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单次口服大剂量维生素 D 补充对周围动脉疾病患者内皮功能的影响:一项随机对照初步研究。

Effect of a single, oral, high-dose vitamin D supplementation on endothelial function in patients with peripheral arterial disease: a randomised controlled pilot study.

机构信息

Division of Angiology, Department of Surgery, Ospedale La Carità, Via all' Ospedale, 6600 Locarno, Switzerland.

出版信息

Eur J Vasc Endovasc Surg. 2012 Sep;44(3):307-12. doi: 10.1016/j.ejvs.2012.06.023. Epub 2012 Jul 24.

DOI:10.1016/j.ejvs.2012.06.023
PMID:22831874
Abstract

OBJECTIVE

Apart from its role in bone metabolism, vitamin D may also influence cardiovascular disease. The objective of this study was: (1) to determine the effect of a single, oral, high-dose vitamin D supplementation on endothelial function and arterial stiffness in patients with peripheral arterial disease (PAD) and (2) to investigate the impact of this supplementation on coagulation and inflammation parameters.

METHODS

In this double-blind, placebo-controlled, interventional pilot study, we screened 76 Caucasian patients with PAD for vitamin D deficiency. Sixty-two were randomised to receive a single, oral supplementation of 100,000 IU vitamin D3 or placebo. At baseline and after 1 month, we measured serum vitamin D and parathormone levels, and surrogate parameters for cardiovascular disease.

RESULTS

Sixty-five of 76 patients (86%) had low 25-hydroxyvitamin D levels (<30 ng ml(-1)); of those, 62 agreed to participate in the study. At baseline, only parathormone was related to vitamin D. In supplemented patients, vitamin D levels increased from 16.3 ± 6.7 to 24.3 ± 6.2 ng ml(-1) (P < 0.001), with wide variations between single patients; in the placebo group vitamin levels did not change. Seasonal factors accounted for a decrease of vitamin D levels by 8 ng ml(-1) between summer and winter. After 1 month, none of the measured parameters was influenced by vitamin substitution.

CONCLUSION

In this pilot study, most patients with PAD were vitamin D deficient. Vitamin D supplementation increased serum 25-hydroxyvitamin D without influencing endothelial function, arterial stiffness, coagulation and inflammation parameters, although the study was underpowered for definite conclusions.

摘要

目的

除了在骨骼代谢中的作用外,维生素 D 还可能影响心血管疾病。本研究的目的是:(1)确定单次口服大剂量维生素 D 补充对周围动脉疾病(PAD)患者的内皮功能和动脉僵硬的影响;(2)研究这种补充对凝血和炎症参数的影响。

方法

在这项双盲、安慰剂对照、干预性初步研究中,我们对 76 名患有 PAD 的白种人患者进行了维生素 D 缺乏症筛查。62 名患者被随机分配接受单次口服 100,000IU 维生素 D3 或安慰剂。在基线和 1 个月后,我们测量了血清维生素 D 和甲状旁腺激素水平以及心血管疾病的替代参数。

结果

76 名患者中有 65 名(86%)25-羟维生素 D 水平较低(<30ng/ml);其中 62 名同意参加研究。在基线时,只有甲状旁腺激素与维生素 D 有关。在补充组中,维生素 D 水平从 16.3±6.7ng/ml 增加到 24.3±6.2ng/ml(P<0.001),单个患者之间存在很大差异;在安慰剂组中,维生素水平没有变化。季节性因素导致维生素 D 水平在夏季和冬季之间下降了 8ng/ml。1 个月后,维生素替代对测量的参数均无影响。

结论

在这项初步研究中,大多数 PAD 患者维生素 D 缺乏。维生素 D 补充增加了血清 25-羟维生素 D,但不影响内皮功能、动脉僵硬、凝血和炎症参数,尽管研究结果没有足够的证据得出明确的结论。

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