维生素D缺乏与老年高血压的相关性研究

Correlation between Low Serum 25-hydroxyvitamin D Level and High Arterial Blood Pressure

目的探讨维生素D缺乏与老年高血压的相关性。方法选取2010—2011年在温州医学院附属第一医院门诊就诊或干部病房住院的老年患者316例为研究对象,年龄>60岁,测量并记录其血压水平,抽取静脉血标本,测定血浆25羟基维生素D3(25-OH-Vit D3)和甲状旁腺素(PTH)水平;根据25-OH-Vit D3水平分为维生素D缺乏组(<50 nmol/L)和维生素D不缺乏组(≥50 nmol/L),对比分析两组的收缩压(SBP)、舒张压(DBP)、PTH及血脂水平;并对维生素D缺乏组25-OH-Vit D3水平与SBP、DBP及PTH水平间的关系进行相关性分析及多元线性逐步回归分析。结果维生素D缺乏组与维生素D不缺乏组患者的性别、年龄、体质指数(BMI)、空腹血糖、Ca2+、血浆清蛋白、肌酐清除率、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)水平间差异均无统计学意义(P>0.05);维生素D缺乏组25-OH-Vit D3水平较维生素D不缺乏组降低,而SBP、DBP、PTH水平较维生素D不缺乏组均升高,差异有统计学意义(P<0.05)。维生素D缺乏组的25-OH-Vit D3水平与SBP、DBP、PTH水平均呈负相关(r值分别为-0.710、-0.441和-0.581;P<0.05);进一步行多元线性逐步回归分析结果显示:维生素D缺乏组的SBP(β=-40.258)、DBP(β=19.568)、PTH(β=-12.564)与25-OH-Vit D3有相关性(P<0.05),回归方程为25-OH-Vit D3=35.263-0.126 SBP-12.048 PTH+0.094 DBP,方程F=8.605,P<0.05。结论维生素D缺乏与老年高血压发病相关,适量补充维生素D有可能成为预防和治疗老年高血压的一种简单有效的手段。

Objective To explore the relationship between low serum vitamin D levels and high arterial blood pressure in elderly patients. Methods A total of 316 outpatients and inpatients aged over 60 years treated in our hospital from 2010 to 2011 were enrolled in this study. Blood pressure was measured and recorded and venous blood samples were obtained to deter mine serum 25 hydroxyvitamin D3 （25 OH Vit D3 ） levels and parathyroid hormone （PTH）. These patients were divided into hypovitaminosis group （ 〈50 nmol/L） and non hypovitaminosis group （≥50 nmol/L） based on the 25 OH Vit D3 lev els. The systolic blood pressure （ SBP）, diastolic blood pressure （ DBP）, PTH and blood lipids were measured in both groups, and correlation analysis and multivariate stepwise regression analysis for these indexes were also performed. Results The hypovi taminosis group and non hypovitaminosis group showed no statistically significant differences in terms of gender, age, body mass index, blood glucose, Ca2 ＋ , plasma albumin, creatinine clearance rate, TC, TG and LDL C （ all P 〉 0.05 ）, whereas the 25 OH Vit D3 levels were significantly decreased, the SBP, DBP and PTH were significantly increased in the hypovita minosis D group compared with the non hypovitaminosis group （ P 〈 O. 05 ）. A significantly negative correlation was found be tween serum 25OHVitD3 level and SBP （r= 0.710, P〈0.05）, DBP （r= 0.441, P〈0.05） and PTH （r= 0. 802, P 〈 0. 05 ）. Multivariate stepwise regression analysis showed that in the hypovitaminosis D group, SBP （ [3 = 40. 258 ）, DBP （ [3 = 19. 568 ） and PTH （ ~ = 12. 564） were correlated with 25 OH Vit D3 （ P 〈 0.05 ）, and the formu la was 25 OH Vit D3 = 35. 263 0. 126 SBP 12. 048 PTH ＋ 0. 094 DBP, F = 8. 605, P 〈 0.05. Conclusion Vitamin D deficiency is related to hypertension in the elderly. Appropriate supplementation of vitamin D may be an effective way for the pre vention and treatment of hypertension in elderly people.