血清 25-羟维生素 D 浓度与心力衰竭老年患者的功能能力有关。
Serum 25-hydroxyvitamin D concentration is associated with functional capacity in older adults with heart failure.
机构信息
Department of Medicine, Case Western Reserve University, Cleveland, OH, USA.
出版信息
Am Heart J. 2010 Nov;160(5):893-9. doi: 10.1016/j.ahj.2010.08.004.
BACKGROUND
Vitamin D is a fat-soluble hormone necessary for calcium homeostasis. Recently, studies have demonstrated that vitamin D may be important to the health of the cardiovascular system.
METHODS
Adults ≥ 50 years of age with heart failure were recruited for assessment of serum 25-hydroxyvitamin D (25OHD) concentrations. Cardiopulmonary exercise testing was used to assess functional capacity. Proximal muscle strength was evaluated with a Biodex isokinetic dynamometer [corrected] (Biodex, Shirley, NY), and health status was assessed with the Kansas City Cardiomyopathy Questionnaire. Univariate associations between physical performance and health status measures and 25OHD followed by a linear regression model were used to study associations, adjusting for other potential explanatory variables.
RESULTS
Forty adults 67.8 ± 10.9 years of age (55% women and 57.5% African American) with mean ejection fraction 40% were analyzed (New York Heart Association class II in 70% and class III in 30%). Comorbidities included 77.5% hypertension and 47.5% diabetes. The mean 25OHD concentration was 18.5 ± 9.1 ng/mL, and mean peak Vo₂, 14 ± 4 mL/kg/min. In univariate regression analysis, 25OHD was positively associated with peak Vo₂ (P = .045). Multivariable regression analysis sustained positive association between 25OHD and peak Vo₂ (P = .044) after adjusting for age, race, and respiratory exchange ratio (adjusted R² = 0.32). Association between proximal muscle strength with the 25OHD concentration was not significant. The Kansas City Cardiomyopathy Questionnaire physical limitation domain score was negatively associated with 25OHD (P = .04) but was not sustained in multivariable analysis.
CONCLUSIONS
25-Hydroxyvitamin D may be an important marker or modulator of functional capacity in patients with heart failure. Randomized controlled trials are needed to assess the effect of vitamin D repletion on functional performance.
背景
维生素 D 是一种维持钙稳态所必需的脂溶性激素。最近的研究表明，维生素 D 可能对心血管系统的健康很重要。
方法
招募年龄≥50 岁的心力衰竭成人患者，评估其血清 25-羟维生素 D（25OHD）浓度。心肺运动测试用于评估功能能力。使用 Biodex 等速测力计（Biodex，Shirley，NY）评估近端肌肉力量，使用堪萨斯城心肌病问卷评估健康状况。使用单变量分析评估身体表现和健康状况测量与 25OHD 之间的关系，然后使用线性回归模型进行分析，同时调整其他潜在的解释变量。
结果
对 40 名年龄 67.8±10.9 岁（55%为女性，57.5%为非裔美国人）、平均射血分数为 40%的成年人（70%为纽约心脏协会心功能 II 级，30%为 III 级）进行了分析。合并症包括 77.5%的高血压和 47.5%的糖尿病。平均 25OHD 浓度为 18.5±9.1ng/mL，平均峰值 Vo₂为 14±4mL/kg/min。在单变量回归分析中，25OHD 与峰值 Vo₂呈正相关（P=0.045）。多变量回归分析显示，在调整年龄、种族和呼吸交换率后，25OHD 与峰值 Vo₂之间仍存在正相关关系（调整后的 R²=0.32）。25OHD 与近端肌肉力量之间的关联不显著。堪萨斯城心肌病问卷的身体受限域评分与 25OHD 呈负相关（P=0.04），但在多变量分析中未得到维持。
结论
25-羟维生素 D 可能是心力衰竭患者功能能力的一个重要标志物或调节剂。需要进行随机对照试验来评估维生素 D 补充对功能表现的影响。
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