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循环维生素 D3 与老年亚洲人群亚临床动脉粥样硬化的关系。

The relationship between circulating vitamin D3 and subclinical atherosclerosis in an elderly Asian population.

机构信息

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.

出版信息

Sci Rep. 2020 Oct 30;10(1):18704. doi: 10.1038/s41598-020-75391-0.

Abstract

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.

摘要

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。

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