Tønnesen Rune, Schwarz Peter, Hovind Peter, Jensen Lars Thorbjørn
Department of Clinical Physiology and Nuclear Medicine, Rigshospitalet, Glostrup, Copenhagen, Denmark.
Department of Endocrinology PE, Research Centre of Aging and Osteoporosis, Rigshospitalet, Copenhagen, Denmark.
Physiol Rep. 2018 Apr;6(7):e13635. doi: 10.14814/phy2.13635.
The level of circulating vitamin D is known to be associated with the ejection fraction in heart failure patients and studies in rats have shown that vitamin D depletion leads to increased levels of circulating norepinephrine and decreased atrial contractility. We elucidated the effects of vitamin D supplementation on the autonomous nervous system in healthy youngsters. Thirty healthy subjects aged 18-25 years were recruited based on their serum 25-hydroxyvitamin D (25[OH]D): 15 vitamin D insufficient (25[OH]D < 50 nmol/L) and 15 vitamin D sufficient (25[OH]D > 80 nmol/L) subjects. Both groups had vitamin D supplementation (30 microg/day) and were tested at baseline and after 30, 90, and 180 days. At each visit the serum 25-hydroxyvitamin D was measured and the head-up tilt test performed. Serum 25[OH]D remained stable in the vitamin D sufficient group, while the insufficient group had a significant increase (32.0-64.5 nmol/L), P < 0.0001. Despite the increase, the insufficient group did not reach the level of the vitamin D sufficient group within the 6 months observational period (96.1 vs 64.5 nmol/L), P < 0.01. Serum norepinephrine at baseline was higher in the insufficient group (mean = 1.61 nmol/L) than in the vitamin D sufficient group (mean = 0.94 nmol/L), P < 0.01, whereas the response to tilt was lower in the insufficient group (mean = 0.69 nmol/L) compared to the sufficient group (mean = 1.17 nmol/L), P < 0.01. The heart rate at rest was higher in the insufficient group (mean = 67.7 bpm) than in the vitamin D sufficient group (mean = 56.6 bpm), P < 0.01, for the three first visits. At the last visit no difference was found. The systolic and diastolic blood pressure differed between the groups after a month, with higher pressures in the insufficient group than in the sufficient group. Vitamin D supplementation modulates the sympathetic nervous system in healthy youngsters with low serum vitamin D. The observation might lead to a greater focus on possible prevention of cardiac disease later on in life by vitamin D supplementation early in life.
已知循环维生素D水平与心力衰竭患者的射血分数相关，并且在大鼠中的研究表明，维生素D缺乏会导致循环去甲肾上腺素水平升高和心房收缩力下降。我们阐明了补充维生素D对健康年轻人自主神经系统的影响。根据血清25-羟基维生素D（25[OH]D）招募了30名年龄在18 - 25岁的健康受试者：15名维生素D不足（25[OH]D < 50 nmol/L）和15名维生素D充足（25[OH]D > 80 nmol/L）的受试者。两组均补充维生素D（30 μg/天），并在基线以及30、90和180天后进行测试。每次就诊时测量血清25-羟基维生素D并进行头高位倾斜试验。维生素D充足组的血清25[OH]D保持稳定，而不足组有显著升高（从32.0至64.5 nmol/L），P < 0.0001。尽管有所升高，但不足组在6个月观察期内未达到维生素D充足组的水平（96.1对64.5 nmol/L），P < 0.01。不足组基线时的血清去甲肾上腺素（平均值 = 1.61 nmol/L）高于维生素D充足组（平均值 = 0.94 nmol/L），P < 0.01，而不足组对倾斜的反应（平均值 = 0.69 nmol/L）低于充足组（平均值 = 1.17 nmol/L），P < 0.01。在最初三次就诊时，不足组静息心率（平均值 = 67.7次/分钟）高于维生素D充足组（平均值 = 56.6次/分钟），P < 0.01。在最后一次就诊时未发现差异。一个月后两组的收缩压和舒张压存在差异，不足组的血压高于充足组。补充维生素D可调节血清维生素D水平低的健康年轻人的交感神经系统。这一观察结果可能会使人们更加关注在生命早期通过补充维生素D预防后期心脏病的可能性。
