Department of Advanced Biomedical Science, Federico II University Hospital, Naples, Italy.
Department of Advanced Biomedical Science, Federico II University Hospital, Naples, Italy; Interdepartmental Center of Research on High Blood Pressure and Related Conditions "CIRIAPA", Federico II University, Naples, Italy.
Nutr Metab Cardiovasc Dis. 2024 Oct;34(10):2298-2304. doi: 10.1016/j.numecd.2024.05.019. Epub 2024 May 27.
Vitamin D deficiency is a common cause of secondary hyperparathyroidism, particularly in elderly people. The aim of this study was to evaluate the associations of serum vitamin D and parathormone (PTH) concentrations with blood pressure values and hypertension-mediated target organ damage (HMOD), including left ventricular (LV) hypertrophy and carotid plaque (CP).
We enrolled consecutive patients admitted to the Hypertension Center of Federico II University Hospital in Naples, Italy. All patients underwent carotid doppler ultrasound and echocardiography, measurement of vitamin D and PTH levels and main clinical and laboratory parameters. A total of 126 patients (mean age 54 years, 68% males) were enrolled. Pearson's correlation analysis indicated that PTH levels directly correlated with age, diabetes, dyslipidemia, hypertension, fasting glucose, and LV mass, and inversely with glomerular filtration rate, LDL cholesterol, and vitamin D. Vitamin D levels correlated inversely with PTH, diabetes and CP. Multivariate regression models indicated that an increased LV mass was associated with the presence of obesity (β = 0.342; P = 0.001). Maximal intima-media thickness was significantly associated with older age (β = 0.303; P = 0.033). Combined presence of low vitamin D/high PTH levels were associated with more than 4-fold increased risk of having CP in both univariate (OR = 4.77, p = 0.0001) and multivariate regression analysis (OR = 4.52, p = 0.014).
In a population at high cardiovascular risk, vitamin D and PTH levels were not directly associated with blood pressure values and HMOD. Secondary hyperparathyroidism due to vitamin D deficiency is associated with carotid atherosclerosis independently of other common cardiovascular risk factors.
维生素 D 缺乏是导致继发性甲状旁腺功能亢进症的常见原因,尤其是在老年人中。本研究旨在评估血清维生素 D 和甲状旁腺激素(PTH)浓度与血压值和高血压介导的靶器官损伤(HMOD)之间的相关性,包括左心室(LV)肥厚和颈动脉斑块(CP)。
我们连续纳入了意大利那不勒斯 Federico II 大学医院高血压中心收治的患者。所有患者均接受了颈动脉多普勒超声和超声心动图检查,测量了维生素 D 和 PTH 水平以及主要的临床和实验室参数。共纳入 126 例患者(平均年龄 54 岁,68%为男性)。Pearson 相关分析表明,PTH 水平与年龄、糖尿病、血脂异常、高血压、空腹血糖和 LV 质量直接相关,与肾小球滤过率、LDL 胆固醇和维生素 D 水平呈负相关。维生素 D 水平与 PTH、糖尿病和 CP 呈负相关。多元回归模型表明,LV 质量增加与肥胖有关(β=0.342;P=0.001)。最大内膜-中层厚度与年龄较大显著相关(β=0.303;P=0.033)。在单因素和多因素回归分析中,低维生素 D/高 PTH 水平的同时存在与 CP 的风险增加 4 倍以上相关(OR=4.77,p=0.0001;OR=4.52,p=0.014)。
在心血管风险较高的人群中,维生素 D 和 PTH 水平与血压值和 HMOD 无直接关系。维生素 D 缺乏引起的继发性甲状旁腺功能亢进症与颈动脉粥样硬化有关,与其他常见心血管危险因素无关。