Roy Ambuj, Lakshmy Ramakrishnan, Tarik Mohamad, Tandon Nikhil, Reddy K Srinath, Prabhakaran Dorairaj
Additional Professor, Dept. of Cardiology, Cardiothoracic Centre, All India Institute of Medical Sciences (AIIMS), Ansari Nagar, New Delhi, 110029, India.
Dept. of Cardiac Biochemistry, Cardiothoracic Centre, All India Institute of Medical Sciences (AIIMS), Ansari Nagar, New Delhi, 110029, India.
Indian Heart J. 2015 Jan-Feb;67(1):27-32. doi: 10.1016/j.ihj.2015.02.002. Epub 2015 Mar 11.
Association of vitamin D deficiency with coronary heart disease (CHD) has been widely reported. Emerging data has shown high prevalence of vitamin D deficiency among Indians. However, this association has not been studied in Indians.
A case-control study with 120 consecutive cases of first incident acute myocardial infarction (MI) and 120 age and gender matched healthy controls was conducted at All India Institute of Medical Sciences, New Delhi. The standard clinical and biochemical risk factors for MI were assessed for both cases and controls. Serum 25 (OH) vitamin D assay was performed from stored samples for cases and controls using radioimmunoassay.
Vitamin D deficiency [25(OH) D < 30 ng/ml] was highly prevalent in cases and controls (98.3% and 95.8% respectively) with median levels lower in cases (6 ng/ml and 11.1 ng/ml respectively; p < 0.001). The cases were more likely to have diabetes, hypertension and consume tobacco and alcohol. They had higher waist hip ratio, total and LDL cholesterol. Multivariate logistic regression analysis revealed severe vitamin D deficiency [25(OH) vitamin D < 10 ng/ml] was associated with a risk of MI with an odds ratio of 4.5 (95% CI 2.2-9.2).
This study reveals high prevalence of vitamin D deficiency among cases of acute MI and controls from India, with levels of 25 (OH)D being significantly lower among cases. Despite rampant hypovitaminosis, severe vitamin D deficiency was associated with acute MI after adjusting for conventional risk factors. This association needs to be tested in larger studies in different regions of the country.
维生素D缺乏与冠心病（CHD）的关联已被广泛报道。新出现的数据显示印度人维生素D缺乏的患病率很高。然而，这种关联在印度人群中尚未得到研究。
在新德里全印度医学科学研究所进行了一项病例对照研究，纳入120例连续发生的首次急性心肌梗死（MI）病例和120名年龄及性别匹配的健康对照。对病例和对照均评估了MI的标准临床和生化危险因素。使用放射免疫分析法对病例和对照的储存样本进行血清25（OH）维生素D检测。
维生素D缺乏[25（OH）D<30 ng/ml]在病例和对照中都非常普遍（分别为98.3%和95.8%），病例组的中位数水平更低（分别为6 ng/ml和11.1 ng/ml；p<0.001）。病例组更易患糖尿病、高血压，且有吸烟和饮酒习惯。他们的腰臀比、总胆固醇和低密度脂蛋白胆固醇更高。多因素逻辑回归分析显示，严重维生素D缺乏[25（OH）维生素D<10 ng/ml]与MI风险相关，比值比为4.5（95%CI 2.2 - 9.2）。
本研究揭示了印度急性MI病例和对照中维生素D缺乏的高患病率，病例组的25（OH）D水平显著更低。尽管维生素D缺乏普遍存在，但在调整传统危险因素后，严重维生素D缺乏与急性MI相关。这种关联需要在该国不同地区的更大规模研究中进行验证。
