Department of Internal Medicine, and Bundang CHA General Hospital, CHA University, Seongnam, South Korea.
Kidney Blood Press Res. 2012;35(5):349-54. doi: 10.1159/000335952. Epub 2012 Apr 4.
BACKGROUND/AIMS: The role of vitamin D in the process of vascular calcification is unclear in patients with chronic kidney disease. We investigated whether serum 25-hydroxyvitamin D [25(OH)D] is associated with vascular calcification in predialysis and dialysis patients.
We included 86 predialysis and 139 dialysis patients. The simple vascular calcification score (SVCS) was evaluated by examining plain X-rays of the pelvis and hands as described previously. The carotid-to-femoral pulse wave velocity (CF-PWV) was assessed with a commercially available device.
We found a high prevalence of vitamin D deficiency in our population (78.2%). Vascular calcification was present in 46.2% of all patients. Higher calcification (SVCS >3) was significantly associated with lower 25(OH)D levels in predialysis and dialysis patients. Multiple logistic regression analysis for SVCS >3 showed that 25(OH)D levels were negative independent predictors in predialysis (OR: 0.781; 95% CI: 0.623-0.908, p = 0.019) and dialysis patients (OR: 0.805; 95% CI: 0.749-0.853, p = 0.009). Lower 25(OH)D levels were associated with higher CF-PWV in predialysis patients, but this inverse relationship was no longer present in multivariate analysis.
We showed an independent relationship between low serum 25(OH)D levels and vascular calcification in both predialysis and dialysis patients.
背景/目的：维生素 D 在慢性肾脏病患者血管钙化过程中的作用尚不清楚。我们研究了血清 25-羟维生素 D [25(OH)D] 是否与透析前和透析患者的血管钙化有关。
我们纳入了 86 例透析前患者和 139 例透析患者。正如先前所述，通过检查骨盆和手部的普通 X 光片来评估简单血管钙化评分 (SVCS)。使用市售设备评估颈动脉-股动脉脉搏波速度 (CF-PWV)。
我们发现我们人群中维生素 D 缺乏的患病率很高（78.2%）。所有患者中有 46.2%存在血管钙化。在透析前和透析患者中，较高的钙化（SVCS >3）与 25(OH)D 水平较低显著相关。SVCS >3 的多变量逻辑回归分析显示，25(OH)D 水平是透析前（OR：0.781；95%CI：0.623-0.908，p = 0.019）和透析患者（OR：0.805；95%CI：0.749-0.853，p = 0.009）的独立负预测因子。在透析前患者中，较低的 25(OH)D 水平与较高的 CF-PWV 相关，但在多变量分析中这种负相关关系不再存在。
我们表明，在透析前和透析患者中，血清 25(OH)D 水平较低与血管钙化之间存在独立关系。
