Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Road, Taipei, Taiwan.
Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan.
Sci Rep. 2020 Oct 30;10(1):18704. doi: 10.1038/s41598-020-75391-0.
The current evidence regarding the association between vitamin D deficiency and cardiovascular diseases/metabolic disorders is contradictory and inconclusive. In this large-scale observational study, we investigated the relationship between the serum 25-hydroxy vitamin D3 [25(OH)D] concentration and subclinical atherosclerosis in an elderly Asian population. In the I-Lan longitudinal study (ILAS), 1798 elderly, aged 50 and older, were enrolled. For each subject, serum 25-hydroxy vitamin D3 [25(OH)D] concentration and demographic data were recorded. The participants were divided into two groups according to their serum 25(OH)D level (sufficient, > 20 ng/mL and deficient, ≤ 20 ng/mL). Carotid intima-media thickness (cIMT) was measured at bilateral common carotid arteries. Subclinical atherosclerosis was defined as a mean cIMT > 0.81 mm. The mean subject age was 64 ± 9 years old, and 604 (33.6%) were identified as having serum 25(OH)D level ≤ 20 ng/mL. Subjects with serum 25(OH)D level ≤ 20 ng/mL were younger, more likely to be female and smoker, and had a higher incidence of hypertension, dyslipidemia, and metabolic syndrome, compared to those with serum 25(OH)D level > 20 ng/mL. Additionally, patients with serum 25(OH)D level ≤ 20 ng/mL were associated with a lower risk of subclinical atherosclerosis (crude OR: 0.63, 95% CI 0.50-0.81, p < 0.001), according to univariate analysis. However, after adjusting for gender and age, serum 25(OH)D level ≤ 20 ng/mL was not a significant risk factor for subclinical atherosclerosis. Serum 25(OH)D level ≤ 20 ng/mL was not an independent risk factor for subclinical atherosclerosis in this large elderly Asian population. Association observed in the univariate analysis may be confounded by gender or comorbidities.
目前关于维生素 D 缺乏与心血管疾病/代谢紊乱之间关联的证据相互矛盾且尚无定论。在这项大规模的观察性研究中，我们调查了血清 25-羟维生素 D3 [25(OH)D]浓度与老年亚洲人群亚临床动脉粥样硬化之间的关系。在宜兰纵向研究 (ILAS) 中，纳入了 1798 名年龄在 50 岁及以上的老年人。对于每个受试者，记录了血清 25-羟维生素 D3 [25(OH)D]浓度和人口统计学数据。根据血清 25(OH)D 水平将参与者分为两组（充足，>20ng/mL 和不足，≤20ng/mL）。在双侧颈总动脉测量颈动脉内膜中层厚度 (cIMT)。亚临床动脉粥样硬化定义为平均 cIMT>0.81mm。受试者的平均年龄为 64±9 岁，604 名（33.6%）被确定为血清 25(OH)D 水平≤20ng/mL。与血清 25(OH)D 水平>20ng/mL 的受试者相比，血清 25(OH)D 水平≤20ng/mL 的受试者年龄更小，更有可能是女性和吸烟者，且高血压、血脂异常和代谢综合征的发生率更高。此外，根据单因素分析，与血清 25(OH)D 水平>20ng/mL 的受试者相比，血清 25(OH)D 水平≤20ng/mL 的受试者发生亚临床动脉粥样硬化的风险较低（粗 OR：0.63，95%CI 0.50-0.81，p<0.001）。然而，在校正性别和年龄后，血清 25(OH)D 水平≤20ng/mL 并不是亚临床动脉粥样硬化的显著危险因素。在这个大型老年亚洲人群中，血清 25(OH)D 水平≤20ng/mL 不是亚临床动脉粥样硬化的独立危险因素。单因素分析中观察到的关联可能受到性别或合并症的混杂影响。
