Department of Neurology, Qilu Hospital of Shandong University, Jinan, 250012, China.
Department of Neurology, Jinan City People's Hospital, Jinan, 271199, China.
BMC Neurol. 2019 Jul 17;19(1):164. doi: 10.1186/s12883-019-1395-2.
The exact relationship between 25-hydroxyvitamin D [25(OH) D] levels and small vessel disease (SVD) are not clear in China. The aim of this study was to determine such the association between 25(OH) D and SVD in China.
We retrospectively enrolled 106 patients with SVD and 115 controls between Jan 2017 and Dec 2017. All the subjects were categorized into three subgroups according to the level of 25 (OH) D: vitamin D deficiency (< 12 ng/ml), insufficiency (12-20 ng/ml) and sufficiency (> 20 ng/ml).
Among 106 SVD patients, 80 (75.5%) were men and the mean age was 61.6 ± 13.2 years. The deficiency of 25(OH) D was observed in 76 (71.7%) of SVD patients and 47 (40.9%) of controls (P = 0.001). Compared with controls, patients with SVD were more likely to be male, a stroke history, smokers, with hyperlipidemia, higher systolic and diastolic blood pressure and low-density lipoprotein, and lower of 25(OH)D level (P < 0.05). Logistic regression analysis revealed the level of 25 (OH) D as an independent predictor of SVD (OR 0.772, 95% CI 0.691-0.862, P = 0.001). Compared with the sufficient 25 (OH) D group, the ORs of SVD in deficient and insufficient 25(OH)D group were 5.609 (95% CI 2.006-15.683) and 1.077 (95% CI: 0.338-3.428) after adjusting for potential confounders, respectively. In hypertensives with vitamin D deficient and insufficient group compared with sufficient group, the ORs of SVD increased to 9.738 (95% CI 2.398-39.540) and 1.108 (95% CI 0.232-5.280), respectively (P = 0.001).
We found significant associations between SVD and 25(OH)D deficiency. The combined presence of hypertension and vitamin D deficiency increased the probability of developing SVD. Our findings will warrant further prospective studies in the future.
25-羟维生素 D [25(OH)D] 水平与小血管疾病 (SVD) 之间的确切关系在中国尚不清楚。本研究旨在确定 25(OH)D 与中国 SVD 之间的关联。
我们回顾性纳入了 2017 年 1 月至 12 月期间的 106 例 SVD 患者和 115 例对照。所有受试者根据 25(OH)D 水平分为三组：维生素 D 缺乏症（<12ng/ml）、不足（12-20ng/ml）和充足（>20ng/ml）。
在 106 例 SVD 患者中，80 例（75.5%）为男性，平均年龄为 61.6±13.2 岁。76 例（71.7%）SVD 患者和 47 例（40.9%）对照组存在 25(OH)D 缺乏（P=0.001）。与对照组相比，SVD 患者更可能为男性、有脑卒中病史、吸烟者、血脂异常、收缩压和舒张压及低密度脂蛋白较高，25(OH)D 水平较低（P<0.05）。Logistic 回归分析显示，25(OH)D 水平是 SVD 的独立预测因子（OR 0.772，95%CI 0.691-0.862，P=0.001）。与充足 25(OH)D 组相比，25(OH)D 缺乏和不足组的 SVD 比值比（OR）分别为 5.609（95%CI 2.006-15.683）和 1.077（95%CI：0.338-3.428），校正潜在混杂因素后差异有统计学意义。在维生素 D 缺乏和不足的高血压患者与充足组相比，SVD 的比值比分别增加至 9.738（95%CI 2.398-39.540）和 1.108（95%CI 0.232-5.280）（P=0.001）。
我们发现 SVD 与 25(OH)D 缺乏之间存在显著关联。高血压和维生素 D 缺乏的共同存在增加了发生 SVD 的概率。我们的研究结果将需要在未来进行进一步的前瞻性研究。
