摘要
目的探讨维生素D与老年人高血压及靶器官损害的相关性。方法回顾性分析,收集2013年1月至2014年2月在我科住院治疗的年龄≥60岁患者365例,高血压组247例,非高血压组118例。比较两组患者25羟基维生素D[25(OH)D]水平,并对高血压相关因素进行分析。根据血清25(OH)D水平将高血压组患者,分为维生素D缺乏组(198例)与非缺乏组(49例),比较两组间靶器官损害指标。结果365例老年患者25(OH)D中位数水平低(35.3nmol/L),77.5%(283例)为缺乏状态。高血压组25(0H)D低于非高血压组(34.0nmol/L比38.7nmol/L,P〈0.05)。高血压患者维生素D缺乏组与非缺乏组肾早期损害、血肌酐、估算肾小球滤过率、脉搏波传导速度、踝臂指数、颈动脉内中膜厚度、Sokolow-Lyon指数、Cornell指数及左心室质量指数比较,差异无统计学意义(均P〉0.05)。高血压合并冠心病患者25(OH)D低于非冠心病患者(P〈0.05),25(OH)D与冠心病呈负相关(B=0.021,P=0.019),冠状动脉双支病变及3支病变患者25(OH)D低于非冠心病患者(P〈O.01)。结论老年患者常见25(0H)D缺乏,老年高血压患者25(OH)D水平低于非高血压患者;高血压合并冠心病患者25(OH)D降低。维生素D缺乏与肾、外周血管、心脏结构等靶器官损害无相关性。
Objective To investigate the correlation of vitamin D with essential hypertension and its target organ damages in the elderly. Methods In the retrospective study, 365 elderly participants aged ≥ 60 years hospitalized in our department during January 2013 to February 2014 were involved,including 247 patients with confirmed essential hypertension(HT)and 118 patients without HT. Serum 25-hydroxy vitamin D[25(OH)D]levels were measured and compared between HT and non-HT group,and binary regression analysis was used to discuss potential influencing factors of HT. The damage index of vitamin D target organ was compared between vitamin D deficiency group(n =198)and vitamin D non deficiency group(n=49). Results The median serum 25(OH)D level of participants is 35.3 nmol/L,77.5 % (283 cases)were in the insufficient vitamin D status. The level of 25(OH)D was significantly lower in HT group than in non-HT group(34.0 vs. 38.7 nmol/L,P〈: 0.05). There were not statistically significant differences between vitamin D insufficient group and sufficient group(P〉 0.05) in albumin/creatinine ratio, serum creatinine, estimated glomerular filtration rate,ankle-brachial index,pulse wave velocity,intima media thickness of carotid artery, Sokolow-Lyon index,cornell index and left ventricular mass index. The serum 25(OH)D level was significantly lower in CHD plus HT group than non-CHD(P〈0.05). The 25(OH)D level was negatively correlated with coronary heart disease(B= =0. 021 ,P=0. 019). The serum 25(OH)D level was significantly lower in groups with double-and triple-vessel coronary artery disease than in non-CHD group(P〈0.01). Conclusions Vitamin D insufficiency is common in the elderly. The serum 25 (OH)D level is significantly lower in old patients with HT especially with stage 3 HT than in non-HT ones. The 25(OH)D level is lower in HT patients with comorbid CHD, and more obvious in HT patients with multi-vessel coronary artery disease. An insufficient vitamin D status is not correlated with hypertensive target organ damages including kidney, peripheral vascular and left ventricular cardiac structure.
出处
《中华老年医学杂志》
CAS
CSCD
北大核心
2017年第7期719-723,共5页
Chinese Journal of Geriatrics
基金
基金项目:国家科技支撑计划(2012BA137805)
关键词
维生素D
高血压
冠状动脉病
Vitamin D
Hypertension
Coronary arlery disease