Gurses Kadri Murat, Tokgozoglu Lale, Yalcin Muhammed Ulvi, Kocyigit Duygu, Dural Muhammet, Canpinar Hande, Yorgun Hikmet, Sahiner Mehmet Levent, Kaya Ergun Baris, Akin Safak, Gurlek Alper, Guc Dicle, Aytemir Kudret
Department of Cardiology, Hacettepe University Faculty of Medicine, 06100 Ankara, Turkey.
Department of Cardiology, Hacettepe University Faculty of Medicine, 06100 Ankara, Turkey.
Atherosclerosis. 2014 Dec;237(2):784-9. doi: 10.1016/j.atherosclerosis.2014.10.096. Epub 2014 Oct 29.
Recent studies have revealed a relationship between vitamin D deficiency and atherosclerosis. This study aims to investigate the impact of vitamin D deficiency and replacement on markers of subclinical atherosclerosis in young premenopausal women in whom vitamin D deficiency is prevalent.
Thirty-one premenopausal vitamin D deficient women and 27 age and gender-matched control subjects were enrolled in this study. Markers of subclinical atherosclerosis including carotid intima-media thickness (cIMT), flow-mediated dilatation (FMD), endothelial progenitor cell (EPC) count and cytokine levels were determined at baseline. All measurements were repeated at 6-month follow-up in vitamin D-deficient subjects after vitamin D replacement.
Vitamin D deficient premenopausal women had lower FMD (9.9 ± 1.3 vs. 13.8 ± 1.7%, p < 0.001) and EPC counts at baseline. This population also had lower IL-10 and higher IL-17 levels. A 6-month vitamin D replacement therapy resulted in a significant increase in FMD (9.9 ± 1.3 vs. 11.4 ± 1.4%, p < 0.001) and EPC counts. Furthermore, cytokine profile shifted toward a more anti-inflammatory phenotype including elevated IL-10 and decreased IL-17 levels. cIMT was not different between patient and control groups and did not change following vitamin D replacement. Change in 25(OH)D and IL-17 levels were independent predictors of the change in FMD measurements following vitamin D replacement.
This study demonstrates that endothelial function is impaired in otherwise healthy vitamin D deficient young premenopausal women and improves with 6-month replacement therapy. Immune-modulatory effects of vitamin D may, at least partly, be responsible for its beneficial effects on vascular health.
近期研究揭示了维生素D缺乏与动脉粥样硬化之间的关系。本研究旨在调查维生素D缺乏及补充对维生素D缺乏普遍存在的年轻绝经前女性亚临床动脉粥样硬化标志物的影响。
本研究纳入了31名绝经前维生素D缺乏的女性以及27名年龄和性别匹配的对照受试者。在基线时测定亚临床动脉粥样硬化标志物，包括颈动脉内膜中层厚度（cIMT）、血流介导的血管舒张功能（FMD）、内皮祖细胞（EPC）计数和细胞因子水平。在维生素D缺乏的受试者进行维生素D补充后，于6个月随访时重复所有测量。
绝经前维生素D缺乏的女性在基线时FMD较低（9.9±1.3%对13.8±1.7%，p<0.001）且EPC计数较低。该人群的白细胞介素-10（IL-10）水平也较低，白细胞介素-17（IL-17）水平较高。为期6个月的维生素D替代疗法导致FMD（9.9±1.3%对11.4±1.4%，p<0.001）和EPC计数显著增加。此外，细胞因子谱向更具抗炎性的表型转变，包括IL-10升高和IL-17水平降低。患者组和对照组之间的cIMT无差异，维生素D替代后也未改变。25(OH)D和IL-17水平的变化是维生素D替代后FMD测量变化的独立预测因素。
本研究表明，在其他方面健康的维生素D缺乏的年轻绝经前女性中，内皮功能受损，而6个月的替代疗法可使其改善。维生素D的免疫调节作用可能至少部分地解释了其对血管健康的有益作用。
