Unit of Internal Medicine, Angiology and Arteriosclerosis Diseases, Department of Clinical and Experimental Medicine, University of Perugia, Perugia, Italy.
J Atheroscler Thromb. 2012;19(10):924-31. doi: 10.5551/jat.13128. Epub 2012 Jul 10.
Vitamin D insufficiency and increased parathyroid hormone (PTH) levels have been suggested as prognostic indices for cardiovascular disease. Arterial stiffness, a surrogate marker for cardiovascular disease, is often increased in patients with primary hyperparathyroidism. PTH levels increase in patients with low 25-OH-vitamin D levels, but the influence of such an increase on arterial stiffness has not been investigated in postmenopausal women with reduced 25-OH-vitamin D levels. We therefore investigated the association between PTH and aortic stiffness in postmenopausal women with reduced 25-OH-vitamin D levels.
One hundred fifty postmenopausal women with 25-OH-vitamin D insufficiency (<30 ng/mL) were recruited. Aortic pulse wave velocity (aPWV), a measure of arterial stiffness, PTH and 25-OH-vitamin D levels were measured. Cardiovascular risk factors and markers of bone formation were evaluated.
The 25-OH-vitamin D levels were associated with aPWV (rho=-0.23, p=0.006), but the association was not significant when controlling for PTH. Significant correlates of aPWV included age, body mass index, mean arterial pressure and PTH (rho=0.39, p<0.001). Arterial stiffness was predicted by logarithmically transformed PTH levels (β=0.23, p=0.007), independent of traditional cardiovascular risk factors and factors involved in bone formation. Increased PTH levels (>62 pg/mL) were associated with a 3.0-5.4-fold increased probability of having a mild-severe increase in aortic stiffness, irrespective of confounders.
Among postmenopausal women with reduced 25-OH-vitamin D levels, elevated PTH levels were a significant predictor of aortic stiffness, irrespective of cardiovascular risk factors and of factors involved in bone formation. PTH accounted for the association between 25-OH-vitamin D levels and aortic stiffness.
维生素 D 不足和甲状旁腺激素（PTH）水平升高被认为是心血管疾病的预后指标。原发性甲状旁腺功能亢进症患者的动脉僵硬度往往增加，动脉僵硬度是心血管疾病的替代标志物。甲状旁腺激素（PTH）水平在 25-羟维生素 D 水平低的患者中升高，但在 25-羟维生素 D 水平降低的绝经后妇女中，这种升高对动脉僵硬度的影响尚未得到研究。因此，我们研究了 25-羟维生素 D 水平降低的绝经后妇女中 PTH 与主动脉僵硬度之间的关系。
我们招募了 150 名患有 25-羟维生素 D 不足（<30ng/ml）的绝经后妇女。测量了主动脉脉搏波速度（aPWV），这是动脉僵硬度的一个指标，还测量了 PTH 和 25-羟维生素 D 水平。评估了心血管危险因素和骨形成标志物。
25-羟维生素 D 水平与 aPWV 相关（rho=-0.23，p=0.006），但在校正 PTH 后相关性不显著。aPWV 的显著相关因素包括年龄、体重指数、平均动脉压和 PTH（rho=0.39，p<0.001）。动脉僵硬度由对数转换的 PTH 水平预测（β=0.23，p=0.007），独立于传统心血管危险因素和骨形成相关因素。PTH 水平升高（>62pg/ml）与主动脉僵硬度轻度至重度增加的概率增加 3.0-5.4 倍相关，无论混杂因素如何。
在 25-羟维生素 D 水平降低的绝经后妇女中，升高的 PTH 水平是主动脉僵硬度的一个显著预测因子，独立于心血管危险因素和骨形成相关因素。PTH 解释了 25-羟维生素 D 水平与主动脉僵硬度之间的关系。
