维生素D对冠心病的发生及病变程度的影响

罗梦莹; 邹德玲

doi:10.13201/j.issn.1001-1439.2021.06.009

维生素D对冠心病的发生及病变程度的影响

罗梦莹,
邹德玲^,

- 中国医科大学附属盛京医院心内科(沈阳,110004)

详细信息

通讯作者: 邹德玲,E-mail:zoudl@sj-hospital.org

中图分类号: R541.4

收稿日期: 2020-12-28

Effect of vitamin D level on the occurrence and severity of coronary atherosclerotic heart disease

LUO Mengying,
ZOU Deling^,

- Department of Cardiology,Shengjing Hospital of China Medical University, Shenyang, 110004, China

More Information

Corresponding author: ZOU Deling, E-mail: zoudl@sj-hospital.org

Received Date: 28 December 2020

摘要

摘要: 目的:探讨维生素D与冠心病发生及其病变程度的相关性。方法:选取中国医科大学附属盛京医院心内科行冠状动脉(冠脉)造影的患者261例,其中冠心病组194例,造影结果排除冠心病者67例为对照组。应用Gensini评分系统对冠心病组患者冠脉病变程度进行定量评分,并将其分为3个亚组:低危组(Gensini评分<25分,68例),中危组(25分≤Gensini评分≤69分,72例),;高危组(Gensini评分>69分,54例)。比较4组患者一般临床资料及血清25-羟基维生素D(25-OHD)水平差异。应用Spearman检验分析病变程度与血清25-OHD、低密度脂蛋白胆固醇(LDL-C)及高密度脂蛋白胆固醇(HDL-C)的相关性。应用logistic回归分析冠心病的独立危险因素。结果:冠心病组25-OHD水平低于正常水平,并低于对照组,差异有统计学意义(P<0.05);Gensini评分高危组患者血清25-OHD水平分别低于中危组及低危组患者,中危组血清25-OHD水平低于低危组患者,均差异有统计学意义(均P<0.05)。相关性分析显示,冠脉病变程度与血清25-OHD与HDL-C水平呈负相关(均P<0.05)。Logistic回归分析显示,血清25-OHD缺乏为冠心病的危险因素。结论:冠心病患者血清维生素D水平低于正常值,并明显低于非冠心病患者。血清维生素D水平越低,患者冠脉病变程度越重。血清维生素D缺乏为冠心病的危险因素,可能与冠心病的发生发展密切相关。
- 冠心病 /
- 血清25-OHD /
- Gensini评分
Abstract: Objective: To explore the relationship between vitamin D and the occurrence and severity of coronary atherosclerotic heart disease.Methods: 261 patients who underwent coronary angiography at the Department of Cardiology from Shengjing Hospital Affiliated to China Medical University were selected, including 194 patients with coronary heart disease(CHD group), and 67 cases without coronary heart disease(control group). All patients in the CHD group were divided into three subgroups according to the Gensini score: low-risk group(Gensini score<25 points, n=68), intermediate-risk group(25 points≤Gensini score≤69 points, n=72), high-risk group(Gensini score>69 points, n=54). General clinical data and 25-hydroxy-vitamin D(25-OHD) were compared among groups. Spearman analysis was used to analyze the correlation between the degree of coronary lesions and serum 25-OHD, low density lipoprotein(LDL-C), and high density lipoprotein(HDL-C). Logistic regression analysis was used to analyze the independent risk factors of coronary heart disease.Results: The 25-OHD level in the CHD group was lower than the normal level and lower than that in the control group(both P<0.05). In particular, the serum 25-OHD level in the high-risk group was lower than that in the intermediate-risk and middle-risk group, and the serum 25-OHD level in the medium risk group was lower than that in the low-risk group(all P<0.05). Correlation analysis showed that the degree of coronary artery disease was negatively correlated with serum 25-OHD level and HDL-C(P<0.05). Logistic regression analysis showed that serum 25-OHD deficiency was a risk factor for coronary heart disease.Conclusion: Serum vitamin D levels in patients with coronary heart disease are lower than the normal level and significantly lower than those in patients without coronary heart disease. The lower the level of serum vitamin D, the more severe the coronary artery disease. Serum vitamin D deficiency is a risk factor of coronary heart disease, which may be closely related to the occurrence and development of coronary heart disease.
- coronary heart disease /
- serum 25-OHD /
- Gensini score

HTML全文

参考文献(23)

[1]	高秀鑫,丁振江,王文丰,等.三酰甘油/高密度脂蛋白胆固醇比值与冠心病的患病风险[J].临床心血管病杂志,2019,35(12):1085-1088.
[2]	Safaie N,Rezaee H,Seif Dvati B,et al.Vitamin D deficiency predicts the ST elevation type of myocardial infarction in patients with acute coronary syndrome[J].Iran J Pharm Res,2018,17(Suppl):73-78.
[3]	王平善.不同剂量阿托伐他汀对冠心病冠状动脉搭桥术患者术后血脂和心功能的影响[J].蚌埠医学院学报,2015,(6):746-748.
[4]	王文倩.高血压患者Cys-C、uACR和eGFR与冠心病及Gensini积分的相关性研究[D].天津医科大学,2016.
[5]	Al-Dabhani K,Tsilidis KK,Murphy N,et al.Prevalence of vitamin D deficiency and association with metabolic syndrome in a Qatari population[J].Nutr Diabetes,2017,7(4):e263.
[6]	Nath RK,Soni DK.Retrograde non trans-septal balloon mitral valvotomy in mitral stenosis with interrupted inferior vena cava,left superior vena cava,and hugely dilated coronary sinus[J].Catheter Cardiovasc Interv,2015,86(7):1289-1293.
[7]	Mahdavi K,Amirajam Z,Yazdankhah S,et al.The prevalence and prognostic role of vitamin D deficiency in patients with acute coronary syndrome:a single centre study in South-West of Iran[J].Heart Lung Circ,2013,22(5):346-351.
[8]	Verdoia M,Schaffer A,Sartori C,et al.Vitamin D deficiency is independently associated with the extent of coronary artery disease[J].Eur J Clin Invest,2014,44(7):634-642.
[9]	Di Liberto D,Scazzone C,La Rocca G,et al.Vitamin D increases the production of IL-10 by regulatory T cells in patients with systemic sclerosis[J].Clin Exp Rheumatol,2019,37 Suppl 119(4):76-81.
[10]	Yiu YF,Yiu KH,Siu CW,et al.Randomized controlled trial of vitamin D supplement on endothelial function in patients with type 2 diabetes[J].Atherosclerosis,2013,227(1):140-146.
[11]	Carvalho LS,Sposito AC.Vitamin D for the prevention of cardiovascular disease:Are we ready for that?[J].Atherosclerosis,2015,241(2):729-740.
[12]	Yao T,Ying X,Zhao Y,et al.Vitamin D receptor activation protects against myocardial reperfusion injury through inhibition of apoptosis and modulation of autophagy[J].Antioxid Redox Signal,2015,22(8):633-650.
[13]	Hoseini R,Damirchi A,Babaei P.Vitamin D increases PPARγ expression and promotes beneficial effects of physical activity in metabolic syndrome[J].Nutrition,2017,36:54-59.
[14]	Wang L,Wang H,Wen H,et al.Relationship between HOMA-IR and serum vitamin D in Chinese children and adolescents[J].J Pediatr Endocrinol Metab,2016,29(7):777-781.
[15]	吴树兴,林静娜.维生素D水平与冠状动脉狭窄严重程度的关系[J].继续医学教育,2017,31(12):105-106.
[16]	韩桂芬.维生素D如何影响心脏病和糖尿病[J].基础医学与临床,2015,35(12):1681.
[17]	Institute of Medicine (US) Committee to Review Dietary Reference Intakes for Vitamin D and Calcium.Dietary reference intakes for calcium and vitamin D[M].National Academies Press(US),2011.
[18]	van Ballegooijen AJ,Kestenbaum B,Sachs MC,et al.Association of 25-hydroxyvitamin D and parathyroid hormone with incident hypertension:MESA(Multi-Ethnic Study of Atherosclerosis)[J].J Am Coll Cardiol,2014,63(12):1214-1222.
[19]	Cao P,Huang G,Yang Q,et al.The effect of chitooligosaccharides on oleic acid-induced lipid accumulation in HepG2cells[J].Saudi Pharm J,2016,24(3):292-298.
[20]	Timms PM,Mannan N,Hitman GA,et al.Circulating MMP9,vitamin D and variation in the TIMP-1response with VDR genotype:mechanisms for inflammatory damage in chronic disorders?[J].QJM,2002,95(12):787-796.
[21]	Gepner AD,Ramamurthy R,Krueger DC,et al.A prospective randomized controlled trial of the effects of vitamin D supplementation on cardiovascular disease risk[J].PLoS One,2012,7(5):e36617.
[22]	Mohammad AM,Shammo NA,Jasem JA.Vitamin D status in acute myocardial infarction:a case-control study[J].Cardiovasc Endocrinol Metab,2018,7(4):93-96.
[23]	周小莉,王一春,石惠.补充维生素D对冠心病患者冠状动脉病变程度的影响[J].中国临床医学,2020,27(1):60-64.