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急性心肌梗死患者的维生素D缺乏:一项意大利单中心研究。

Vitamin D Deficiency in Patients with Acute Myocardial Infarction: An Italian Single-Center Study.

作者信息

Aleksova Aneta, Belfiore Rita, Carriere Cosimo, Kassem Salam, La Carrubba Salvatore, Barbati Giulia, Sinagra Gianfranco

机构信息

1 Cardiovascular Department, "Ospedali Riuniti" and University of Trieste, Trieste, Italy.

2 Internal Medicine, Villa Sofia Hospital, Palermo, Italy.

出版信息

Int J Vitam Nutr Res. 2015;85(1-2):23-30. doi: 10.1024/0300-9831/a000220.

Abstract

BACKGROUND

Hypovitaminosis D is a vitamin deficiency that has been increasing in developed countries; it was also suggested as an emerging risk factor for developing of atherosclerosis and acute myocardial infarction. The primary source of vitamin D is its cutaneous synthesis under exposure to sunlight. It has been suggested that 30 min of sun exposure twice weekly leads to sufficient vitamin D synthesis. The residents of Trieste (Italy) are well-known for their high exposure to sunlight in all seasons. We aimed to investigate the vitamin D status in subjects with acute myocardial infarction living in this area.

METHODS

Vitamin D status was identified in 478 subjects diagnosed with acute myocardial infarction.

RESULTS

The median serum 25-hydroxyvitamin D concentration was 14.5 [7.8 - 22.7] ng/mL. Vitamin D deficiency and insufficiency were present in 324 (68 %) and 107 (22 %) subjects, respectively. Vitamin D deficiency was less frequent among subjects enrolled in the period from July to the end of September (p < 0.001). In a multivariate analysis vitamin D deficiency was predicted by older age (p = 0.02), female gender (p = 0.002), higher body mass index (p = 0.05), autumn/winter sampling (p < 0.001), increased parathyroid hormone (p = 0.03) and alkaline phosphatase (p = 0.003).

CONCLUSIONS

We observed very high prevalence of vitamin D deficiency among subjects with myocardial infarction in all seasons of enrollment. However, it was lower in the summer when sun exposure is higher. The exposure to sunlight may be a cost-saving therapeutic strategy for the management of vitamin D deficiency.

摘要

背景

维生素D缺乏症是一种在发达国家呈上升趋势的维生素缺乏症;它还被认为是动脉粥样硬化和急性心肌梗死发生的一个新的风险因素。维生素D的主要来源是皮肤在阳光照射下的合成。有人提出,每周两次30分钟的阳光照射可导致足够的维生素D合成。的里雅斯特(意大利)的居民以全年都大量暴露于阳光下而闻名。我们旨在调查居住在该地区的急性心肌梗死患者的维生素D状况。

方法

对478名诊断为急性心肌梗死的患者进行了维生素D状况鉴定。

结果

血清25-羟基维生素D浓度中位数为14.5 [7.8 - 22.7] ng/mL。维生素D缺乏和不足分别存在于324名(68%)和107名(22%)患者中。7月至9月底入组的患者中维生素D缺乏的发生率较低(p < 0.001)。在多变量分析中,维生素D缺乏可通过年龄较大(p = 0.02)、女性(p = 0.002)、较高的体重指数(p = 0.05)、秋冬采样(p < 0.001)、甲状旁腺激素升高(p = 0.03)和碱性磷酸酶升高(p = 0.003)来预测。

结论

我们观察到在入组的所有季节中,心肌梗死患者中维生素D缺乏的患病率非常高。然而,在阳光照射较多的夏季患病率较低。阳光照射可能是一种节省成本的治疗维生素D缺乏的策略。

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