Liew J Y, Sasha S R, Ngu P J, Warren J L, Wark J, Dart A M, Shaw J A
Department of Cardiovascular Medicine, Alfred Hospital, Melbourne, Victoria, Australia; Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia; Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria, Australia.
Department of Cardiovascular Medicine, Alfred Hospital, Melbourne, Victoria, Australia; Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia.
Nutr Metab Cardiovasc Dis. 2015 Mar;25(3):274-9. doi: 10.1016/j.numecd.2014.12.005. Epub 2014 Dec 23.
To investigate the association between vitamin D levels, angiographic severity of coronary artery disease, arterial stiffness and degree of peripheral arterial disease (PAD) as assessed by ankle brachial index (ABI).
375 patients undergoing coronary angiography from November 2012 to September 2013 were recruited. Serum 25-hydroxyvitamin D (25OHD) levels were measured as were ABI and pulse wave velocity (PWV). Based on the findings of the coronary angiogram, patients were divided into subgroups: Absent, Single, Double and Triple Vessel Disease (as defined by >50% stenosis in each major coronary artery) 0.275 patients not taking vitamin D supplements were included in the analysis. Mean age was 66.0 ± 11.2 (mean ± SD) years. Levels of 25(OH)D were significantly lower in patients with CAD when compared to patients without CAD (57.0 ± 1.73 versus 70.1 ± 2.46 nmol/L; p < 0.01). One way ANOVA revealed triple vessel disease patients had significantly lower 25(OH)D levels when compared to single vessel disease patients (50.6 ± 2.84 nmol/L versus 61.3 ± 3.16 p < 0.01) and trended to be lower when compared to double vessel disease patients (50.6 ± 2.84 versus 59.0 ± 2.99 nmol/L; p = 0.07). Stepwise regression revealed that age, gender (male), hypertension, hyperlipidemia and 25(OH)D were significant predictors of CAD (p < 0.05). Vitamin D was the most significant predictor for CAD (p < 0.001) There was no correlation between 25(OH)D levels, ABI and PWV.
Among patients presenting for coronary angiography, low serum 25-hydroxyvitamin D levels are associated with the presence and extent of angiographic CAD but not arterial stiffness or PAD.
通过踝臂指数（ABI）评估维生素D水平、冠状动脉疾病的血管造影严重程度、动脉僵硬度与外周动脉疾病（PAD）程度之间的关联。
招募了2012年11月至2013年9月期间接受冠状动脉造影的375例患者。测量血清25-羟基维生素D（25OHD）水平、ABI和脉搏波速度（PWV）。根据冠状动脉造影结果，将患者分为亚组：无病变、单支血管病变、双支血管病变和三支血管病变（定义为各主要冠状动脉狭窄>50%）。分析纳入了275例未服用维生素D补充剂的患者。平均年龄为66.0±11.2（平均值±标准差）岁。与无CAD的患者相比，CAD患者的25(OH)D水平显著更低（57.0±1.73对70.1±2.46 nmol/L；p<0.01）。单因素方差分析显示，与单支血管病变患者相比，三支血管病变患者的25(OH)D水平显著更低（50.6±2.84 nmol/L对61.3±3.16，p<0.01），与双支血管病变患者相比有降低趋势（50.6±2.84对59.0±2.99 nmol/L；p = 0.07）。逐步回归显示，年龄、性别（男性）、高血压、高脂血症和25(OH)D是CAD的显著预测因素（p<0.05）。维生素D是CAD最显著的预测因素（p<0.001）。25(OH)D水平、ABI和PWV之间无相关性。
在接受冠状动脉造影的患者中，低血清25-羟基维生素D水平与血管造影显示的CAD的存在和程度相关，但与动脉僵硬度或PAD无关。
