老年高血压患者25-羟维生素D水平与动脉僵硬度和左心室肥厚的关系

摘要

目的 探讨老年原发性高血压患者25-羟维生素D水平与动脉僵硬度、左心室肥厚(LVH)的关系. 方法 选择166例老年原发性高血压患者,测量患者颈股动脉脉搏波传导速度(cfPWV);超声心动图评价左室质量指数(LVMI),采用电化学发光法测定血清25羟维生素D水平,根据患者25-羟维生素D水平将患者分为两组,低25-羟维生素D水平组(25-羟维生素D水平＜20μg/L)和高25-羟维生素D水平组(25-羟维生素D水平≥20 μg/L). 结果 低25-羟维生素D组cfPWV、LVMI值分别为(15.00±3.04) m/s、(120.14±25.82) g/m2,均高于高25羟维生素D组(11.26±3.09)m/s、(96.74±23.10)g/m2(t=6.79、-5.16,均P=0.000).多元线性回归分析结果显示,除外年龄、性别的影响,25羟维生素D水平与LVMI(β=-0.215,P=0.001)和cfPWV(β=-0.469,P＜0.001)相关. 结论 血清25-羟维生素D水平与动脉僵硬度、左室肥厚相关,维生素D可能在老年高血压患者动脉僵硬度和左室肥厚中起着重要的作用.%Objective To examine the association of serum 25-hydroxyvitamin D levels with arterial stiffness and left ventricular hypertrophy (LVH) in elderly hypertension patients.Methods We recruited 166 elderly patients [mean age,(80.8 ± 6.2) years] with primary hypertension.Arterial stiffness was assessed by carotid femoral pulse wave velocity (cfPWV).Left ventricular mass index (LVMI) was determined according to the Devereux formula.Based on serum 25-hydroxyvitamin D levels,the patients were divided into two groups,the low 25-hydroxyvitamin D group (＜20 μg/L)and the high 25-hydroxyvitamin D group (≥20 μg/L).Results Faster cfPWV and larger LVMI values were observed in the low 25-hydroxyvitamin D group as compared with the high 25-hydroxyvitamin Dgroup [(15.00±3.04) m/s vs.(11.26±3.09) m/s;(120.14±25.82) g/m2 vs.(96.74±23.10) g/m2 ; t=-6.79,-5.16,respectively; both P=0.000].Multiple liner regression analysis showed that the 25-hydroxyvitamin D level was independently associated with LVMI (β=0.215,P=0.001) and cfPWV (β=-0.469,P＜0.001).Conclusions Serum 25-hyroxyvitamin D is independently associated with arterial stiffness,LVH Vitamin D may play an important role in the pathogenesis of arterial stiffness and LVH in elderly hypertension patients.