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通过纠正维生素 D 状态提高高密度脂蛋白胆固醇水平,可显著降低维生素 D 缺乏的阿拉伯成年人 10 年动脉粥样硬化性心血管疾病风险评分。

Improved HDL Cholesterol through Vitamin D Status Correction Substantially Lowers 10-Year Atherosclerotic Cardiovascular Disease Risk Score in Vitamin D-Deficient Arab Adults.

机构信息

Biochemistry Department, College of Science, King Saud University, Riyadh 11451, Saudi Arabia.

Sunlight, Nutrition and Health Research Center, P.O. Box 641603, San Francisco, CA 94164-1603, USA.

出版信息

Nutrients. 2023 Jan 20;15(3):551. doi: 10.3390/nu15030551.

Abstract

This interventional study aimed to determine whether correcting vitamin D status in deficient Arab adults [25(OH)D <50 nmol/L] improves their 10-year risk of Atherosclerotic Cardiovascular Disease (ASCVD) risk scores. Saudi adults (58 males 62 females) with baseline vitamin D deficiency (<50 nmol/L) were given 50,000 IU cholecalciferol weekly for 2 months, then twice a month, followed by daily 1000 IU until month 6. Fasting blood samples were collected pre- and post-intervention and assessed for glucose, lipids, and 25(OH)D levels. The predicted 10-year ASCVD risk scores were calculated at baseline and after intervention. At baseline, significantly higher 10-year ASCDV risk scores were observed in males than females (9% vs. 3%, < 0.001). After 6 months, only 21% (25 out of 120) achieved 25(OH)D levels above optimal level (≥75 nmol/L). While modest improvements were seen in glucose and lipid profiles, only HDL cholesterol showed favorable significant changes in all participants, which translated to significantly improved 10-year ASCVD risk scores independent of whether they achieved optimum vitamin D status. Still, those who achieved optimal vitamin D levels had a modestly larger decrease in ASCVD risk scores than those with less optimal 25(OH)D levels (-23% versus -18%) and this improvement was slightly more pronounced in males (-26% versus -10%, or 16% improvement) than females (-47% versus -32%, or 15% improvement). In conclusion, vitamin D status correction significantly enhances HDL cholesterol which prospectively reduces 10-year ASCVD risk as vitamin D levels approach optimum status among adult Arabs with baseline vitamin D deficiency. This improvement appears to be slightly more apparent in males than females.

摘要

本介入性研究旨在确定纠正缺乏维生素 D 的阿拉伯成年人(25(OH)D<50nmol/L)的维生素 D 状态是否能改善他们的 10 年动脉粥样硬化性心血管疾病(ASCVD)风险评分。研究纳入了基线维生素 D 缺乏(<50nmol/L)的沙特成年人(58 名男性,62 名女性),他们每周接受 50,000IU 胆钙化醇治疗 2 个月,然后每 2 个月一次,接着在第 6 个月前每天服用 1000IU。在干预前后采集空腹血样,检测血糖、血脂和 25(OH)D 水平。在基线和干预后计算预测的 10 年 ASCVD 风险评分。基线时,男性的 10 年 ASCVD 风险评分显著高于女性(9%对 3%,<0.001)。6 个月后,只有 21%(25 名/120 名)的患者达到了 25(OH)D 水平高于最佳水平(≥75nmol/L)。虽然血糖和血脂谱有所改善,但只有高密度脂蛋白胆固醇在所有参与者中显示出有利的显著变化,这与是否达到最佳维生素 D 状态无关,可显著降低 10 年 ASCVD 风险评分。然而,与那些维生素 D 水平不太理想的患者相比(-23%对-18%),达到最佳维生素 D 水平的患者的 ASCVD 风险评分下降幅度略大(-26%对-10%,或改善 16%),这种改善在男性中比女性中更为明显(-47%对-32%,或改善 15%)。总之,维生素 D 状态的纠正显著提高了高密度脂蛋白胆固醇,这使得在基线维生素 D 缺乏的阿拉伯成年人中,随着维生素 D 水平接近最佳状态,前瞻性地降低了 10 年 ASCVD 风险。这种改善在男性中似乎比女性更明显。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/49ce/9921125/dac7d408172f/nutrients-15-00551-g001.jpg

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