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维生素 D 补充可改善非透析慢性肾脏病患者的内皮功能障碍。

Vitamin D supplementation improves endothelial dysfunction in patients with non-dialysis chronic kidney disease.

机构信息

Department of Nephrology, Affiliated Drum Tower Hospital, Medical School of Nanjing University, 321 Zhong Shan Road, Nanjing, 210008, China.

出版信息

Int Urol Nephrol. 2018 May;50(5):923-927. doi: 10.1007/s11255-018-1829-6. Epub 2018 Feb 26.

Abstract

PURPOSE

Hypovitaminosis D is common in chronic kidney disease (CKD) and is associated with endothelial dysfunction and cardiovascular events. This study aimed to investigate the effects of vitamin D supplementation on endothelial dysfunction in non-dialysis CKD patients.

MATERIALS AND METHODS

Seventy-one non-dialysis CKD patients with low vitamin D (serum 25(OH)D < 30 ng/mL) were recruited. Patients received oral cholecalciferol 50,000 units once a week for 12 weeks. Changes in endothelial function by brachial artery flow-mediated dilation (FMD), soluble vascular cell adhesion molecule-1 (sVCAM-1), and sE-selectin were studied.

RESULTS

There was a significant increase in serum levels of 25(OH)D after cholecalciferol supplementation (33.7 ± 12.1 vs. 13.2 ± 5.4 ng/mL, P < 0.001). Multivariable regression analysis showed that higher proteinuria (β = - 0.548, P < 0.001) and lower levels of 25(OH)D (β = 0.360, P < 0.001) at baseline were related to lower 25(OH)D level after supplementation. FMD increased significantly from 4.4 ± 1.3 to 5.1 ± 1.5% (P < 0.001), and soluble endothelial biomarkers decreased: sVCAM-1 from 926.9 ± 158.0 to 867.0 ± 129.0 ng/mL (P < 0.001), and sE-selectin 69.7 ± 15.8 to 63.3 ± 14.7 ng/mL (P < 0.001).

CONCLUSIONS

Vitamin D supplementation can improve endothelial dysfunction in pre-dialysis CKD patients.

摘要

目的

维生素 D 缺乏在慢性肾脏病(CKD)中很常见,与内皮功能障碍和心血管事件有关。本研究旨在探讨维生素 D 补充对非透析 CKD 患者内皮功能障碍的影响。

材料和方法

招募了 71 名维生素 D 水平低(血清 25(OH)D<30ng/mL)的非透析 CKD 患者。患者每周接受口服胆钙化醇 50000 单位,共 12 周。通过肱动脉血流介导的扩张(FMD)、可溶性血管细胞黏附分子-1(sVCAM-1)和 sE-选择素研究内皮功能的变化。

结果

胆钙化醇补充后血清 25(OH)D 水平显著升高(33.7±12.1 vs. 13.2±5.4ng/mL,P<0.001)。多变量回归分析显示,基线时较高的蛋白尿(β=-0.548,P<0.001)和较低的 25(OH)D 水平(β=0.360,P<0.001)与补充后 25(OH)D 水平较低有关。FMD 从 4.4±1.3 显著增加到 5.1±1.5%(P<0.001),可溶性内皮生物标志物降低:sVCAM-1 从 926.9±158.0 降至 867.0±129.0ng/mL(P<0.001),sE-选择素从 69.7±15.8 降至 63.3±14.7ng/mL(P<0.001)。

结论

维生素 D 补充可改善预透析 CKD 患者的内皮功能障碍。

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