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代谢综合征患者维生素D缺乏的高患病率及血清维生素D与心血管风险的相关性

High Prevalence of Vitamin D Deficiency and Correlation of Serum Vitamin D with Cardiovascular Risk in Patients with Metabolic Syndrome.

作者信息

Alkhatatbeh Mohammad J, Abdul-Razzak Khalid K, Khasawneh Lubna Q, Saadeh Nesreen A

机构信息

1 Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology , Irbid, Jordan .

2 Department of Internal Medicine, Faculty of Medicine, Jordan University of Science and Technology , Irbid, Jordan .

出版信息

Metab Syndr Relat Disord. 2017 Jun;15(5):213-219. doi: 10.1089/met.2017.0003. Epub 2017 Mar 27.

Abstract

BACKGROUND

Metabolic syndrome (MetS) identifies subjects with increased risk of cardiovascular disease when they have a combination of insulin resistance, obesity, hypertension, hyperglycemia, low high-density lipoprotein cholesterol (HDL-C), and elevated triglycerides (TGs). Increasing evidence suggests that vitamin D deficiency could be associated with diabetes and MetS. The aim is to assess if 25-hydroxyvitamin D (25-OHD) is correlated with cardiovascular risk components of MetS.

METHODS

A cross-sectional study involved 124 diabetic patients with MetS according to International Diabetes Federation definition. 25-OHD was measured using liquid chromatography-tandem mass spectrometry (LC-MS/MS). Fasting insulin, lipid profile, glucose, and hemoglobin-A1c (HbA1c) were determined using routinely standard laboratory methods. Insulin resistance was assessed using homeostatic model assessment (HOMA).

RESULTS

59.68% and 27.42% of patients have vitamin D deficiency and insufficiency, respectively. Systolic blood pressure (SBP) was significantly higher in patients with vitamin D deficiency compared to patients with sufficient vitamin D (P < 0.05). Serum log (25-OHD) was inversely correlated with SBP, HbA1c, low-density lipoprotein cholesterol (LDL-C), TGs, and total cholesterol and directly correlated with pancreatic β cell function (HOMA-β) (P < 0.05). Multiple linear regression analysis has shown that SBP can be predicted from log (25-OHD) (B = -9.388, P < 0.05), while HbA1c, LDL-C, TGs, total cholesterol, and HOMA-β cannot be predicted from log (25-OHD), (P > 0.05).

CONCLUSIONS

Vitamin D deficiency was very prevalent among patients with MetS. 25-OHD was inversely correlated with glycemic control and cardiovascular risk components of MetS except HDL-C, insulin resistance, and obesity. SBP was the only cardiovascular risk component that can be predicted from vitamin D concentrations.

摘要

背景

代谢综合征(MetS)用于识别那些同时存在胰岛素抵抗、肥胖、高血压、高血糖、低高密度脂蛋白胆固醇(HDL-C)以及甘油三酯(TGs)升高的心血管疾病风险增加的受试者。越来越多的证据表明维生素D缺乏可能与糖尿病和代谢综合征有关。本研究旨在评估25-羟基维生素D(25-OHD)是否与代谢综合征的心血管风险成分相关。

方法

一项横断面研究纳入了124例根据国际糖尿病联盟定义诊断为患有代谢综合征的糖尿病患者。采用液相色谱-串联质谱法(LC-MS/MS)测定25-OHD。使用常规标准实验室方法测定空腹胰岛素、血脂谱、血糖和糖化血红蛋白(HbA1c)。采用稳态模型评估(HOMA)评估胰岛素抵抗。

结果

分别有59.68%和27.42%的患者存在维生素D缺乏和不足。与维生素D充足的患者相比,维生素D缺乏的患者收缩压(SBP)显著更高(P < 0.05)。血清log(25-OHD)与SBP、HbA1c、低密度脂蛋白胆固醇(LDL-C)、TGs和总胆固醇呈负相关,与胰腺β细胞功能(HOMA-β)呈正相关(P < 0.05)。多元线性回归分析表明,SBP可由log(25-OHD)预测(B = -9.388,P < 0.05),而HbA1c、LDL-C、TGs、总胆固醇和HOMA-β不能由log(25-OHD)预测(P > 0.05)。

结论

代谢综合征患者中维生素D缺乏非常普遍。25-OHD与代谢综合征的血糖控制和心血管风险成分(HDL-C、胰岛素抵抗和肥胖除外)呈负相关。SBP是唯一可由维生素D浓度预测的心血管风险成分。

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