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在明显健康但缺乏维生素D的个体中,补充维生素D可恢复心脏自主神经功能障碍。

Cardiac autonomic dysfunctions are recovered with vitamin D replacement in apparently healthy individuals with vitamin D deficiency.

作者信息

Dogdus Mustafa, Burhan Sebnem, Bozgun Zeynal, Cinier Goksel, Koyuncu Ilhan, Yucel Karabay Can, Zoghi Mehdi

机构信息

Department of Cardiology, Karaman State Hospital, Karaman, Turkey.

Department of Internal Medicine, Karaman State Hospital, Karaman, Turkey.

出版信息

Ann Noninvasive Electrocardiol. 2019 Nov;24(6):e12677. doi: 10.1111/anec.12677. Epub 2019 Jul 24.

Abstract

BACKGROUND

Vitamin D (VitD) has important prohormone functions in a wide range of clinical processes. Although it is known that individuals with VitD deficiency have cardiac autonomic dysfunction, there are no convincing data regarding the effect of VitD replacement. We aimed to evaluate the impact of VitD replacement on cardiac autonomic dysfunction.

METHODS

Fifty-two apparently healthy subjects with VitD deficiency and 50 healthy control subjects were enrolled. Prior to VitD replacement, 24-hr Holter recordings were obtained, and HRV parameters were recorded. VitD levels were measured 2 months later after replacement, and control 24-hr Holter recordings were analyzed.

RESULTS

The mean age of the patients was 36.04 ± 7.6 years, and 53.9% were female. SDNN (68.58 ± 13.53 vs. 121.02 ± 27.45 ms, p = .001), SDANN (95.96 ± 22.26 vs. 166.48 ± 32.97 ms, p = .001), RMSSD (23 vs. 59 ms, p < .001), and PNN50 (6.5% vs. 36%, p < .001) were significantly lower in patients with VitD deficiency compared with the control group. HRV parameters were improved after VitD replacement [SDNN (68.58 ± 13.53 to 119.87 ± 28.28 ms, p < .001), SDANN (95.96 ± 22.26 to 164.44 ± 33.90 ms, p < .001), RMSSD (23 to 58 ms, p < .001), and PNN50 (6.5 to 33%, p < .001)].

CONCLUSION

The present study suggested that VitD deficiency was significantly correlated with impaired cardiac autonomic functions assessed by parameters of HRV, and cardiac autonomic dysfunction improved after VitD replacement in otherwise apparently healthy individuals.

摘要

背景

维生素D(VitD)在广泛的临床过程中具有重要的激素原功能。尽管已知维生素D缺乏个体存在心脏自主神经功能障碍,但关于维生素D替代治疗效果的令人信服的数据却很少。我们旨在评估维生素D替代治疗对心脏自主神经功能障碍的影响。

方法

纳入52名明显健康的维生素D缺乏受试者和50名健康对照受试者。在进行维生素D替代治疗前,进行24小时动态心电图记录,并记录心率变异性(HRV)参数。替代治疗2个月后测量维生素D水平,并分析对照24小时动态心电图记录。

结果

患者的平均年龄为36.04±7.6岁,53.9%为女性。与对照组相比,维生素D缺乏患者的标准差值的平均值(SDNN)(68.58±13.53对121.02±27.45毫秒,p = 0.001)、全程标准差(SDANN)(95.96±22.26对166.48±32.97毫秒,p = 0.001)、相邻正常RR间期差值的均方根(RMSSD)(23对59毫秒,p < 0.001)和50RR间期标准差(PNN50)(6.5%对36%,p < 0.001)显著降低。维生素D替代治疗后HRV参数得到改善[SDNN(68.58±13.53至119.87±28.28毫秒,p < 0.001),SDANN(95.96±22.26至164.44±33.90毫秒,p < 0.001),RMSSD(23至58毫秒,p < 0.001),PNN50(6.5至33%,p < 0.001)]。

结论

本研究表明,维生素D缺乏与通过HRV参数评估的心脏自主神经功能受损显著相关,在其他方面明显健康的个体中,维生素D替代治疗后心脏自主神经功能障碍得到改善。

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