Division of Pediatric Nephrology, University of California San Diego, La Jolla, CA 92093, USA.
Nat Rev Nephrol. 2013 Jun;9(6):337-47. doi: 10.1038/nrneph.2013.74. Epub 2013 Apr 23.
Vitamin-D-related pathways are implicated in various endocrine, inflammatory and endothelial functions. An estimated 1 billion people in the world have vitamin D deficiency or insufficiency, and undiagnosed vitamin D deficiency is common. Vitamin D deficiency is associated with substantial increases in the incidence of hypertension, hyperlipidaemia, myocardial infarction and stroke, as well as in diseases such as chronic kidney disease and type 2 diabetes. Low vitamin D levels also upregulate the renin-angiotensin-aldosterone system, increase inflammation and cause endothelial dysfunction. However, the role of vitamin D deficiency in cardiovascular morbidity and mortality is an emerging and hotly debated topic. Epidemiological studies suggest an association between low vitamin D levels and risk factors for cardiovascular disease, but a causal relationship has not been established, and clinical trials and meta-analyses have not demonstrated convincing evidence that vitamin D therapy improves cardiovascular outcomes. Some evidence suggests that vitamin D status is a biomarker of lifestyle, since unhealthy and sedentary lifestyles are associated with vitamin D insufficiency or deficiency and are also risk factors for cardiovascular complications.
维生素 D 相关途径涉及各种内分泌、炎症和内皮功能。据估计，全世界有 10 亿人患有维生素 D 缺乏或不足，未确诊的维生素 D 缺乏很常见。维生素 D 缺乏与高血压、高脂血症、心肌梗死和中风的发病率显著增加以及慢性肾脏病和 2 型糖尿病等疾病有关。低维生素 D 水平还会上调肾素-血管紧张素-醛固酮系统，增加炎症并导致内皮功能障碍。然而，维生素 D 缺乏在心血管发病率和死亡率中的作用是一个新兴的热门话题。流行病学研究表明，低维生素 D 水平与心血管疾病的危险因素有关，但尚未建立因果关系，临床试验和荟萃分析也没有证明维生素 D 治疗能改善心血管结局。一些证据表明，维生素 D 状态是生活方式的生物标志物，因为不健康和久坐不动的生活方式与维生素 D 不足或缺乏有关，也是心血管并发症的危险因素。
