原发性高血压患者血浆25羟基维生素D与血浆肾素活性、血压及动脉弹性的相关性

Correlation of 25-hydroxyvitamin D with renin activity,blood pressure and arterial elasticity of patients with essential hypertension

目的探讨高血压患者血浆25羟基维生素DE25（OH）D]水平与血压、动脉弹性的关系以及血浆肾素活性（PRA）在此关系中的作用。方法检测未经治疗高血压患者531例的血压、臂踝动脉脉搏波传导速度（baPWV）、血浆25（OH）D浓度及PRA，按血浆25（OH）D水平将患者分为25（OH）D缺乏组[26（OH）D≤20μg／L，n=184]、25（OH）D不足组（20～〈30μg／L，n=306）和25（OH）D充足组E25（OH）D≥30μg／L，n=41]，比较3组间上述各指标水平的差异。采用Pearson相关和偏相关分析25（OH）D和收缩压、脉压、baPWV、PRA的相关性，采用多元线性回归分析PRA的相关影响因素。结果高血压患者中25（OH）D缺乏者占34．7％，不足者占57．6％，25（OH）D充足者占7．7％；女性25（OH）D均值低于男性[（21．93±4．95）比（22．82±4．81）μg／L，P〈0．05]。女性矿下工作者中维生素D充足的比例低于矿上工作者（2．8％比12．5％）。高血压患者血浆25（OH）D水平与收缩压、脉压及baPWV无明显相关。高血压患者血浆25（0H）D水平与PRA呈负相关（r=-0．27，P〈0．01）。此种相关性在青年中更明显（r=一0．30，P〈0．01）。多元回归分析提示，25（OH）D和血浆三酰甘油水平与PRA密切相关（P〈0．01）。结论开滦煤矿高血压患者中25（0H）D缺乏及不足现象十分普遍，矿下工作者中维生素D充足的比例低于矿上工作者；25（OH）D水平与PRA呈负相关，此种相关性在青年中更明显。

Objective To investigate the relationship between 25-hydroxyvitamin(OH)D[25(OH)D]level and blood pressure,arterial elasticity in patients with hypertension,as well as the impact of plasma renin activity(PRA) on this relationship. Methods Blood pressure and brachial-ankle pulse wave velocity(baPWV)in 531hypertensive patients were determined,concentration of 25(OH)D and PRA were measured. According to the 25(OH)D levels, patients were divided into 25(OH)D deficient group[25(OH)D≤20μg/L,n=184],25(OH)D insufficient group [20-<30μg/L,n=306]and 25(OH)D sufficiency group[25(OH)D≥30μg/L,n=41]. The differences in above index of the three groups were compared. Pearson correlation analysis and partial correlation analysis were used to explore the correlation of 25(OH)D with systolic blood pressure,pulse pressure,baPWV and PRA. Multiple liner regression analysis was used to analyse the factors related to PRA. Results Among patients with hypertension,those with 25(OH)D deficiency,insufficiency and sufficiency were accounted for 34.7%,57.6% and 7.7%,respectively. The mean concentration of 25(OH)D was lower in female than in male[(21.93±4.95)vs(22.82±4.81)μg/L,P<0.05];25(OH)D sufficiency rate was lower in mine workers than in field workers(2.8% vs 12.5%). There was no remarkable correlation between serum 25(OH)D level and systolic blood pressure,pulse pressure and baPWV. But 25(OH)D level negatively correlated with PRA(r=-0.27,P <0.01). This correlation was more remarkable in young patients(r=-0.30,P<0.01). Multiple linear regression analysis indicated that 25(OH)D and plasma triglyceride levels were closely correlated with PRA(P < 0.01). Conclusions Vitamin D deficiency and insufficiency are very common in hypertensive patients in Kailuan Coal Group. The rate of 25(OH)D sufficiency is lower in mine workers than in field workers. Vitamin D level is negatively correlated with PRA,which is especially significant in youth.