稳定型心绞痛患者的血维生素D浓度和循环内皮祖细胞的关系

摘要

Objective To evaluate the relationship between 25 - hydroxyvitamin D3 [ 25 ( OH) D3 ] and circulating endothelial progenitor cells (EPCs) in patients with stable coronary artery disease. Methods A total of 320 patients with stable coronary artery disease obtained from our reference area were enrolled in this sudy. A medical record, arterial BP and biological analysis in duding serum 25 (0H)D3 , PTH, blood glucose, cholesterol and the levels of circulating EPCs were obtained. Patients were divided into four groups according to the serum 25(OH)D3 levels (Ql: < 20. 25nmol/L,78 cases; Q2:20.25 - 27. 57nmol/L,82 cases; Q3 :27. 57 - 34. 89nmol/ L,83 cases;Q4: >34. 89nmol/L,77 cases). Results 25(OH)D3 of Ql group with circulating EPCs [(0.024 -.015)%] were lower than that of Q4 group which with EPCs (0.036 -.018)% , P <0.05. Pearson correlation analysis showed that circulating EPCs levels was positively correlated with serum 25 ( OH) D3 levels( r = 0. 523 ,P < 0. 05 ) . Multivariate regression analysis showed that 25( OH) D3concentration was an independent predictor of circulating EPCs levels in this cohort(β 10. 87 ,P <0. 05). Conclusion Serum 25( OH) D3 concentration is positively correlated with EPCs levels and lower 25 (OH) D3 concentration may be a risk factor to predict acute cardiovascular occurrence in patients with stable coronary artery disease.%目的 探讨在稳定型心绞痛患者中血清维生素D浓度同循环EPCs水平的相关性及临床意义.方法 入选320例稳定型心绞痛患者,用电化学发光法检测检测血清25(OH)D3浓度、流式细胞术分析循环内皮祖细胞(EPCs)水平,同时检测血糖、血脂、甲状旁腺激素(PTH)等生化指标.根据血清25(OH)D3浓度的四分位数分为4组:Q1组(＜20.25nmol/L,78例),Q2组(20.25～27.57nmol/L,82例),Q3组(27.57～34.89nmol/L,83例),Q4组(＞34.89nmol/L,77例),分析25(OH)D3浓度与循环EPCs的相关性.结果 在稳定型心绞痛患者中,血清25(OH)D3低浓度组的循环EPCs水平(0.024±0.015)％比高浓度组的循环EPCs水平(0.036±0.018)％下降有统计学意义(P＜0.05),Pearson相关分析显示血清25(OH)D3浓度与循环EPCs呈正相关(r =0.523,P＜0.05),进一步多元回归分析发现循环EPCs与血清25(OH)D3具有独立相关性(β=10.87,P＜0.05).结论 稳定型心绞痛患者的血清25(OH)D3浓度降低是循环EPCs水平下降的独立危险因素,推测血清25(OH)D3浓度的下降也可以预测心血管危险事件发生的风险.