维生素D_3对高血压病伴糖耐量减低患者炎症因子的影响

Effect of vitamin D_3 on inflammatory factors among patients with high blood pressure and impaired glucose tolerance

目的观察维生素D3对高血压病伴糖耐量减低(IGT)患者血清25-羟维生素D3[25(OH)D3]和炎症因子水平干预效应。方法选择老年患者148例,根据血糖、血压分为高血压病组(69例),IGT组(30例)、高血压病伴IGT组(49例),同期选择健康体检者50例为对照组。测定血清25(OH)D3、肿瘤坏死因子α(TNF-α)、高敏C反应蛋白(hs-CRP)。高血压病组、IGT组及高血压病伴IGT组患者均予维生素D3800U,1次/d,治疗12周后,再次检测3种血清因子水平并进行比较。多组间比较采用单因素方差分析,两组内比较采用t检验,相关分析采用pearson分析,P<0.05为差异有统计学意义。结果高血压病组、高血压病伴IGT组和IGT组25(OH)D3水平低于对照组,差异有统计学意义(F=7.589,P=0.000),hs-CRP、TNF-α水平均高于对照组,差异有统计学意义(F=97.628,5.266,P=0.000、0.004);高血压病伴IGT组25(OH)D3水平低于高血压病组,hs-CRP、TNF-α水平均高于高血压病组,差异有统计学意义(P<0.05);25(OH)D3与血压(r=-0.308,P<0.01),餐后2h血糖(2hPG)呈负相关(r=-0.47,P<0.01),hs-CRP和TNF-α与血压呈正相关(r=0.665,0.809,均P<0.01),与2hPG呈正相关(r=0.966,0.735,均P<0.01)。与治疗前比较,维生素D3干预治疗后25(OH)D3水平均上升,hs-CRP、TNF-α水平下降,差异均有统计学意义(P<0.05)。结论高血压病伴IGT组患者炎性反应较高血压病者严重,维生素D3干预治疗后可减轻炎症反应。

Objective To observe the effect of vitamin D3 on inflammatory factors among patients with high blood pressure（HBP）and impaired glucose tolerance（IGT）. Methods 148 senior patients were enrolled into the study,69 with HBP,30 with IGT and 49 with both.Another 50 healthy seniors served as controls.All patients were given vitamin D3 once a day for 12 weeks.Blood samples were collected and serum levels of HsCRP,TNF-αand 25（OH）D3were determined.at baseline and after vitamin D3 treatment as well.One-way ANOVA and student t test were used for data analysis.Pearson was used for correlation analysis. ResultsThe serum level of 25（OH）D3in patients was lower than that in healthy controls,and much lower in patients with both HBP and IGT than that in patients with only HBP,the differences were statistically significant（F=7.589,P=0.000）.While,the serum levels of hs-CRP and TNF-αin patients were higher than that in healthy controls,and much higher in patients with both HBP and IGT than that in patients with only HBP,the differences were also statistically significant（F=97.628,5.266,P=0.000,0.004）.25（OH）D3level was negatively correlated with blood pressure and 2-hour postprandial blood glucose;while,hs-CRP and TNF-αlevels were positively correlated with blood pressure and 2-hour postprandial blood glucose.After vitamin D3 treatment,the serum levels of hs-CRP and TNF-αdecreased,while 25（OH）D3level increased（P〈0.05）.Glucose were positively correlated.After vitamin D treatment,The levels of hs-CRP、TNF-αwere declined obviously（P〈0.05）. Conclusions Inflammatory factor levels of patients with HBP and IGT are higher than that in patients with only HBP,and intervention with vitamin D3 may reduce the inflammatory reaction.