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皮肤色素沉着与循环维生素 D 浓度和皮肤微血管内皮功能呈负相关。

Skin pigmentation is negatively associated with circulating vitamin D concentration and cutaneous microvascular endothelial function.

机构信息

Department of Kinesiology, The Pennsylvania State University, University Park, Pennsylvania.

Graduate Program in Physiology, The Pennsylvania State University, University Park, Pennsylvania.

出版信息

Am J Physiol Heart Circ Physiol. 2022 Sep 1;323(3):490-498. doi: 10.1152/ajpheart.00309.2022. Epub 2022 Aug 5.

Abstract

Darkly pigmented individuals are at the greatest risk of hypovitaminosis D, which may result in microvascular endothelial dysfunction via reduced nitric oxide (NO) bioavailability and/or increased oxidative stress and inflammation. We investigated the associations among skin pigmentation (M-index; skin reflectance spectrophotometry), serum vitamin D concentration [25(OH)D], circulating inflammatory cytokine (TNF-α, IL-6, and IL-10) concentrations, and the NO contribution to local heating-induced cutaneous vasodilation (%NO-mediated vasodilation) in a diversely pigmented cohort of young adults. An intradermal microdialysis fiber was placed in the forearms of 33 healthy adults (14 men/19 women; 18-27 yr; M-index, 30-81 AU) for local delivery of pharmacological agents. Lactated Ringer's solution was perfused through the fiber during local heating-induced (39°C) cutaneous vasodilation. After attaining stable elevated blood flow, 15 mM -nitro-l-arginine methyl ester (l-NAME; NO synthase inhibiter) was infused to quantify %NO-mediated vasodilation. Red cell flux was measured (laser-Doppler flowmetry; LDF) and cutaneous vascular conductance (CVC = LDF/MAP) was normalized to maximal (%CVC; 28 mM sodium nitroprusside + 43°C). Serum [25(OH)D] and circulating cytokines were analyzed by ELISA and multiplex assay, respectively. M-index was negatively associated with [25(OH)D] ( = -0.57, < 0.0001) and %NO-mediated vasodilation ( = -0.42, = 0.02). Serum[25(OH)D] was positively related to %NO ( = 0.41, = 0.02). Controlling for [25(OH)D] weakened the association between M-index and %NO-mediated dilation ( = 0.16, = -0.26). There was a negative curvilinear relation between [25(OH)D] and circulating IL-6 ( = -0.56, < 0.001), but not TNF-α or IL-10 ( ≥ 0.14). IL-6 was not associated with %NO-mediated vasodilation ( = 0.44). These data suggest that vitamin D insufficiency/deficiency may contribute to reduced microvascular endothelial function in healthy, darkly pigmented young adults. Endothelial dysfunction, an antecedent to hypertension and overt CVD, is commonly observed in otherwise healthy Black adults, although the underlying causes remain unclear. We show that reduced vitamin D availability with increasing degrees of skin pigmentation is associated with reduced microvascular endothelial function, independent of race or ethnicity, in healthy young adults. Greater prevalence of vitamin D deficiency in more darkly pigmented individuals may predispose them to increased risk of endothelial dysfunction.

摘要

肤色较深的人患维生素 D 缺乏症的风险最高,这可能导致微血管内皮功能障碍,表现为一氧化氮(NO)生物利用度降低和/或氧化应激和炎症增加。我们在一个不同肤色的年轻成年人队列中研究了皮肤色素沉着(M 指数;皮肤反射分光光度计)、血清维生素 D 浓度[25(OH)D]、循环炎症细胞因子(TNF-α、IL-6 和 IL-10)浓度与局部加热诱导的皮肤血管舒张的 NO 贡献(%NO 介导的血管舒张)之间的关联(局部加热诱导(39°C)皮肤血管舒张时,在 33 名健康成年人(14 名男性/19 名女性;18-27 岁;M 指数 30-81AU)的前臂放置了一个皮内微透析纤维,用于局部输送药物。在达到稳定的升高血流后,输注 15mM-硝基-L-精氨酸甲酯(l-NAME;一氧化氮合酶抑制剂)以量化%NO 介导的血管舒张。用激光多普勒血流仪(LDF)测量红细胞通量,并将皮肤血管传导性(CVC=LDF/MAP)归一化为最大(%CVC;28mM 硝普钠+43°C)。通过 ELISA 和多重测定法分别分析血清[25(OH)D]和循环细胞因子。M 指数与[25(OH)D]呈负相关(= -0.57,<0.0001)和%NO 介导的血管舒张(= -0.42,= 0.02)。血清[25(OH)D]与%NO 呈正相关(= 0.41,= 0.02)。控制[25(OH)D]后,M 指数与%NO 介导的扩张之间的相关性减弱(= 0.16,= -0.26)。[25(OH)D]与循环 IL-6 呈负曲线关系(= -0.56,<0.001),但与 TNF-α或 IL-10 无关(≥0.14)。IL-6 与%NO 介导的血管舒张无关(= 0.44)。这些数据表明,维生素 D 不足/缺乏可能导致健康的深色皮肤年轻成年人微血管内皮功能下降。内皮功能障碍是高血压和明显心血管疾病的前兆,在其他方面健康的黑人成年人中很常见,尽管其潜在原因尚不清楚。我们表明,随着皮肤色素沉着程度的增加,维生素 D 可用性的降低与微血管内皮功能的降低有关,这与种族或民族无关,在健康的年轻成年人中。在肤色较深的人中,维生素 D 缺乏症的患病率更高,这可能使他们更容易患内皮功能障碍。

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