Park Kyung Mi, Jun Hak Hoon, Bae Jinkun, Choi Yu Bum, Yang Dong Ho, Jeong Hye Yun, Lee Mi Jung, Lee So-Young
Division of Nephrology, Department of Internal Medicine, Seochang Happy Internal Medicine Clinic, Incheon, Korea.
Department of Surgery, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea.
Electrolyte Blood Press. 2017 Dec;15(2):27-36. doi: 10.5049/EBP.2017.15.2.27. Epub 2017 Dec 31.
We investigated the effect of vitamin D deficiency on cardiovascular risk profiles in an Asian population with chronic kidney disease (CKD).
A total of 210 participants (62 non-dialysis CKD patients and 148 hemodialysis [HD] patients) were enrolled between December 2009 and February 2010. Vitamin D deficiency was determined using the serum 25-hydroxyvitamin D [25(OH)D] concentration. Blood pressure and arterial stiffness were measured. Subjects were divided into groups according to 25(OH)D concentration based on a cut-off of 13.5 ng/mL in non-dialysis CKD patients and 11.3 ng/mL in HD patients.
The mean age was 61.7±12.3 years in non-dialysis CKD patients and 57.0±12.7 years in HD patients. In the non-dialysis CKD group, mean estimated glomerular filtration rate (eGFR) was 29.7±15.4 mL/min/1.73 m. Mean 25(OH)D concentration was 13.6±7.8 ng/mL in non-dialysis CKD patients and 11.3±6.7 ng/mL in HD patients. More than half of the subjects had vitamin D deficiency (67.6% in non-dialysis CKD patients and 80.4% in HD patients). There were no significant differences in systolic blood pressure, pulse pressure, and arterial stiffness between higher and lower 25(OH)D groups among non-dialysis CKD and HD patients. Multivariate analysis revealed that female sex (odds ratio [OR]: 5.890; 95% confidence interval [CI]: 2.597-13.387; p<0.001) and presence of diabetes (OR: 2.434; 95% CI: 1.103-5.370; p=0.028) were significantly associated with lower serum 25(OH)D levels in HD patients.
The prevalence of vitamin D deficiency was high in both nondialysis CKD patients and HD patients. Serum 25(OH)D concentration was not a significant factor associated with blood pressure and arterial stiffness among non-dialysis CKD and HD patients.
我们研究了维生素D缺乏对亚洲慢性肾脏病（CKD）人群心血管风险状况的影响。
2009年12月至2010年2月期间共纳入210名参与者（62名非透析CKD患者和148名血液透析[HD]患者）。采用血清25-羟基维生素D[25(OH)D]浓度来确定维生素D缺乏情况。测量血压和动脉僵硬度。根据非透析CKD患者25(OH)D浓度临界值为13.5 ng/mL以及HD患者为11.3 ng/mL，将受试者分组。
非透析CKD患者的平均年龄为61.7±12.3岁，HD患者为57.0±12.7岁。在非透析CKD组中，平均估计肾小球滤过率（eGFR）为29.7±15.4 mL/min/1.73 m²。非透析CKD患者的平均25(OH)D浓度为13.6±7.8 ng/mL，HD患者为11.3±6.7 ng/mL。超过一半的受试者存在维生素D缺乏（非透析CKD患者中为67.6%，HD患者中为80.4%）。在非透析CKD和HD患者中，25(OH)D水平较高组与较低组之间的收缩压、脉压和动脉僵硬度无显著差异。多因素分析显示，女性（比值比[OR]：5.890；95%置信区间[CI]：2.597 - 13.387；p<0.001）和糖尿病的存在（OR：2.434；95%CI：1.103 - 5.370；p = 0.028）与HD患者较低的血清25(OH)D水平显著相关。
非透析CKD患者和HD患者中维生素D缺乏的患病率均较高。在非透析CKD和HD患者中，血清25(OH)D浓度不是与血压和动脉僵硬度相关的显著因素。
