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维生素 D 缺乏并不能预测系统性红斑狼疮患者冠状动脉钙、颈动脉内膜中层厚度或高敏 C 反应蛋白的进展。

Vitamin D deficiency does not predict progression of coronary artery calcium, carotid intima-media thickness or high-sensitivity C-reactive protein in systemic lupus erythematosus.

机构信息

Division of Rheumatology, Johns Hopkins University School of Medicine, 1830 East Monument Street Suite 7500, Baltimore, MD 21205, USA.

出版信息

Rheumatology (Oxford). 2013 Nov;52(11):2071-6. doi: 10.1093/rheumatology/ket271. Epub 2013 Aug 16.

Abstract

OBJECTIVE

Vitamin D deficiency is common in SLE. Cardioprotective effects of vitamin D have been postulated due to modulation of inflammatory cytokines. However, the effects of vitamin D supplementation on inflammatory cytokines in trials have been inconsistent. We determined whether levels of vitamin D at baseline were associated with subclinical measures of atherosclerosis, or with changes in subclinical measures over 2 years.

METHODS

Of the 200 patients enrolled in the Lupus Atherosclerosis Prevention Study, complete baseline and follow-up data [including coronary artery calcium (CAC), carotid intima-media thickness (IMT), 25-hydroxy vitamin D [25(OH)D] and high-sensitivity CRP (hsCRP) levels] were available for 154 patients. Assessments were repeated 2 years later.

RESULTS

25(OH)D values ranged from 4 to 79 ng/ml. Among African American patients, 25(OH)D values ranged from 4 to 55 ng/ml. With low 25(OH)D (vitamin D <21 ng/ml), a higher proportion had a CAC score >100 (11%) compared with those with vitamin D insufficiency (21-32 ng/ml) (10%) and normal (≥32 ng/ml) 25(OH)D (3%), which was not statistically significant. 25(OH)D was neither associated with nor did it predict progression of CAC or carotid IMT over 2 years. The mean hsCRP decreased over 2 years.

CONCLUSION

25(OH)D was not associated with any measure of subclinical atherosclerosis. 25(OH)D deficiency was associated with higher hsCRP at baseline, but did not predict a change in hsCRP over 2 years.

摘要

目的

SLE 患者普遍存在维生素 D 缺乏。维生素 D 具有调节炎性细胞因子的作用,因此具有心脏保护作用。然而,临床试验中维生素 D 补充对炎性细胞因子的影响并不一致。我们旨在确定基线维生素 D 水平是否与亚临床动脉粥样硬化指标相关,或者与 2 年内亚临床指标的变化相关。

方法

在 Lupus Atherosclerosis Prevention Study 中,共纳入 200 例患者,其中 154 例患者具有完整的基线和随访数据(包括冠状动脉钙含量[CAC]、颈动脉内膜中层厚度[IMT]、25-羟维生素 D[25(OH)D]和高敏 C 反应蛋白[hsCRP]水平)。2 年后重复评估。

结果

25(OH)D 值范围为 4-79ng/ml。在非裔美国患者中,25(OH)D 值范围为 4-55ng/ml。低 25(OH)D(维生素 D<21ng/ml)患者的 CAC 评分>100(11%)的比例高于维生素 D 不足(21-32ng/ml)(10%)和正常(≥32ng/ml)(3%)患者,但无统计学差异。25(OH)D 与 CAC 或颈动脉 IMT 在 2 年内的进展均无相关性,也不能预测其进展。hsCRP 平均值在 2 年内逐渐降低。

结论

25(OH)D 与任何亚临床动脉粥样硬化指标均无相关性。25(OH)D 缺乏与基线时 hsCRP 升高相关,但不能预测 2 年内 hsCRP 的变化。

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