血清 25-羟维生素 D、甲状旁腺激素和钙与心血管危险因素的关系：3 个 NHANES 周期（2001-2006 年）的分析。
Associations of serum 25-hydroxyvitamin D, parathyroid hormone and calcium with cardiovascular risk factors: analysis of 3 NHANES cycles (2001-2006).
机构信息
Department of Social Medicine, Medical Research Council Centre for Causal Analyses in Translational Epidemiology, University of Bristol, Bristol, United Kingdom.
出版信息
PLoS One. 2010 Nov 9;5(11):e13882. doi: 10.1371/journal.pone.0013882.
BACKGROUND
Increasing evidence suggests a role for mineral metabolism in cardiovascular disease risk. 25-hydroxyvitamin D (25(OH)D), parathyroid hormone (PTH), and calcium may be directly associated with cardiovascular risk factors or mediated by each other.
METHODOLOGY/PRINCIPAL FINDINGS: We combined data for adult participants in three cycles of the National Health and Nutrition Examination Survey (2001-2, 2003-4, 2005-6), a representative sample of the civilian, non-institutionalized US population (N = 3,958). Using this data we examined joint associations of 25(OH)D, PTH and calcium with a range of cardiovascular risk factors. 25(OH)D was inversely associated with fasting insulin (mean difference in insulin per 1 standard deviation 25(OH)D: -0.053 (95%CI: -0.091, -0.015)), glucose (-0.046 95%CI: -0.081, -0.012) and systolic blood pressure (SBP) (-0.032 95%CI: -0.062, -0.001), and positively associated with high density lipoprotein cholesterol HDL-c (0.088 95%CI: 0.044, 0.148), after adjustment for ethnicity, smoking, socio-economic status and waist circumference. PTH was positively associated with diastolic blood pressure (0.110, 95%CI: 0.055, 0.164) in confounder adjusted models, but was not associated with other cardiovascular risk factors. Albumin adjusted calcium was associated with triglycerides (0.102 95%CI: 0.063, 0.141), postload glucose (0.078, 95%CI: 0.025, 0.130), fasting insulin (0.074, 95%CI: 0.044, 0.104), HbA1c (0.070, 95%CI: 0.036, 0.105), SBP (0.064, 95%CI: 0.028, 0.100), fasting glucose (0.055, 95%CI: 0.018, 0.092) and low density lipoprotein cholesterol (0.052, 95%CI: 0.014, 0.091). With mutual adjustment for each other, these associations remained essentially unchanged.
CONCLUSIONS/SIGNIFICANCE: Lower levels of 25(OH)D and higher levels of calcium and PTH appear to be associated with different cardiovascular risk factors and may therefore affect cardiovascular disease risk through different mechanisms.
背景
越来越多的证据表明，矿物质代谢与心血管疾病风险有关。25-羟维生素 D（25（OH）D）、甲状旁腺激素（PTH）和钙可能与心血管危险因素直接相关，也可能通过彼此相互作用来影响心血管风险。
方法/主要发现：我们结合了三个国家健康与营养调查周期（2001-2、2003-4、2005-6）中成年参与者的数据，这是美国平民非机构化人群的代表性样本（N=3958）。利用这些数据，我们研究了 25（OH）D、PTH 和钙与一系列心血管危险因素的联合关联。25（OH）D 与空腹胰岛素呈负相关（每标准差 25（OH）D 的胰岛素差异：-0.053（95%CI：-0.091，-0.015））、血糖（-0.046 95%CI：-0.081，-0.012）和收缩压（SBP）（-0.032 95%CI：-0.062，-0.001），与高密度脂蛋白胆固醇（HDL-c）呈正相关（0.088 95%CI：0.044，0.148），经过调整种族、吸烟、社会经济地位和腰围后。在调整混杂因素的模型中，PTH 与舒张压呈正相关（0.110，95%CI：0.055，0.164），但与其他心血管危险因素无关。白蛋白校正钙与甘油三酯（0.102 95%CI：0.063，0.141）、负荷后血糖（0.078，95%CI：0.025，0.130）、空腹胰岛素（0.074，95%CI：0.044，0.104）、糖化血红蛋白（0.070，95%CI：0.036，0.105）、SBP（0.064，95%CI：0.028，0.100）、空腹血糖（0.055，95%CI：0.018，0.092）和低密度脂蛋白胆固醇（0.052，95%CI：0.014，0.091）有关。相互调整后，这些关联基本保持不变。
结论/意义：较低的 25（OH）D 水平和较高的钙和 PTH 水平似乎与不同的心血管危险因素有关，因此可能通过不同的机制影响心血管疾病风险。
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