Suthar Om Prakash, Mathur Shyam, Gupta Vikas, Agarwal Harish, Mathur Arvind, Singh Pradeep, Sharma Sohan Lal
Senior Resident.
Senior Professor.
J Assoc Physicians India. 2018 Mar;66(3):18-21.
Vitamin D deficiency is highly prevalent condition in western countries as well as in India. Lower level of vitamin D is associated with increased arterial stiffness by activating renin-angiotensin-aldosterone system leading to increased cardiovascular morbidity and mortality including increased risk of coronary artery disease, stroke, peripheral vascular disease, hypertension, diabetes mellitus and metabolic syndrome. Our aim was to study the correlation between serum vitamin D level, various measures of arterial stiffness and cardiovascular morbidity in elderly individuals.
The present study was conducted in collaboration with Department of Medicine, Department of Cardiology and Regional Geriatric Centre, NPHCE, MDM Hospital attached to Dr. S.N. medical college Jodhpur. Total 100 elderly individuals 60 yrs and above attending hospital for minor short illness, acute illness or for routine health checkup or with acute coronary events are included in the study. Vitamin D level was assessed by chemiluminescent immunoassay. Pulse Wave Velocity was determined by Periscope.
In subjects with coronary artery disease, 28.30% were vitamin D deficient, 49.05% were vitamin D insufficient and only 22.64% are vitamin D sufficient. In healthy subjects, 25.53% were vitamin D deficient, 23.40% were vitamin D insufficient and 51.04% were vitamin D sufficient. The difference between these groups was statistically highly significant. (p value-0.006). Various measures of arterial stiffness including Rt baPWV, Lt baPWV, cf PWV and pulse pressure are more in vitamin D deficient group as compared to vitamin D sufficient group. The difference was statistically significant.
Vitamin D deficiency is quite common condition in elderly individuals which besides its bone mineralization action is also involved in cardiovascular functions. Deficiency of vitamin D may cause increase in arterial stiffness and widening of pulse pressure which are the predictor of atherosclerosis and cardiovascular morbidity and mortality.
维生素D缺乏在西方国家以及印度都是极为普遍的情况。维生素D水平较低与动脉僵硬度增加有关，这是通过激活肾素 - 血管紧张素 - 醛固酮系统，导致心血管发病率和死亡率上升，包括冠状动脉疾病、中风、外周血管疾病、高血压、糖尿病和代谢综合征的风险增加。我们的目的是研究老年个体血清维生素D水平、动脉僵硬度的各种测量指标与心血管发病率之间的相关性。
本研究是与焦特布尔S.N.医学院附属MDM医院的内科、心脏病学系和区域老年医学中心合作进行的。共有100名60岁及以上因轻微短期疾病、急性疾病或进行常规健康检查或患有急性冠状动脉事件而到医院就诊的老年人被纳入研究。维生素D水平通过化学发光免疫分析法进行评估。脉搏波速度由Periscope测定。
在患有冠状动脉疾病的受试者中，28.30%维生素D缺乏，49.05%维生素D不足，仅有22.64%维生素D充足。在健康受试者中，25.53%维生素D缺乏，23.40%维生素D不足，51.04%维生素D充足。这些组之间的差异具有高度统计学意义（p值 - 0.006）。与维生素D充足组相比，维生素D缺乏组的各种动脉僵硬度测量指标，包括右肱踝脉搏波速度、左肱踝脉搏波速度、颈股脉搏波速度和脉压都更高。差异具有统计学意义。
维生素D缺乏在老年人中是相当常见的情况，除了其骨矿化作用外，还与心血管功能有关。维生素D缺乏可能导致动脉僵硬度增加和脉压增宽，而这是动脉粥样硬化以及心血管发病率和死亡率的预测指标。
