维生素D缺乏与系统性硬化症中的心血管受累：与超声心动图参数及危险因素的关联

Vitamin D insufficiency and cardiovascular involvement in systemic sclerosis: Association with echocardiographic parameters and risk factors.

作者信息

Pagnoni Gianluca, Giuggioli Dilia, de Pinto Marco, Maini Arianna, Battigaglia Elisa, Macripò Pierluca, Spinella Amelia, Olivetti Giulia, Manenti Antonio, Pinti Marcello, Boriani Giuseppe, Aschieri Daniela, Mattioli Anna Vittoria, Fedele Francesco, Coppi Francesca

机构信息

Cardiology Unit of Emergency Department, Guglielmo da Saliceto Hospital, 29121, Piacenza, Italy.

Rheumatology Unit, Azienda Ospedaliero-Universitaria Policlinico di Modena, University of Modena and Reggio Emilia, Modena, Italy.

出版信息

Int J Cardiol Cardiovasc Risk Prev. 2025 Aug 26;27:200502. doi: 10.1016/j.ijcrp.2025.200502. eCollection 2025 Dec.

DOI:10.1016/j.ijcrp.2025.200502

PMID:40978573

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12445228/

Abstract

BACKGROUND

Vitamin D plays several roles beyond bone metabolism, potentially protecting the cardiovascular system. Systemic sclerosis (SSc) is an autoimmune disease characterized by fibrosis and vascular dysfunction, carrying a high cardiovascular risk. However, the relationship between vitamin D insufficiency and cardiovascular involvement in SSc patients remains unclear. This study aims to assess the association between low vitamin D levels, echocardiographic parameters indicative of ventricular dysfunction, and cardiovascular risk factors in SSc patients.

METHODS

A retrospective observational study involved 160 SSc patients undergoing echocardiography and serum 25-hydroxyvitamin D measurement. Patients were categorized into two groups: vitamin D insufficiency (<30 ng/mL) and normal levels (≥30 ng/mL). Echocardiographic parameters and cardiovascular risk factors were evaluated.

RESULTS

Vitamin D insufficiency was detected in 68.9 % of patients. Patients with insufficient vitamin D had higher systolic pulmonary arterial pressure (PAPs; 37.68 ± 7.56 mmHg vs. 33.12 ± 6.17 mmHg; p = 0.004), reduced TAPSE/PAPs ratio (0.65 ± 0.13 vs. 0.72 ± 0.14; p = 0.021), increased interventricular septal thickness (8.17 ± 1.28 mm vs. 7.69 ± 1.18 mm; p = 0.028), and greater left ventricular end-diastolic diameter (44.06 ± 4.28 mm vs. 42.67 ± 3.44 mm; p = 0.037), indicating ventricular dysfunction. Vitamin D insufficiency significantly correlated with hypertension (OR = 2.31; p = 0.032), dyslipidemia (OR = 2.45; p = 0.015), and overweight/obesity (OR = 4.73; p = 0.002), but not with diabetes or smoking.

CONCLUSIONS

Vitamin D insufficiency may contribute to cardiovascular dysfunction in SSc patients. Monitoring vitamin D levels might improve cardiovascular risk stratification. Further studies are necessary to determine if supplementation could enhance cardiac outcomes.

摘要

背景

维生素D在骨代谢之外还发挥多种作用，可能对心血管系统起到保护作用。系统性硬化症（SSc）是一种以纤维化和血管功能障碍为特征的自身免疫性疾病，具有较高的心血管疾病风险。然而，维生素D缺乏与SSc患者心血管受累之间的关系仍不明确。本研究旨在评估SSc患者中低维生素D水平、提示心室功能障碍的超声心动图参数与心血管危险因素之间的关联。

方法

一项回顾性观察性研究纳入了160例行超声心动图检查和血清25-羟基维生素D检测的SSc患者。患者被分为两组：维生素D缺乏组（<30 ng/mL）和正常水平组（≥30 ng/mL）。评估超声心动图参数和心血管危险因素。

结果

68.9%的患者检测出维生素D缺乏。维生素D缺乏的患者收缩期肺动脉压更高（37.68±7.56 mmHg对33.12±6.17 mmHg；p = 0.004），TAPSE/PAPs比值降低（0.65±0.13对0.72±0.14；p = 0.021），室间隔厚度增加（8.17±1.28 mm对7.69±1.18 mm；p = 0.028），左心室舒张末期直径更大（44.06±4.28 mm对42.67±3.44 mm；p = 0.037），提示心室功能障碍。维生素D缺乏与高血压（OR = 2.31；p = 0.032）、血脂异常（OR = 2.45；p = 0.015）和超重/肥胖（OR = 4.73；p = 0.002）显著相关，但与糖尿病或吸烟无关。