Akhtar Tauseef, Aggarwal Ramesh, Jain Sachin Kumar
Department of Medicine, Lady Hardinge Medical College and Dr. Ram Manohar Lohia Hospital, New Delhi, India.
Department of Medicine, John H. Stroger Jr. Hospital of Cook County, Chicago, Illinois, USA.
Adv Med. 2019 Feb 3;2019:6823417. doi: 10.1155/2019/6823417. eCollection 2019.
Vitamin D, a fat-soluble vitamin, has various extraskeletal effects, and several human and animal studies have suggested that vitamin D deficiency may be a contributory factor in the pathogenesis of coronary artery disease (CAD). However, such studies in the Indian subcontinent are either lacking or have shown conflicting results.
This was a descriptive cross-sectional study involving 121 patients with CAD from a tertiary care center and their 80 age-matched healthy controls. Serum vitamin D levels along with serum and urine chemistries were measured in both the groups. The average duration of sun exposure/day and use of sunscreen were also considered in the study cohort using a questionnaire. Serum vitamin D levels were categorized into deficient (<30 nmol/lit), insufficient (30-75 nmol/lit), and sufficient (>75 nmol/lit) groups.
Among the cases, 51.2% of the patients were vitamin D deficient and 44.6% patients had insufficient vitamin D levels, whereas among controls, 40% and 31% of the population had deficient and insufficient levels of vitamin D, respectively. However, the mean value of the serum vitamin D level was not statistically different in the cases as compared to that of the controls (34.06 vs 40.19 nmol/lit) (=0.08). Corrected serum calcium (9.26 vs 9.59 mg%) ( ≤ 0.0001) and serum albumin levels (4.21 vs 4.75 gm%) ( ≤ 0.0001) were lower in the cases than those of the controls. The average sun exposure/day was higher among the cases than that among the controls (2.93 vs 1.85 hours) (=0.001).
Vitamin D deficiency is widely prevalent in Indian population despite abundant sunshine, and the duration of sun exposure is not correlated with serum vitamin D levels. Vitamin D deficiency is not associated with CAD. However, serum calcium is deficient in CAD patients as compared to the controls. Large-scale studies are required to explore the association further to evaluate the benefits of screening and correction of vitamin D deficiency in patients with CAD.
维生素D是一种脂溶性维生素，具有多种骨骼外效应，多项人体和动物研究表明，维生素D缺乏可能是冠状动脉疾病（CAD）发病机制中的一个促成因素。然而，印度次大陆的此类研究要么缺乏，要么结果相互矛盾。
这是一项描述性横断面研究，纳入了一家三级护理中心的121例CAD患者及其80例年龄匹配的健康对照。对两组患者均检测了血清维生素D水平以及血清和尿液化学指标。通过问卷调查还考虑了研究队列中平均每日日照时长和防晒霜使用情况。血清维生素D水平分为缺乏（<30 nmol/lit）、不足（30 - 75 nmol/lit）和充足（>75 nmol/lit）组。
在病例组中，51.2%的患者维生素D缺乏，44.6%的患者维生素D水平不足；而在对照组中，分别有40%和31%的人群维生素D水平缺乏和不足。然而，病例组血清维生素D水平的平均值与对照组相比无统计学差异（34.06对40.19 nmol/lit）（P = 0.08）。病例组校正血清钙（9.26对9.59 mg%）（P≤0.0001）和血清白蛋白水平（4.21对4.75 gm%）（P≤0.0001）低于对照组。病例组平均每日日照时长高于对照组（2.93对1.85小时）（P = 0.001）。
尽管阳光充足，但维生素D缺乏在印度人群中广泛存在，日照时长与血清维生素D水平无关。维生素D缺乏与CAD无关。然而，与对照组相比，CAD患者血清钙缺乏。需要进行大规模研究以进一步探索这种关联，评估对CAD患者进行维生素D缺乏筛查和纠正的益处。
