Sahin Irfan, Okuyan Ertugrul, Gungor Baris, Kaya Adnan, Avci Ilhan Ilker, Biter Halil İbrahim, Cetin Sukru, Enhos Asim, Avsar Murat, Dinçkal Mustafa Hakan
Department of Cardiology, Bagcilar Training and Research Hospital , Istanbul , Turkey.
Scand Cardiovasc J. 2014 Oct;48(5):278-83. doi: 10.3109/14017431.2014.940062. Epub 2014 Aug 6.
Vitamin D regulates calcium and bone homeostasis, and parathyroid hormone (PTH) secretion. Cross-sectional associations between lower vitamin D levels and cardiovascular diseases have been reported, but the relationship between vitamin D levels and collateral arteries in stable coronary artery disease (CAD) has not been reported before.
Two hundred and fourteen patients with above 95% stenosis in at least one epicardial coronary artery were consecutively recruited after coronary angiography (CAG) during the winter season. The coronary collateral circulation (CCC) was graded using Rentrop classification. Poor CCC group included patients with Rentrop Grade 0-1 CCC and control group included patients with Rentrop Grade 2-3 CCC. Vitamin D and PTH levels were measured on the day of CAG.
In the poor CCC group, vitamin D levels were lower (34 ± 25 pmol/L vs. 49 ± 33 pmol/L; p = 0.01) and the prevalence of vitamin D deficiency (< 37 pmol/L) was higher (67% vs. 43%; p = 0.01) compared to the controls. PTH levels, calcium, and phosphate levels were not significantly different between the groups. Female gender, lower HDL cholesterol, and lower vitamin D levels were independently correlated with poor CCC in the study population.
Lower vitamin D levels may be associated with poor collateral development in patients with stable CAD.
维生素D调节钙和骨稳态以及甲状旁腺激素（PTH）分泌。已有报道称维生素D水平较低与心血管疾病之间存在横断面关联，但维生素D水平与稳定型冠状动脉疾病（CAD）中侧支动脉之间的关系此前尚未见报道。
在冬季，对至少一条心外膜冠状动脉狭窄程度超过95%的214例患者进行冠状动脉造影（CAG）后连续招募。采用Rentrop分类法对冠状动脉侧支循环（CCC）进行分级。CCC不良组包括Rentrop分级为0 - 1级的CCC患者，对照组包括Rentrop分级为2 - 3级的CCC患者。在CAG当天测量维生素D和PTH水平。
与对照组相比，CCC不良组的维生素D水平较低（34±25 pmol/L对49±33 pmol/L；p = 0.01），维生素D缺乏（<37 pmol/L）的患病率较高（67%对43%；p = 0.01）。两组间PTH水平、钙和磷水平无显著差异。在研究人群中，女性、较低的高密度脂蛋白胆固醇和较低的维生素D水平与CCC不良独立相关。
较低的维生素D水平可能与稳定型CAD患者侧支血管发育不良有关。
