Department of Cardiology, Adana Numune Training and Research Hospital, Adana, Turkey.
J Investig Med. 2013 Aug;61(6):989-94. doi: 10.2310/JIM.0b013e31829a82bc.
Vitamin D may modulate vascular inflammation, vascular smooth muscle cell proliferation, the renin-angiotensin system, and cardiomyocyte proliferation, myocardial fibrosis, and proliferation. These mechanisms may play a role on arterial stiffness and left ventricle hypertrophy (LVH) in hypertensive patients. We aimed to evaluate the association between serum vitamin D with arterial stiffness and LVH in patients with hypertension.
We studied 133 patients with newly diagnosed hypertension [mean (SD) age, 62.9 (10.6) years]. Pulse wave velocity (PWV), which reflects arterial stiffness, was calculated using the single-point method via the Mobil-O-Graph ARCsolver algorithm. Left ventricular mass index (LVMI) was determined according to Deverux formula. The patients were divided into the following 2 groups according to serum vitamin D level: vitamin Dlow group with less than 20 ng/mL and vitamin Dhigh group with greater than or equal to 20 ng/mL.
The highest PWV, high-sensitivity C reactive protein, and LVMI values were observed in vitamin Dlow group compared with vitamin Dhigh group. Multiple linear regression analysis showed that vitamin D level was independently associated with LVMI (β = -0.235, P = 0.002) and PWV (β = -0.432, P < 0.001). Adjustment for age, sex, parathyroid hormone level, body surface area, and mean blood pressure did not modify these associations. Vitamin D level was also independently associated with high-sensitivity C reactive protein (β = -0.143, P = 0.047). However, adjustment for parathyroid hormone level or body surface area and mean blood pressure attenuate this association.
Serum 25-hyroxyvitamin D is independently related with arterial stiffness, LVH, and inflammation. Vitamin D may play a role on pathogenesis of arterial stiffness and LVH in patient with newly diagnosed hypertension.
维生素 D 可能调节血管炎症、血管平滑肌细胞增殖、肾素-血管紧张素系统以及心肌细胞增殖、心肌纤维化和增殖。这些机制可能在高血压患者的动脉僵硬度和左心室肥厚（LVH）中发挥作用。我们旨在评估血清维生素 D 与高血压患者动脉僵硬度和 LVH 的相关性。
我们研究了 133 例新诊断的高血压患者[平均（标准差）年龄 62.9（10.6）岁]。使用 Mobil-O-Graph ARCsolver 算法通过单点法计算脉搏波速度（PWV），该方法反映了动脉僵硬度。根据 Deverux 公式确定左心室质量指数（LVMI）。根据血清维生素 D 水平将患者分为以下 2 组：维生素 D 水平<20ng/ml 的维生素 D 低组和维生素 D 水平≥20ng/ml 的维生素 D 高组。
与维生素 D 高组相比，维生素 D 低组的最高 PWV、高敏 C 反应蛋白和 LVMI 值。多元线性回归分析表明，维生素 D 水平与 LVMI（β=-0.235，P=0.002）和 PWV（β=-0.432，P<0.001）独立相关。调整年龄、性别、甲状旁腺激素水平、体表面积和平均血压并未改变这些相关性。维生素 D 水平也与高敏 C 反应蛋白独立相关（β=-0.143，P=0.047）。然而，调整甲状旁腺激素水平或体表面积和平均血压会减弱这种相关性。
血清 25-羟维生素 D 与动脉僵硬度、LVH 和炎症独立相关。维生素 D 可能在新诊断的高血压患者的动脉僵硬度和 LVH 发病机制中发挥作用。
