Ernst J B, Kuhn J, Becker T, Dreier J, Börgermann J, Knabbe C, Gummert J F, Zittermann A
Clinic for Thoracic and Cardiovascular Surgery, Heart and Diabetes Center North Rhine-Westphalia, Ruhr University Bochum, Bad Oeynhausen, Germany.
Institute for Laboratory and Transfusion Medicine, Heart and Diabetes Center North Rhine-Westphalia, Ruhr University Bochum, Bad Oeynhausen, Germany.
Nutr Metab Cardiovasc Dis. 2015 Mar;25(3):280-6. doi: 10.1016/j.numecd.2014.10.014. Epub 2014 Nov 5.
Low vitamin D status, i.e. circulating 25-hydroxyvitamin D (25OHD) levels <50 nmol/l, is independently associated with increased CVD risk. Medication use may influence 25OHD levels. We therefore investigated the association of circulating 25OHD with medication use in patients scheduled for cardiac surgery.
A total of 11,256 patients were included in this cross-sectional study. We compared 25OHD levels of medication users (18 groups of continuously used and 5 groups of intermittently used medications) with levels of non-users. Moreover, we assessed variables (medications, demographic and clinical parameters) that were independently associated with 25OHD levels <50 nmol/l. The prevalence of 25OHD levels <50 nmol/l was 65.7%. The use of statins and immunosuppressive agents was significantly associated with higher 25OHD levels and lower odds ratios of 25OHD levels <50 nmol/l. The use of ACE-inhibitors, catecholamines and antibiotics was associated with lower 25OHD levels and higher odds ratios of 25OHD levels <50 nmol/l. However, only use of antibiotics, immunosuppressive agents and catecholamines showed clinically relevant differences in 25OHD levels, i.e. differences of more than +4 nmol/l or -4 nmol/l, compared with respective non-users. These medications were prescribed either intermittently (antibiotics, catecholamines) and/or infrequently (<2%; immunosuppressive agents, catecholamines) and/or its causal relationship with circulating 25OHD is questionable (antibiotics). Female sex and blood drawing during wintertime were associated with the highest odds ratios of 25OHD levels <50 nmol/l.
Data indicate that in patients with high cardiovascular risk profile medication use does not substantially contribute to 25OHD levels <50 nmol/l.
维生素D水平低下，即循环25-羟维生素D（25OHD）水平<50 nmol/L，与心血管疾病（CVD）风险增加独立相关。药物使用可能会影响25OHD水平。因此，我们调查了计划进行心脏手术的患者中循环25OHD与药物使用之间的关联。
本横断面研究共纳入11256例患者。我们比较了药物使用者（18组持续使用药物和5组间歇使用药物）与非使用者的25OHD水平。此外，我们评估了与25OHD水平<50 nmol/L独立相关的变量（药物、人口统计学和临床参数）。25OHD水平<50 nmol/L的患病率为65.7%。他汀类药物和免疫抑制剂的使用与较高的25OHD水平以及25OHD水平<50 nmol/L的较低比值比显著相关。血管紧张素转换酶抑制剂、儿茶酚胺和抗生素的使用与较低的25OHD水平以及25OHD水平<50 nmol/L的较高比值比相关。然而，与各自的非使用者相比，仅抗生素、免疫抑制剂和儿茶酚胺的使用在25OHD水平上显示出临床相关差异，即差异超过+4 nmol/L或 -4 nmol/L。这些药物要么是间歇性给药（抗生素、儿茶酚胺）和/或不频繁给药（<2%；免疫抑制剂、儿茶酚胺）和/或其与循环25OHD的因果关系存疑（抗生素）。女性和冬季采血与25OHD水平<50 nmol/L的最高比值比相关。
数据表明，在心血管风险较高的患者中，药物使用对25OHD水平<50 nmol/L的影响不大。
