Vendramini Larissa Collis, Dalboni Maria Aparecida, de Carvalho José Tarcísio Giffoni, Batista Marcelo Costa, Nishiura José Luiz, Heilberg Ita Pfeferman
Nephrology Division, Universidade Federal de São Paulo, São Paulo, Brazil.
Front Med (Lausanne). 2019 May 24;6:112. doi: 10.3389/fmed.2019.00112. eCollection 2019.
Vitamin D possesses renoprotective effects beyond mineral metabolism, potentially reducing arterial blood pressure and inflammation and vitamin D enzymes (CYP24A1 and CYP27B1) as well as vitamin D receptor (VDR) contribute to its homeostasis. In the present study, we aimed to determine vitamin D association with kidney volume, blood pressure parameters and inflammatory markers in ADPKD. This cross-sectional study, conducted from August 2011 through May 2016, evaluated 25(OH)D, 1,25(OH)2D and other hormonal/biochemical serum and urinary parameters, inflammatory markers and monocyte expression of VDR, CYP24A1, CYP27B1 in 74 ADPKD patients. The height-adjusted total kidney volume (htTKV) was determined by MRI and blood pressure (BP) measured through 24-h ambulatory BP monitoring (ABPM).Vitamin D insufficiency was present in 62% of patients and CYP24A1 was overexpressed in this group, raising a hypothesis of 25(OH)D increased catabolism. Serum 25(OH)D levels and VDR expression were negatively correlated with htTKV as was VDR with IL-6, IL-10, CRP, and NFκB. A multiple linear regression analysis with htTKV as dependent variable, including hypertension, CRP, eGFR, age, time since diagnosis, VDR, and 25(OH)D adjusted for season of the year showed that only the first three parameters were independent predictors of the former. There has been no association of serum 25(OH)D and VDR expression with ABPM parameters. Present findings suggested that low levels of serum 25(OH)D and VDR expression are associated with a higher kidney volume in ADPKD patients, but do not represent independent risk factors for htTKV.
维生素D具有超出矿物质代谢的肾脏保护作用，可能降低动脉血压和炎症，并且维生素D酶（CYP24A1和CYP27B1）以及维生素D受体（VDR）有助于其体内平衡。在本研究中，我们旨在确定维生素D与常染色体显性多囊肾病（ADPKD）患者肾脏体积、血压参数和炎症标志物之间的关联。这项横断面研究于2011年8月至2016年5月进行，评估了74例ADPKD患者的25（OH）D、1,25（OH）2D以及其他激素/生化血清和尿液参数、炎症标志物和单核细胞中VDR、CYP24A1、CYP27B1的表达。通过MRI测定身高校正后的总肾体积（htTKV），并通过24小时动态血压监测（ABPM）测量血压（BP）。62%的患者存在维生素D不足，且该组中CYP24A1过表达，这引发了关于25（OH）D分解代谢增加的假设。血清25（OH）D水平和VDR表达与htTKV呈负相关，VDR与白细胞介素-6（IL-6）、白细胞介素-10（IL-10）、C反应蛋白（CRP）和核因子κB（NFκB）也呈负相关。以htTKV为因变量进行多元线性回归分析，纳入高血压、CRP、估算肾小球滤过率（eGFR）、年龄、诊断后的时间、VDR和根据一年中的季节进行校正的25（OH）D，结果显示只有前三个参数是htTKV的独立预测因子。血清25（OH）D和VDR表达与ABPM参数之间无关联。目前的研究结果表明，ADPKD患者血清25（OH）D水平低和VDR表达与较高的肾脏体积相关，但并非htTKV的独立危险因素。
