25-羟维生素D及甲状旁腺素与高血压发病关系:剂量反应Meta分析

Blood 25-hydroxyvitamin D concentration,parathyroid hormone concentration,and risk of incident hypertension:a dose response Meta-analysis

目的:采用剂量反应Meta分析分别对25-羟维生素D[25-hydroxyvitamin D,25(OH)D]水平、甲状旁腺素(parathyroid hormone,PTH)水平与高血压发病风险进行综合评价。方法:全面检索Pub Med、Embase、CBM、CNKI和VIP数据库,纳入25(OH)D、PTH与高血压发病风险的前瞻性研究,检索时限均为建库至2016年8月。采用剂量反应模型对25(OH)D、PTH与高血压发病风险进行拟合,采用Stata13.0进行Meta分析。结果:共纳入9项前瞻性研究,研究对象为西方人群,样本含量25 658人。线性剂量反应Meta分析结果显示,25(OH)D每增加25 nmol/L,高血压的发病风险下降7%(RR=0.93,95%CI=0.89~0.97,P=0.000);而PTH每增加15 pg/m L,高血压的发病风险增加6%(RR=1.06,95%CI=1.02~1.10,P=0.001)。结论:针对西方人群,随着25(OH)D水平的降低或PTH水平的升高,可能导致高血压发病风险的增加。这给亚洲人群高血压的预防提供了重要线索。

Objective：To evaluate the relationship between the levels of 25-hydroxyvitamin D[25（OH）D],parathyroid hormone（PTH）and incidence of hypertension by dose response Meta-analysis,respectively. Methods：Databases including Pub Med,Embase,CBM,CNKI and VIP were searched for prospective studies on the relationship between the levels of 25（OH）D,PTH and incidence of hypertension up to August 2016. The relationship between the levels of 25（OH）D,PTH and incidence of hypertension was assessed by dose response model,and a general analysis was conducted by using Stata 13.0 software. Results：Eight studies involving 25 658 participation which are from western countries were included. Linear dose response Meta-analysis indicated that by 25 nmol/L 25（OH）D and15 pg/m L PTH elevation,the risk of hypertension incidence would decrease 7%（RR=0.93,95%CI=0.89 to 0.97,P=0.000）and increase 6%（RR=1.06,95%CI=1.02 to 1.10,P=0.001）,respectively. Conclusion：The risk of hypertension showed a rising trend with the decrease in 25（OH）D concentrations and increase in PTH concentrations among the westerners,respectively. This provides information for the prevention of hypertension among the Asians.