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血清维生素 D 浓度状况及其与急性心肌梗死后早期重塑标志物的相关性。

Serum vitamin D concentration status and its correlation with early biomarkers of remodeling following acute myocardial infarction.

机构信息

Department of Clinical Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

Clin Res Cardiol. 2012 May;101(5):321-7. doi: 10.1007/s00392-011-0394-0. Epub 2011 Dec 11.

Abstract

BACKGROUND

Low serum level of vitamin D was shown to be associated with cardiovascular diseases as well as the presence of diabetes, dyslipidemia, and hypertension. Vitamin D deficiency is a global problem, and is an Iranian problem as well. To the best of our knowledge, this was the first study on acute myocardial infarction that evaluates the correlation of vitamin D level with inpatients' outcomes, particularly on the early biomarkers of myocardial remodeling.

METHODS

In a prospective study, patients with acute ST segment elevation myocardial infarction were included. The patients' 25 (OH) D levels were identified and the associations with clinical characteristics, including early remodeling biomarkers and in-hospital outcomes, were investigated.

RESULTS

From the 139 included patients, 80.5% were male. The 25 (OH) deficiency was present in 72.7% of the patients. Hypertension and positive history of cardiovascular drug use were risk factors for the presence of low vitamin D levels (OR = 2.92; CI = 1.34-6.37, P < 0.05) and (OR = 2.36; CI = 1.05-5.29, P < 0.05), respectively. Moreover, a significant positive relationship between the inpatients' survival and the concentration of vitamin D was present (P < 0.001). By performing a multivariate analysis, we found that there was a significant inverse relationship between the level of 25 (OH) D and the level of MMP-9 after 72 h (P = 0.011).

CONCLUSION

The results of our study revealed a significant inverse relationship between serum MMP-9 as a biomarker of early remodeling and the level of 25(OH) D in patients after an acute myocardial infarction. Moreover, low level of vitamin D was associated with patients' mortality in this study.

摘要

背景

已有研究表明,血清维生素 D 水平较低与心血管疾病以及糖尿病、血脂异常和高血压的发生有关。维生素 D 缺乏是一个全球性问题,也是伊朗存在的问题。据我们所知,这是第一项评估维生素 D 水平与住院患者预后相关性的急性心肌梗死研究,特别是评估维生素 D 水平与心肌重构早期生物标志物的相关性。

方法

在一项前瞻性研究中,纳入了急性 ST 段抬高型心肌梗死患者。确定了患者的 25(OH)D 水平,并研究了其与临床特征的相关性,包括早期重构生物标志物和住院期间的结局。

结果

在纳入的 139 例患者中,80.5%为男性。72.7%的患者存在 25(OH)D 缺乏。高血压和心血管药物使用阳性史是维生素 D 水平降低的危险因素(OR=2.92;95%CI=1.34-6.37,P<0.05)和(OR=2.36;95%CI=1.05-5.29,P<0.05)。此外,患者存活率与维生素 D 浓度之间存在显著正相关(P<0.001)。通过多变量分析,我们发现 25(OH)D 水平与 72 小时后 MMP-9 水平之间存在显著的负相关(P=0.011)。

结论

本研究结果表明,血清 MMP-9 作为早期重构的生物标志物与急性心肌梗死后患者 25(OH)D 水平之间存在显著的负相关。此外,本研究中维生素 D 水平较低与患者死亡率相关。

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