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脂质状态与25-羟基维生素D的关联:终末期肾病患者的横断面研究

Lipid status association with 25-hydroxy vitamin D: Cross sectional study of end stage renal disease patients.

作者信息

Milinković Neda, Sarić Marija, Jovičić Snežana, Mirković Duško, Ležaić Višnja, Ignjatović Svetlana

机构信息

University of Belgrade, Faculty of Pharmacy, Department of Medical Biochemistry, Belgrade.

University of Belgrade, Faculty of Medicine, Department of Nephrology.

出版信息

J Med Biochem. 2020 Sep 2;39(3):309-317. doi: 10.2478/jomb-2019-0032.

Abstract

BACKGROUND

Some observational studies indicate an association of 25-hydroxy vitamin D (25(OH)D) insufficiency and atherogenic cholesterol concentrations. The aim of this study was to investigate relationship between 25(OH)D concentrations and lipid parameters in end stage renal disease (ESRD) patients, separately for predialysis, hemodialysis and peritoneal dialysis patients.

METHODS

We have adjusted 25(OH)D concentrations for seasonal variability with cosinor analysis, and performed all further analysis using these corrected 25(OH)D concentrations. Concentrations of 25(OH)D and the lipid parameters were determined in 214 ESRD patients and 50 control group participants. The analysis included the measurement of 25(OH)D by HPLC, apolipoprotein (Apo) AI, ApoB and Lp(a) by nephelometry, total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and triglyceride (TG) by spectrophotometry and manually calculated ApoB/ApoAI and LDL-C/HDL-C ratio.

RESULTS

ESRD patients with adjusted 25(OH)D concentrations of 50 nmol/L had significantly higher TC (P = 0.005) and ApoAI (P = 0.049). Significantly higher HDLC (P = 0.011) and ApoAI (P = 0.020) were found in hemodialysis patients with the 25(OH)D concentrations of 50 nmol/L. The other analyzed lipid parameters differed significantly between predialysis, hemodialysis and peritoneal dialysis patients with 25(OH)D concentrations of < 50 nmol/L.

CONCLUSIONS

Our study indicate the significant relationship between 25(OH)D repletion and optimal concentrations of lipid parameters in ESRD patients. Further research is necessary to explain whether joint evaluation of vitamin D status and lipid abnormalities could improve cardiovascular outcome in ESRD patients.

摘要

背景

一些观察性研究表明,25-羟维生素D(25(OH)D)不足与致动脉粥样硬化的胆固醇浓度之间存在关联。本研究的目的是分别调查终末期肾病(ESRD)患者在透析前、血液透析和腹膜透析患者中,25(OH)D浓度与血脂参数之间的关系。

方法

我们使用余弦分析对25(OH)D浓度进行季节性变化调整,并使用这些校正后的25(OH)D浓度进行所有进一步分析。在214例ESRD患者和50例对照组参与者中测定了25(OH)D和血脂参数的浓度。分析包括通过高效液相色谱法测定25(OH)D,通过散射比浊法测定载脂蛋白(Apo)AI、ApoB和Lp(a),通过分光光度法测定总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)和甘油三酯(TG),并手动计算ApoB/ApoAI和LDL-C/HDL-C比值。

结果

校正后25(OH)D浓度为50 nmol/L的ESRD患者的TC(P = 0.005)和ApoAI(P = 0.049)显著更高。25(OH)D浓度为50 nmol/L的血液透析患者的HDLC(P = 0.011)和ApoAI(P = 0.020)显著更高。在25(OH)D浓度<50 nmol/L的透析前、血液透析和腹膜透析患者中,其他分析的血脂参数存在显著差异。

结论

我们的研究表明,25(OH)D补充与ESRD患者血脂参数的最佳浓度之间存在显著关系。有必要进一步研究以解释维生素D状态和脂质异常的联合评估是否可以改善ESRD患者的心血管结局。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2849/7682808/2d1ec84d9aa1/jomb-39-3-2003309M-g001.jpg

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