血清25羟基维生素D3与冠状动脉病变相关性研究

The study on relation between 25-hydroxyvitamin D3 and coronary artery disease

目的探讨血清25羟基维生素D3[25（OH）D3]水平对冠状动脉病变及其狭窄程度的影响。 方法 310例行选择性冠状动脉造影（CAG）患者，按造影结果分为两组：非冠状动脉狭窄组76例、冠状动脉狭窄组234例。冠状动脉狭窄程度采取国际通用的Gensini评分系统；全自动生化分析仪测定空腹血糖（FPG）、总胆固醇（TC）、三酰甘油（TG）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）水平，采用串联质谱法检测25（OH）D3水平。分析冠状动脉病变积分与各因素的相关性；冠状动脉狭窄的多因素分析采用Logistic回归分析。 结果冠状动脉狭窄组与非冠状动脉狭窄组年龄、Gensini积分、25（OH）D3、FPG、LDL-C水平比较差异有统计学意义（P〈0.05）。按25（OH）D3水平分组，25（OH）D3缺乏组冠状动脉病变支数及Gensini积分均明显高于25（OH）D3非缺乏组，差异有统计学意义（P〈0.01）。Logistic回归分析结果显示，年龄、FPG及25（OH）D3水平是影响冠状动脉病变形成的危险因素（P〈0.01或〈0.05），其中25（OH）D3水平与冠状动脉狭窄呈负相关（B=-0.100），是冠状动脉病变的保护因素（OR= 0.904，95% CI：0.911~0.983，P= 0.000）。 结论 25（OH）D3缺乏是冠心病的危险因素之一。

Objective To investigate the relation between 25-hydroxyvitamin D3125（OH）D3] and coronary artery disease. Methods Three hundred and ten patients with selective coronary angiogram （CAG） were enrolled in this study and they were divided into two groups： non-coronary artery stenosis group with 76 patients and coronary artery stenosis group with 234 patients. The degree of coronary artery stenosis was evaluated by the international general Gensini integration system. The levels of fasting plasma glucose （FPG）, total cholesterol （TC）, triglyceride （TG）, high density lipoprotein （HDL-C）, low density lipoprotein （LDL-C） were detected by automatic biochemistry analyzer. The level of 25（OH）D3 was detected by tandem mass spectrometry. The relationship of Gensini integration scores and risk factors were analyzed. Logistic regression analysis was used in muhieity factors analysis. Results The levels of age, Gensini integration scores, 25（OH）D3, FPG and LDL-C in non-coronary artery stenosis group and coronary artery stenosis group had significant differences （P 〈 0.05）. The number of coronary stenosis and Gensini integration scores in 25（OH） D3 deficiency group were significantly higher than those in non-25 （OH）D3 deficiency group （P 〈 0.01）. Logistic regression analysis showed that age, FPG and 25（OH）D3 levels were risk factors for coronary artery stenosis （P 〈 0.01 or 〈 0.05）, and the level of 25（OH）D3 had negative correlation with coronary artery stenosis （B =- 0.100）, and it was a protection factor （OR = 0.904, 95% CI： 0.911-0.983, P = 0.000）. Conclusions 25（OH）D3 deficiency is one of the risk factor of coronary artery disease.