维生素D缺乏与慢性肾脏病患者血管内皮细胞功能异常的相关性研究

摘要

Objective To investigate the correlation between vitamin D deficiency and endothelial dysfunction in patients with non-dialysis chronic kidney disease (CKD).Methods Patients with non-dialysis CKD and a stable clinical state were enrolled in this study.Vitamin D status of the patients was determined using serum 25-hydroxyvitamin D.Endothelial function was assessed by brachial artery flow-mediated dilation (FMD).Results Of 139 patients enrolled,there were 71 (51.08％) cases of vitamin D deficiency,58 (41.73％) cases of vitamin D insufficiency and only 10 had normal vitamin D level.Patients with vitamin D deficiency and insufficiency had lower brachial artery FMD than patients with sufficient vitamin D level with the lowest level observed in vitamin D deficient group.Correlation analysis showed a positive correlation between FMD and 25(OH)D (r =0.623,P＜0.01).The multiple regression analysis revealed vitamin D deficiency was an independent risk factor for endothelial dysfunction (β =0.418,P＜0.01).Conclusions Vitamin D deficiency was associated with endothelial dysfunction in patients with non-dialysis CKD.Vitamin D supplementation may improve endothelial function in these patients.%目的 观察慢性肾脏病(CKD)患者血清25-羟维生素D水平与血管内皮细胞功能异常的相关性.方法 选取病情稳定的非透析CKD患者为研究对象,以血流介导的血管舒张功能(FMD)作为评价血管内皮细胞功能的指标,观察血清25-羟维生素D水平与FMD的相关性.结果 符合条件的139例患者进入本研究,血清25-羟维生素D缺乏、不足及正常的患者分别为71例(51.(08％)、58例(41.73％)和10例(7.19％).25-羟维生素D缺乏与不足患者的肱动脉FMD低于25-羟维生素D水平正常者,并以缺乏组患者的FMD最低.相关分析显示,血清25-羟维生素D与肱动脉FMD呈显著正相关(r=0.623,P＜0.01),多因素回归分析显示血清25-羟维生素D水平降低是血管内皮细胞损伤的独立危险因素(β=0.418,P＜0.01).结论 血清25-羟维生素D水平降低是非透析CKD患者血管内皮细胞功能异常的独立危险因素,补充25-羟维生素D可能有助于改善患者的内皮细胞功能.