Ana Aslan National Institute of Gerontology and Geriatrics, Bucharest, Romania.
Aging Clin Exp Res. 2012 Dec;24(6):595-602. doi: 10.3275/8591. Epub 2012 Sep 10.
Vitamin D deficiency has been identified in the elderly as a potential risk factor for cardiovascular disease development, possibly through its association with other risk factors, such as type 2 diabetes mellitus (T2DM), hypercholesterolemia and hypertension. The aim of this cross-sectional study was to evaluate the vitamin D status in elderly subjects with impaired fasting glucose (IFG) or T2DM, and to examine its relationships to systemic oxidative stress and biochemical markers of endothelial dysfunction.
Serum 25-hydroxyvitamin D [25(OH)D], fasting glucose, insulin, lipid profile, advanced glycation end products (AGEs), advanced oxidation protein products (AOPPs), low-density lipoprotein susceptibility to oxidation (oxLDL) and nitric oxide metabolic pathway products (NOx) were analyzed in elderly subjects with IFG (n=30) and T2DM (n=35) compared with aged-matched controls (n=25).
25(OH)D levels in the IFG and T2DM groups were significantly lower than in controls (31.9±1.9 and 28.5±1.9 vs 39.4±2.4 ng/mL, p<0.001), and associated with significantly (p<0.001) higher levels of the oxidative stress parameters AGEs, AOPPs, oxLDL and NOx. Hypovitaminosis D [25(OH)D)<30 ng/ml] markedly enhanced the oxidative stress and cardiovascular risk in hyperglycemic subjects compared with sufficient vitamin D [25(OH)D)≥30 ng/mL] status subjects. In subjects with IFG and T2DM (n=65), the vitamin D status was significantly inversely correlated both with oxLDL (r=-0.413, p=0.001) and AOPPs (r=-0.475, p<0.001), and strongly positively associated with highdensity lipoprotein cholesterol (r=0.609, p<0.001).
In the elderly with impaired glucose metabolism the vitamin D status is inversely associated with levels of circulating markers of oxidative stress and endothelial dysfunction, especially in subjects with hypovitaminosis D.
维生素 D 缺乏已被确定为老年人发生心血管疾病的潜在危险因素之一,这可能是由于其与其他危险因素(如 2 型糖尿病、高胆固醇血症和高血压)有关。本横断面研究旨在评估空腹血糖受损(IFG)或 2 型糖尿病老年患者的维生素 D 状态,并探讨其与全身氧化应激和内皮功能障碍的生化标志物的关系。
分析 IFG(n=30)和 2 型糖尿病(n=35)老年患者与年龄匹配的对照组(n=25)的血清 25-羟维生素 D [25(OH)D]、空腹血糖、胰岛素、血脂谱、晚期糖基化终产物(AGEs)、晚期氧化蛋白产物(AOPPs)、低密度脂蛋白氧化易感性(oxLDL)和一氧化氮代谢产物(NOx)。
IFG 和 2 型糖尿病组的 25(OH)D 水平明显低于对照组(31.9±1.9 和 28.5±1.9 与 39.4±2.4ng/ml,p<0.001),与氧化应激参数 AGEs、AOPPs、oxLDL 和 NOx 的水平明显升高相关(p<0.001)。与维生素 D 充足[25(OH)D≥30ng/ml]状态相比,低维生素 D 血症[25(OH)D<30ng/ml]显著增强了高血糖患者的氧化应激和心血管风险。在 IFG 和 2 型糖尿病患者(n=65)中,维生素 D 状态与 oxLDL(r=-0.413,p=0.001)和 AOPPs(r=-0.475,p<0.001)呈显著负相关,与高密度脂蛋白胆固醇呈强烈正相关(r=0.609,p<0.001)。
在葡萄糖代谢受损的老年人中,维生素 D 状态与循环氧化应激和内皮功能障碍标志物的水平呈负相关,尤其是在维生素 D 缺乏的患者中。