PTH were independently associated with blood pressure and with the presence of hypertension or prehypertension among the United States adults, though casual relationships remain to be elucidated.
目的
维生素 D 缺乏或甲状旁腺激素（PTH）水平升高似乎是高血压的新兴危险因素。本研究旨在探讨美国成年人血清 25-羟维生素 D [25(OH)D]和 PTH 浓度是否与血压以及高血压或高血压前期的发生独立相关。
方法
对 2003-2006 年全国健康和营养调查（NHANES）中 7228 名（年龄>20 岁）参与者的横断面数据进行分析。采用多元线性回归分析估计血清 25(OH)D 和 PTH 五分位数与收缩压、舒张压和脉压的最小二乘均数和回归系数。采用对数二项式法估计无降压药物治疗（n=5414）参与者中高血压和高血压前期的调整后患病率比及其 95%置信区间。
结果
在未服用降压药物的参与者中（n=5414），血清 25(OH)D 五分位数与校正年龄和性别的收缩压和舒张压呈线性下降，但血清 PTH 五分位数与收缩压和舒张压呈线性上升（所有 P<0.001）；即使广泛调整了协变量，这些关系仍然显著。同样，在血清 25(OH)D 五分位数中，校正年龄后的高血压患病率和高血压及高血压前期的调整后患病率比呈线性下降（所有 P<0.001）。相比之下，高血压和高血压前期的患病率呈非线性上升（两者均 P<0.05），而血清 PTH 五分位数与高血压的调整后患病率比呈线性上升（P<0.001）。
结论
血清 25(OH)D 和 PTH 浓度与美国成年人的血压以及高血压或高血压前期的发生独立相关，但因果关系仍有待阐明。
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