Department of Internal Medicine, Seoul National University College of Medicine and Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam 463-707, Korea.
J Clin Endocrinol Metab. 2012 Jan;97(1):169-78. doi: 10.1210/jc.2011-1580. Epub 2011 Oct 19.
Recent studies suggest an association between vitamin D activity and cardiometabolic risk.
We investigated vitamin D status and its association with subclinical atherosclerosis in a population-based cohort study, the Korean Longitudinal Study on Health and Aging (KLoSHA).
Participants were 439 men and 561 women aged 65 yr or older who were recruited by random stratified sampling for KLoSHA.
Anthropometric and biochemical parameters, the concentration of 25-hydroxyvitamin D (25-OHD), and intact PTH were measured.
We evaluated the coronary artery calcium score and stenosis using multidetector-row cardiac computed tomography, the intima-media thickness using carotid sonography, pulse wave velocity, and the ankle-brachial index.
Among the participants, 49.8, 44.2, and 6.0% had 25-OHD deficiency (<15 ng/ml), insufficiency (15-29.9 ng/ml), and adequacy (≥30 ng/ml), respectively. The frequency of coronary artery stenosis (>50%) differed between 25-OHD categories: 18.5, 12.9, and 1.9% in the 25-OHD-deficient, -insufficient, and -adequate groups, respectively (P < 0.05). After adjusting for cardiometabolic risks and intact PTH concentration, multivariate regression analysis showed that participants with a low 25-OHD concentration had a higher risk of significant coronary artery stenosis; the odds ratios were 2.08 for 25-OHD concentration of 15-29.9 ng/ml vs. at least 30 ng/ml and 3.12 for 25-OHD concentration below 15 ng/ml vs. at least 30 ng/ml (both P < 0.05).
The association between 25-OHD inadequacy and subclinical atherosclerosis underscores the clinical implications of vitamin D status. An intervention strategy to increase vitamin D level through vitamin D-fortified diet and adequate sun exposure may mitigate the consequences of vitamin D deficiency.
最近的研究表明，维生素 D 活性与心血管代谢风险之间存在关联。
我们在一项基于人群的队列研究，即韩国健康老龄化纵向研究（KLoSHA）中，研究了维生素 D 状况及其与亚临床动脉粥样硬化的关系。
参与者为 439 名年龄在 65 岁或以上的男性和 561 名女性，他们是通过 KLoSHA 的随机分层抽样招募的。
测量了人体测量和生化参数、25-羟维生素 D（25-OHD）浓度和完整甲状旁腺激素。
我们使用多排心脏 CT 评估了冠状动脉钙评分和狭窄程度，使用颈动脉超声评估了内膜中层厚度、脉搏波速度和踝臂指数。
在参与者中，分别有 49.8%、44.2%和 6.0%的人 25-OHD 缺乏（<15ng/ml）、不足（15-29.9ng/ml）和充足（≥30ng/ml）。冠状动脉狭窄（>50%）的频率在 25-OHD 类别之间有所不同：25-OHD 缺乏、不足和充足组分别为 18.5%、12.9%和 1.9%（P<0.05）。在校正了心血管代谢风险和完整甲状旁腺激素浓度后，多变量回归分析显示，25-OHD 浓度较低的参与者患严重冠状动脉狭窄的风险更高；25-OHD 浓度为 15-29.9ng/ml 与至少 30ng/ml 相比的比值比为 2.08，25-OHD 浓度低于 15ng/ml 与至少 30ng/ml 相比的比值比为 3.12（均 P<0.05）。
25-OHD 不足与亚临床动脉粥样硬化之间的关联突出了维生素 D 状态的临床意义。通过强化饮食和充足阳光暴露增加维生素 D 水平的干预策略可能减轻维生素 D 缺乏的后果。
