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老年非勺型高血压中国人群血浆25-羟维生素D水平与动脉僵硬度的关系:一项观察性研究。

Relationship between plasma levels of 25-hydroxyvitamin D and arterial stiffness in elderly Chinese with non-dipper hypertension: An observational study.

作者信息

Gu Jian-Wei, Liu Ju-Hua, Xiao Hui-Neng, Yang Yun-Feng, Dong Wen-Ju, Zhang Quan-Bo, Liu Li, He Cheng-Shi, Wu Bi-Hua

机构信息

Department of Medicine, Affiliated Hospital of North Sichuan Medical College, Nanchong City.

Department of Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu City, Sichuan Province, China.

出版信息

Medicine (Baltimore). 2020 Feb;99(7):e19200. doi: 10.1097/MD.0000000000019200.

Abstract

Elderly individuals with non-dipper hypertension are at high risk of cardiovascular disease because of increased stiffness of peripheral arteries. Since, vitamin D deficiency is prevalent in elderly Chinese. We examined whether reduced plasma levels of 25-hydroxyvitamin D [25(OH)D] may help promote this stiffness.Hypertensive patients at least 60 years old without history of peripheral arterial disease at our hospital were retrospectively divided into dipper and non-dipper groups according to the results of 24-hour ambulatory blood pressure monitoring. Plasma levels of 25(OH)D were measured by enzyme immunoassay. Peripheral arterial stiffness was measured based on the cardio-ankle vascular index (CAVI).Of the 155 patients enrolled, 95 (61.3%) were diagnosed with non-dipper hypertension and these patients had significantly lower plasma levels of 25(OH)D than the 60 patients with dipper hypertension (19.58 ± 5.97 vs 24.36 ± 6.95 nmol/L, P < .01) as well as significantly higher CAVI (8.46 ± 1.65 vs 7.56 ± 1.08 m/s, P < .01). Vitamin D deficiency was significantly more common among non-dipper patients (57.9% vs 31.7%, P < .01). Multivariate regression showed that age and 25(OH)D were independently related to CAVI, with each 1-ng/ml decrease in 25(OH)D associated with a CAVI increase of +0.04 m/s.Non-dipper hypertension is associated with vitamin D deficiency and reduced plasma levels of 25(OH)D. The latter may contribute to stiffening of peripheral arteries, increasing the risk of cardiovascular disease.

摘要

非勺型高血压老年个体由于外周动脉僵硬度增加而处于心血管疾病的高风险中。鉴于维生素D缺乏在中国老年人中普遍存在,我们研究了血浆25-羟基维生素D[25(OH)D]水平降低是否会促使这种僵硬度增加。我们医院年龄至少60岁且无外周动脉疾病史的高血压患者,根据24小时动态血压监测结果回顾性地分为勺型和非勺型组。采用酶免疫法测定血浆25(OH)D水平。基于心踝血管指数(CAVI)测量外周动脉僵硬度。在纳入的155例患者中,95例(61.3%)被诊断为非勺型高血压,这些患者的血浆25(OH)D水平显著低于60例勺型高血压患者(19.58±5.97对24.36±6.95nmol/L,P<0.01),CAVI也显著更高(8.46±1.65对7.56±1.08m/s,P<0.01)。非勺型患者中维生素D缺乏明显更常见(57.9%对31.7%,P<0.01)。多变量回归显示年龄和25(OH)D与CAVI独立相关,25(OH)D每降低1ng/ml,CAVI增加+0.04m/s。非勺型高血压与维生素D缺乏及血浆25(OH)D水平降低有关。后者可能导致外周动脉僵硬度增加,增加心血管疾病风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ee39/7035115/58423881c07b/medi-99-e19200-g003.jpg

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