甲状旁腺激素和维生素D与未经治疗的高血压的关联：在白大衣高血压或持续性高血压中是否有所不同？

Association of parathyroid hormone and vitamin D with untreated hypertension: Is it different in white-coat or sustained hypertension?

作者信息

Akgül Ferit, Serçelik Alper, Çetin Hakan, Erten Turgay

机构信息

Bülent Ecevit University, Department of Cardiology, Zonguldak, Turkey.

Sanko University, Department of Cardiology, Gaziantep, Turkey.

出版信息

PLoS One. 2017 Nov 27;12(11):e0188669. doi: 10.1371/journal.pone.0188669. eCollection 2017.

DOI:10.1371/journal.pone.0188669

PMID:29176783

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5703558/

Abstract

BACKGROUND

Previous reports about the relationship between a high parathyroid hormone (PTH) and low vitamin D levels with blood pressure in different hypertension groups are conflicting.

OBJECTIVE

We studied serum PTH and vitamin D levels in white-coat (WCHT) and sustained hypertension (SHT) patients who had not been on antihypertensive treatment. We also investigated the association between serum PTH and vitamin D levels with respect to blood pressure in SHT and WCHT patients.

METHODS

We included 52 SHT patients (54.06 ± 9.2 years, 32 newly diagnosed and 20 previously diagnosed with SHT who had not been treated with antihypertensive medication for 3 months or more), 48 WCHT patients (53.64 ± 9.5 years), and 50 normotensive (NT) healthy controls (53.44 ± 8.4 years) in our study. In addition to routine tests, PTH and vitamin D levels were measured.

RESULTS

Serum PTH levels were significantly higher in SHT patients not taking antihypertensive medications than in WCHT patients and NT controls (p = 0.004). Although PTH levels were higher in WCHT than in NT groups, the difference was not statistically significant. In SHT patients, PTH levels showed a positive correlation with office systolic (r = 0.363, p = 0.008), office diastolic (r = 0.282, p = 0.038), home systolic (r = 0.390, p = 0.004), and home diastolic blood pressures (r = 0.397, p = 0.003). Serum vitamin D levels were similar in SHT, WCHT and NT groups. Vitamin D levels were not associated with blood pressures in the entire study group. Furthermore, no significant relation was found between vitamin D and PTH levels in SHT and WCHT groups.

CONCLUSION

PTH levels are significantly higher in untreated SHT patients than WCHT patients and NT subjects. However, vitamin D levels are similar in SHT, WCHT and NT groups. There is a significant association between PTH levels and blood pressures suggesting PTH has a role in increase of blood pressure in SHT.

摘要

背景

先前关于不同高血压组中高甲状旁腺激素（PTH）和低维生素D水平与血压之间关系的报道相互矛盾。

目的

我们研究了未接受抗高血压治疗的白大衣高血压（WCHT）和持续性高血压（SHT）患者的血清PTH和维生素D水平。我们还研究了SHT和WCHT患者血清PTH和维生素D水平与血压之间的关联。

方法

我们的研究纳入了52例SHT患者（54.06±9.2岁，32例新诊断患者和20例先前诊断为SHT且未接受抗高血压药物治疗3个月或更长时间的患者）、48例WCHT患者（53.64±9.5岁）和50例血压正常（NT）的健康对照者（53.44±8.4岁）。除常规检查外，还测量了PTH和维生素D水平。

结果

未服用抗高血压药物的SHT患者血清PTH水平显著高于WCHT患者和NT对照组（p = 0.004）。虽然WCHT患者的PTH水平高于NT组，但差异无统计学意义。在SHT患者中，PTH水平与诊室收缩压（r = 0.363，p = 0.008）、诊室舒张压（r = 0.282，p = 0.038）、家庭收缩压（r = 0.390，p = 0.004）和家庭舒张压（r = 0.397，p = 0.003）呈正相关。SHT、WCHT和NT组的血清维生素D水平相似。维生素D水平与整个研究组的血压无关。此外，在SHT和WCHT组中，未发现维生素D与PTH水平之间存在显著关系。